A scoping review to identify interventions that support healthier food choices for pupils in specialist schools

Background/Objectives: Children and young people (CYP) with a learning disability are at higher risk of living with overweight and obesity and may consume fewer fruits and vegetables compared to the general paediatric population. They are more likely to experience eating and drinking difficulties, restrictive eating, and mealtime behavioural challenges. The school environment is considered an ideal setting to improve CYP’s dietary intakes. The primary objective was to identify existing interventions to support healthier food choices for CYP attending specialist schools. Secondary objectives considered intervention development, fidelity and outcomes.

Methods: A scoping review and narrative synthesis. Eligible studies were identified from bibliographic databases (e.g., Medline, Embase, PsychInfo) and grey literature (e.g., Clinicaltrials.gov, the Cochrane Library). A two-stage screening process was used. Intervention components were mapped according to the TIDieR-PHP and AACTT frameworks.

Results: Seven studies, reported in ten records, were included. Interventions included modifications to the dining environment, sensory exploration, health promotion and social reinforcement. Interventions were implemented across the school day: lunchtime (n = 2), breaktime (n = 3) and other times (n = 2). Studies mainly focused on adolescents. There was some mixed evidence of increased consumption of fruits and vegetables, whole grains and water. Due to small sample sizes and heterogeneity, definitive conclusions are limited. A key finding is the lack of interventions to improve CYP’s food choices in specialist schools.

Conclusions: This review highlights a crucial need for the development of multi-component interventions co-produced with stakeholders to promote healthy food choices and improve the dietary intakes of CYP attending specialist schools.