Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This pilot interventional study aims to evaluate the usability and preliminary effects of a structured plate designed to support eating behaviors in children with Autism Spectrum Disorder (ASD), as well as its perceived psychosocial impact on their families. Feeding difficulties are common in children with ASD and may include food selectivity, behavioral challenges during mealtimes, and family stress. In this single-group pre-post study, children aged 5 to 7 years with ASD and significant feeding difficulties will use the structured plate during school lunchtime three times per week for two months under the supervision of an occupational therapist. Outcomes will assess changes in feeding behaviors and mealtime functioning, as well as caregiver-reported psychosocial impact. Assessments will be conducted at baseline and after the intervention. Findings from this pilot study will inform the feasibility and design of future larger-scale controlled studies.
This pilot interventional study is designed to examine the usability, feasibility, and preliminary effects of a structured compartment plate used during school lunchtime in children with Autism Spectrum Disorder (ASD) who present significant feeding difficulties. Feeding problems in children with ASD are often multifactorial and may involve sensory processing differences, food selectivity, behavioral challenges during meals, and difficulties with mealtime routines, all of which may affect eating participation and family well-being.
The study will use a single-group pre-post design conducted in a special education school setting. Following baseline assessment, participants will use the structured plate during individual lunchtime sessions three times per week over a two-month period under the supervision of an occupational therapist with experience in feeding intervention. The plate is designed to provide visual organization of food portions through 10 separate compartments. Food is presented in small, clearly delimited portions, and each compartment is covered after completion in order to reduce visual overload and support attention, sequencing, and engagement during the meal.
The evaluation strategy combines caregiver-reported and observational data. Standardized assessments will be administered at baseline and post-intervention to examine changes in feeding difficulties and in the psychosocial impact of the child's feeding on the family. In addition, repeated structured observations during intervention sessions will document behavioral indicators related to mealtime organization, sustained attention, impulse control, flexibility, emotional regulation, autonomy in feeding, acceptance of novel foods, and food selectivity.
Given the exploratory nature of this pilot study and the small sample size, analyses will focus on usability and feasibility indicators, as well as preliminary pre-post change patterns using descriptive, visual, and nonparametric methods. Findings are intended to support refinement of study procedures and to inform the design of future controlled studies.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Structured Plate Intervention | Experimental | Participants assigned to this single experimental arm will receive a structured plate intervention during school lunchtime. The structured plate consists of a matrix of multiple compartments designed to visually organize food portions and guide the sequence of intake. Each compartment contains a small portion of food, and once consumed, it is covered to reduce sensory overload and support attentional focus on the remaining food. The intervention will be delivered individually, three times per week (Monday, Wednesday, and Friday) over a two-month period, under the supervision of an occupational therapist experienced in feeding interventions. The structured plate is intended to support feeding behavior by enhancing organization, predictability, and sensory regulation during mealtimes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Structured Plate | Device | The intervention consists of the use of a structured plate specifically designed to support feeding behavior in children with Autism Spectrum Disorder (ASD). The plate is a compartmentalized device with a matrix of multiple sections that allows food to be presented in small, visually organized portions. Each compartment contains a discrete amount of food, promoting clarity regarding quantity and sequence of intake. During the intervention, the child is guided to consume the food compartment by compartment. After each portion is consumed, the corresponding compartment is covered, reducing visual and sensory load and helping the child focus on the remaining food. This design aims to enhance predictability, support attentional regulation, and reduce anxiety associated with mealtimes. The structured plate is used during school lunchtime in individual sessions, three times per week over a two-month period, under the supervision of an occupational therapist. |
| Measure | Description | Time Frame |
|---|---|---|
| Pediatric Eating Assessment Tool (PediEAT) | The PediEAT is a 78-item caregiver-reported measure of problematic feeding behaviors in children aged 6 months to 7 years who are offered solid foods. Parents score each item on a 6-point Likert scale (Never, Almost Never, Sometimes, Often, Almost Always, Always). Total scores range from 0 to 390, with higher scores indicating more problematic feeding and therefore a worse outcome. Domains include physiological symptoms, problematic mealtime behaviors, selective/restrictive eating, and oral processing. | Baseline (pre-intervention) and 2 months (post-intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Caregiver Psychosocial Impact | Caregiver psychosocial impact will be assessed using the total score of the Feeding Impact Scales. This caregiver-reported instrument includes a 13-item Family Impact scale and a 12-item Parent Impact scale. The total score is calculated by summing both scales and ranges from 25 to 125, with higher scores indicating greater psychosocial impact of the child's feeding on the parent and family, and therefore a worse outcome. |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Facultad de Ciencias de la Salud | Zaragoza | 50009 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34684552 | Background | Plaza-Diaz J, Flores-Rojas K, Torre-Aguilar MJ, Gomez-Fernandez AR, Martin-Borreguero P, Perez-Navero JL, Gil A, Gil-Campos M. Dietary Patterns, Eating Behavior, and Nutrient Intakes of Spanish Preschool Children with Autism Spectrum Disorders. Nutrients. 2021 Oct 10;13(10):3551. doi: 10.3390/nu13103551. | |
| 33950088 | Background |
| Label | URL |
|---|---|
| Autismo España. (2022). Datos de alumnado general no universitario con trastorno del espectro del autismo. | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Baseline (pre-intervention) and 2 months (post-intervention) |
