PROJECT SUMMARY
There is an unmet need for nutrition interventions that address both autism spectrum disorder
(ASD) specific feeding challenges and unbalanced eating habits among children with ASD to
prevent future chronic health conditions. Children with ASD tend to consume few fruit and
vegetables and mainly high-energy dense foods, including sugar-sweetened beverages and
processed snacks. Obesity prevalence in children with ASD is up to 40% higher than in typically
developing children, and recent studies show significantly elevated risks of hyperlipidemia and
hypertension among individuals with ASD, regardless of using psychotropic medications. Our
interdisciplinary team conducted a preliminary study to examine diet quality and mealtime
behaviors among diverse children with ASD in Florida (34% Hispanic/Latino) and parental
preferences for nutrition interventions. Based on the study findings, we developed the manual
for our nutrition intervention, Autism Eats, for children with ASD enrolled in the Part C of
Individuals with Disabilities Education Act (IDEA) Early Intervention (EI) services. Our Autism
Eats manual and parent materials are based on ASD-specific feeding strategies such as escape
extinction and food chaining combined with behaviorally-focused nutrition intervention strategies
such as goal setting and weekly meal planning to promote healthy eating. We pilot-tested the
intervention with a small number of EI providers and parent-child dyads (n=5) to examine how
intervention components fit with the Part C service setting. Preliminary fidelity and provider
interview data indicated that the intervention manual was easy to follow and has potential to be
widely implemented in the EI services, indicating a good fit. Participants further suggested
innovative ways to improve the intervention such as adding more hands-on activities, booster
sessions, and social media components. Based on these suggestions, we will refine our
intervention materials (Aim 1) and conduct a pilot randomized controlled trial (RCT) to test the
feasibility and preliminary efficacy of this innovative nutrition intervention program, Autism Eats,
to prevent problematic mealtime behaviors and promote development of healthy eating habits
among children with ASD enrolled in Part C EI services in Florida (Aim 2). We expect that
Autism Eats will be feasible and well-received by EI providers and parent-child dyads. We will
examine differences in children’s food intakes (fruit and vegetables), food variety, diet quality,
and problematic mealtime behaviors between children in Autism Eats and those in the EUC
groups at post-intervention and 5-month follow-up from baseline.
