Preliminary Exploration of the Usability of a Structured Plate to Improve Eating Behaviors in Children With Autism Spectrum Disorder and Its Impact on the Family: A Pilot Study

NCT07516431 | Completed DMC

• 1 other identifier: C.I. PI25/009
• Study Type: interventional
• Target: 6
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Autism Spectrum Disorder; Feeding and Eating Disorders; Childhood

Keywords

Autism Spectrum Disorder; Feeding Difficulties; Food Selectivity; Occupational Therapy; Structured Plate

Outcome Measures

Primary Outcomes (1)

• 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)

Secondary Outcomes (15)

• Caregiver Psychosocial Impact

  Baseline (pre-intervention) and 2 months (post-intervention)

• Study-Specific Structured Mealtime Observation Protocol: Meal Initiation Within 3 Minutes

  During the 2-month intervention period (3 sessions per week)

• Study-Specific Structured Mealtime Observation Protocol: Sequenced Consumption

  During the 2-month intervention period (3 sessions per week)

• Study-Specific Structured Mealtime Observation Protocol: Meal Completion

  During the 2-month intervention period (3 sessions per week)

• Study-Specific Structured Mealtime Observation Protocol: Sustained Attention to Meal

  During the 2-month intervention period (3 sessions per week)

Study Arms (1)

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.

Device: Structured Plate

Interventions

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.

Structured Plate Intervention

Eligibility Criteria

• Age: 5 Years - 7 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Children aged 5 to 7 years.
• Clinical diagnosis of Autism Spectrum Disorder (ASD) confirmed by a qualified healthcare professional (e.g., neuropediatrics, early intervention services, or child and adolescent mental health services), as documented by caregivers.
• Presence of significant feeding difficulties, defined as a total score above the established cut-off on the Pediatric Eating Assessment Tool (PediEAT): ≥94 for children aged 5-6 years and ≥82 for children aged 6-7 years.
• Availability of a parent, caregiver, or legal guardian able to provide information regarding the child's feeding behavior and psychosocial impact.
• Written informed consent provided by the parent or legal guardian.

You may not qualify if:

• Severe medical conditions affecting feeding (e.g., significant gastrointestinal disorders requiring ongoing medical management).
• Food allergies that substantially restrict dietary variety during the intervention.
• Severe neurological comorbidities that interfere with participation in the intervention (e.g., uncontrolled epilepsy).
• Concurrent participation in another feeding intervention program.

Sponsors & Collaborators

• Universidad de Zaragoza: lead

Study Sites (1)

Facultad de Ciencias de la Salud

Zaragoza, 50009, Spain

Location

Related Publications (11)

• 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.

  PMID: 34684552 BACKGROUND

• 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.

  PMID: 33950088 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.

  PMID: 30005820 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.

  PMID: 26178024 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.

  PMID: 35406004 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.

  PMID: 36771417 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.

  PMID: 28078576 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.

  PMID: 34444847 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.

  PMID: 35112345 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.

  PMID: 33653157 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.

  PMID: 36982001 BACKGROUND

Related Links

• Autismo España. (2022). Datos de alumnado general no universitario con trastorno del espectro del autismo.

MeSH Terms

Conditions

Autism Spectrum Disorder; Feeding and Eating Disorders

Condition Hierarchy (Ancestors)

Child Development Disorders, Pervasive; Neurodevelopmental Disorders; Mental Disorders; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 25, 2026
• First Posted: April 8, 2026
• Study Start: April 20, 2025
• Primary Completion: June 19, 2025
• Study Completion: July 14, 2025
• Last Updated: April 8, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)