| Study-Specific Structured Mealtime Observation Protocol: Meal Initiation Within 3 Minutes | Frequency of intervention sessions in which the child begins eating within the first 3 minutes after food is served, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better mealtime organization. Answer options: Yes or No | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Sequenced Consumption | Frequency of intervention sessions in which the child follows a defined sequence to consume foods from the structured plate, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better meal organization and planning. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Meal Completion | Frequency of intervention sessions in which the child consumes all foods presented on the structured plate, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better task completion during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Sustained Attention to Meal | Frequency of intervention sessions in which the child remains focused on the meal without distraction, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better sustained attention during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Avoidance of Premature Compartment Switching | Frequency of intervention sessions in which the child avoids changing to another compartment before finishing the food in the current compartment, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better impulse control during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Adaptation to Changes in Food Arrangement | Frequency of intervention sessions in which the child adapts to changes in the arrangement or sequence of foods on the structured plate, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better cognitive flexibility during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Following Compartment-Order Instructions | Frequency of intervention sessions in which the child follows instructions regarding the order in which plate compartments should be used, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better flexibility and response to guidance during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Positive Attitude Toward the Structured Plate | Frequency of intervention sessions in which the child shows a calm and positive attitude while using the structured plate, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better emotional regulation during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Frustration Management Related to Portion Limits | Frequency of intervention sessions in which the child manages the limited amount of food presented in each compartment without observable anxiety or frustration, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better emotional regulation during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Independent Use of the Structured Plate | Frequency of intervention sessions in which the child uses the structured plate without adult assistance, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better autonomy in feeding. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Confidence in Choosing the First Compartment | Frequency of intervention sessions in which the child confidently decides which compartment to use first, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates better autonomy and decision-making during meals. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Acceptance of Novel Foods | Frequency of intervention sessions in which the child accepts a novel food presented in one of the plate compartments, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates greater acceptance of new foods. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Repeated Consumption of Novel Foods | Frequency of intervention sessions in which the child repeats consumption of a novel food across different observation sessions, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates greater maintenance of acceptance of new foods. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Study-Specific Structured Mealtime Observation Protocol: Tolerance of Varied Food Textures and Temperatures | Frequency of intervention sessions in which the child consumes foods with varied textures and temperatures, as recorded by the study-specific Structured Mealtime Observation Protocol. Higher frequency indicates lower food selectivity and better tolerance of sensory variation in foods. Answer options: Yes or No. | During the 2-month intervention period (3 sessions per week) |
| Oliveira BMF, Frutuoso MFP. [Far beyond nutrients: experiences and connections with autistic children based on cooking and sharing meals]. Cad Saude Publica. 2021 Apr 30;37(4):e00132020. doi: 10.1590/0102-311X00132020. eCollection 2021. Portuguese. |
| 30005820 | Background | Sharp WG, Postorino V, McCracken CE, Berry RC, Criado KK, Burrell TL, Scahill L. Dietary Intake, Nutrient Status, and Growth Parameters in Children with Autism Spectrum Disorder and Severe Food Selectivity: An Electronic Medical Record Review. J Acad Nutr Diet. 2018 Oct;118(10):1943-1950. doi: 10.1016/j.jand.2018.05.005. Epub 2018 Jul 10. |
| 26178024 | Background | Ranjan S, Nasser JA. Nutritional status of individuals with autism spectrum disorders: do we know enough? Adv Nutr. 2015 Jul 15;6(4):397-407. doi: 10.3945/an.114.007914. Print 2015 Jul. |
| 35406004 | Background | van der Wurff I, Oenema A, de Ruijter D, Vingerhoets C, van Amelsvoort T, Rutten B, Mulkens S, Kohler S, Schols A, de Groot R. A Scoping Literature Review of the Relation between Nutrition and ASD Symptoms in Children. Nutrients. 2022 Mar 26;14(7):1389. doi: 10.3390/nu14071389. |
| 36771417 | Background | Kittana M, Ahmadani A, Williams KE, Attlee A. Nutritional Status and Feeding Behavior of Children with Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review. Nutrients. 2023 Jan 30;15(3):711. doi: 10.3390/nu15030711. |
| 28078576 | Background | Malhi P, Venkatesh L, Bharti B, Singhi P. Feeding Problems and Nutrient Intake in Children with and without Autism: A Comparative Study. Indian J Pediatr. 2017 Apr;84(4):283-288. doi: 10.1007/s12098-016-2285-x. Epub 2017 Jan 12. |
| 34444847 | Background | Brzoska A, Kazek B, Koziol K, Kapinos-Gorczyca A, Ferlewicz M, Babraj A, Makosz-Raczek A, Likus W, Paprocka J, Matusik P, Emich-Widera E. Eating Behaviors of Children with Autism-Pilot Study. Nutrients. 2021 Aug 3;13(8):2687. doi: 10.3390/nu13082687. |
| 35112345 | Background | Bourne L, Mandy W, Bryant-Waugh R. Avoidant/restrictive food intake disorder and severe food selectivity in children and young people with autism: A scoping review. Dev Med Child Neurol. 2022 Jun;64(6):691-700. doi: 10.1111/dmcn.15139. Epub 2022 Feb 2. |
| 33653157 | Background | Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. Autism. 2021 Aug;25(6):1505-1519. doi: 10.1177/1362361321995631. Epub 2021 Mar 2. |
| 36982001 | Background | Esposito M, Mirizzi P, Fadda R, Pirollo C, Ricciardi O, Mazza M, Valenti M. Food Selectivity in Children with Autism: Guidelines for Assessment and Clinical Interventions. Int J Environ Res Public Health. 2023 Mar 14;20(6):5092. doi: 10.3390/ijerph20065092. |
| ID | Term |
|---|---|
| D000067877 | Autism Spectrum Disorder |
| D001068 | Feeding and Eating Disorders |
| ID | Term |
|---|---|
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
Not provided
Not provided