Increasing Vegetable Consumption in Students with Autism Spectrum Disorder Using Pre-Meal Presentation: A Preliminary Analysis

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.