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 (pre-meal 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. Pre-meal 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Black, R. (2003). Micronutrient deficiency—An underlying cause of morbidity and mortality. Bulletin of the World Health Organization, 81, 79.
Cooke, L. (2007). The importance of exposure for healthy eating in childhood: A review. Journal of Human Nutrition & Dietetics, 20(4), 294–301. https://doi.org/10.1111/j.1365-277X.2007.00804.x.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis. Columbus, OH: Merrill Publishing.
Elsbernd, S. L., Reicks, M. M., Mann, T. L., Redden, J. P., Mykerezi, E., & Vickers, Z. M. (2016). Serving vegetables first: A strategy to increase vegetable consumption in elementary school cafeterias. Appetite, 96, 111–115. https://doi.org/10.1016/j.appet.2015.09.001.
Evans, C. E., Christian, M. S., Cleghorn, C. L., Greenwood, D. C., & Cade, J. E. (2012). Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y. The American Journal of Clinical Nutrition, 96(4), 889–901. https://doi.org/10.3945/ajcn.111.030270.
Hendy, H. M., Williams, K. E., & Camise, T. S. (2005). ‘Kids choice’ school lunch program increases children’s fruit and vegetable acceptance. Appetite, 45(3), 250–263. https://doi.org/10.1016/j.appet.2005.07.006.
Hubbard, K. L., Anderson, S. E., Curtin, C., Must, A., & Bandini, L. G. (2014). A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children. Journal of the Academy of Nutrition and Dietetics, 114, 1981–1987. https://doi.org/10.1016/j.jand.2014.04.017.
Johnston, J. M., & Pennypacker, H. S., Jr. (2009). Strategies and tactics of behavioral research (3rd ed.). Abingdon: Routledge/Taylor & Francis Group.
Laraway, S., Snycerski, S., Michael, J., & Poling, A. (2003). Motivating operations and terms to describe them: some further refinements. Journal of Applied Behavior Analysis, 36(3), 407–414. https://doi.org/10.1901/jaba.2003.36-407.
Ledford, J. R., Whiteside, E., & Severini, K. E. (2018). A systematic review of interventions for feeding-related behaviors for individuals with autism spectrum disorders. Research in Autism Spectrum Disorders, 52, 69–80. https://doi.org/10.1016/j.rasd.2018.04.008.
Mari-Bauset, S., Zazpe, I., Mari-Sanchis, A., Llopis-González, A., & Morales-Suárez-Varela, M. (2014). Food selectivity in Autism Spectrum Disorders: A systematic review. Journal of Child Neurology, 29(11), 1554–1561. https://doi.org/10.1177/0883073813498821.
National Cancer Institute. (2007–2010). Usual dietary intakes. Food intakes, U.S. population. Retrieved August 18, 2016, from http://epi.grants.cancer.gov/diet/usualintakes/pop/2007-10. Updated May 20, 2015.
Schreck, K. A., Williams, K., & Smith, A. F. (2004). A comparison of eating behaviors between children with and without autism. Journal of Autism and Developmental Disorders, 34(4), 433–438. https://doi.org/10.1023/b:jadd.0000037419.78531.86.
Seiverling, L., Hendy, H. M., & Williams, K. (2011a). The screening tool of feeding problems applied to children (STEP-CHILD): Psychometric characteristics and associations with child and parent variables. Research in Developmental Disabilities, 32, 1122–1129. https://doi.org/10.1016/j.ridd.2011.01.012.
Seiverling, L. J., Williams, K. E., Ward-Horner, J., & Sturmey, P. (2011b). Interventions to treat feeding problems in children with autism spectrum disorders: A comprehensive review. In J. Matson & P. Sturmey (Eds.), International handbook of autism and pervasive developmental disorders (pp. 491–508). New York: Springer.
Silbaugh, B. C., Swinnea, S., & Penrod, B. (2018). Synthesis of applied behavior analytic interventions for packing in pediatric feeding disorders. Behavior Modification, 42(2), 249–272. https://doi.org/10.1177/0145445517724541.
Williams, K. E., & Seiverling, L. J. (2018). Neophobia in children with special needs: Selective eating and its treatment. In S. Reilly (Ed.), Food Neophobia (pp. 351–371). Baltimore, MD: Woodhead Publishing.
World Health Organization. (2003). Diet, nutrition, and the prevention of chronic diseases: Report of a joint WHO/FAO expert consultation (WHO Technical Report Series Report No. 916). Retrieved from http://apps.who.int/iris/bitstream/10665/42665/1/WHO_TRS_916.pdf.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study. Informed consent was obtained for each participant.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ivy, J.W., Williams, K., Davison, L. et al. Increasing Vegetable Consumption in Students with Autism Spectrum Disorder Using Pre-meal Presentation: A Preliminary Analysis. J Behav Educ 31, 561–574 (2022). https://doi.org/10.1007/s10864-020-09410-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10864-020-09410-5