Increasing Vegetable Consumption in Students with Autism Spectrum Disorder Using Pre-meal Presentation: A Preliminary An
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Increasing Vegetable Consumption in Students with Autism Spectrum Disorder Using Pre‑meal Presentation: A Preliminary Analysis Jonathan W. Ivy1 · Keith Williams2 · Lauren Davison3 · Ben Bacon3 · Fred E. Carriles1 · Helen M. Hendy4 Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study examined the effect of pre-meal presentation on the consumption of vegetables in a sample of 16 students with autism spectrum disorder (ASD). These 16 students (75% male; mean age = 13 years; age range 8–18 years) were enrolled in a private school serving children with autism. School staff offered participants 10 small pieces of two vegetables during lunch (baseline) or prior to lunch (premeal presentation). Observers recorded the number of bites students consumed. We used an A–B–A–B design to examine the effects of pre-meal presentation. Results were evaluated using a mixed-method, individual- and group-level, analysis. Premeal presentation resulted in increased vegetable consumption for 9 of the 16 participants. A reversal to baseline demonstrated expected decreases in bites consumed, and the subsequent return to intervention demonstrated expected increases in bites consumed. One-way repeated measures ANOVA compared bites consumed per session across 10 four-session study blocks and found significant differences between these two conditions. Paired comparisons revealed no change in bites consumed per session from baseline to intervention block #1, but significant increases from baseline to intervention #2 and all subsequent intervention blocks. Our results suggested pre-meal presentation can serve as a low-cost, low-effort intervention for increasing vegetable consumption for some children with ASD. Keywords Group intervention · Healthy eating · Selective eating · Pre-meal presentation
* Jonathan W. Ivy [email protected] Extended author information available on the last page of the article
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Vol.:(0123456789)
Journal of Behavioral Education
Introduction Research has shown consumption of a balanced diet, consisting of vegetables and other healthy foods, is important for long-term health (World Health Organization 2003). Insufficient consumption of healthy foods can lead to micronutrient deficiencies, which are a significant cause of health problems in children worldwide (Black 2003). For children with autism spectrum disorders, food selectivity (i.e., a restricted eating pattern containing limited foods) has been found to be a widespread problem and, among some of these children, has led to adverse health implications (Williams and Seiverling 2018). In a community sample, the parents of 72% of children with ASD reported their children consumed a limited range of foods (Schreck et al. 2004). Similarly, between 70 and 80% of children with ASD demonstrate recurring food selectivity (Marí-Bauset et al. 2014) and are more likely than typically developing peers to refuse vegetables (Hubbard et al. 2014). Food selectivity, likely an extension of the repetitive and stere
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