OTRNQualitativeThe Journal of school nursing : the official publication of the National Association of School Nurses2026

Navigating School Meal Environments: Perspectives of Pupils Diagnosed With Autism Spectrum Disorder or ADHD.

Susanna G Sandberg, Mikaela Nyroos, Maria Waling and 1 others

PMID 39992087

WHAT IT FOUND

Five boys with autism or ADHD stayed near familiar teachers or classmates to navigate school lunch.

Crowded serving, repeated trips, and noisy seating made eating hard; some chose solitude to cope.

Key findings

01The boys kept close to a known teacher or classmate during lunch to stay on track and avoid being left alone.

02The boys often made repeated trips to the serving trolley because serving trays were not provided for them.

03They managed social and noise demands by alternating between familiar company and solitude, sometimes sitting apart from peers.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for RNs

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What it does not show

Only five boys took part, all from four Swedish schools, so the findings cannot be assumed to apply to all pupils with autism or ADHD. No girls participated, and no fathers participated despite invitations to caregivers, so the study reflects boys' and mothers' views. The study did not test any change to seating, trays, quiet rooms, or staff support, so it cannot show that these adjustments work. The boys declined to photograph their meals or environment, so child-led visual data were not available.

Declared interests

The authors declared no potential conflicts of interest. The work was supported by the School of Education at Umeå University, Sweden.

The easy way to misread this

Do not conclude that changing seating, trays, quiet rooms, or staff support will improve outcomes for all pupils with autism or ADHD. This was a small descriptive study of five boys, and the authors warn that the findings are not representative.

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