Exploring the feasibility and acceptability of sensory-adapted menus for adolescents with autism spectrum disorder in a school canteen: the AUT-MENU pilot study

Background Food Selectivity (FS) is highly prevalent among adolescents with Autism Spectrum Disorder (ASD) and may contribute to unbalanced dietary patterns and adverse nutritional outcomes. This pilot study assessed the feasibility and acceptability of sensory-adapted menus nutritionally planned in accordance with Italian dietary recommendations and Mediterranean dietary principles in a school canteen for adolescents with ASD. Methods Eleven adolescents with ASD (14–20 years) participated in a two-phase pilot study consisting of an observational phase (T0) followed by a multicomponent intervention (T1) combining sensory-based menu modifications with changes in mealtime organisation. Sociodemographic and clinical characteristics were collected at baseline. Feeding Problems (FP) and adherence to the Mediterranean Diet (MD) were assessed pre- and post-intervention. Food consumption was assessed using the Pictorial Dietary Assessment Tool (PDAT). Analyses were primarily descriptive and exploratory. Results Descriptive changes in food acceptance varied by dish type. Consumption was higher at T1 for selected first courses and fish-based dishes whereas fruit acceptance was lower. Descriptive changes in mealtime-related behaviors were also observed, including greater peer interaction and less frequent excessive smartphone use. The observed changes in food acceptance, FS, dietary habits, and mealtime-related behavior represent preliminary exploratory findings and should not be interpreted as evidence of intervention effectiveness. Conclusion Larger controlled intervention studies are needed to investigate the potential of school canteen environments to address food selectivity and support mealtime-related social behaviors among children and adolescents with ASD. Clinical trial registration https://clinicaltrials.gov/study/NCT06266377 , identifier NCT06266377.