{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:01:21Z","timestamp":1781157681837,"version":"3.54.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["MR\/X03058X\/1"],"award-info":[{"award-number":["MR\/X03058X\/1"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sensory sensitivities are common in individuals with eating disorders (ED) particularly among those who are also neurodivergent. However, research has primarily focused on the sensory properties of food and clinical environments, rather than the sensory role of cutlery itself.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This mixed-methods study examined how adults receiving intensive ED treatment evaluated the sensory properties of cutlery using a structured object-elicitation workshop. The study was conducted within a specialist ED service implementing the autism-friendly PEACE Pathway. Participants evaluated 31 cutlery items varying in material, weight, size, and shape. Quantitative data captured preference rankings and ratings of ease of use, comfort, and sensory pleasantness for preferred items. Qualitative data were generated through written feedback and focus group discussion and were analysed using a framework approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Metal cutlery was most frequently preferred, whereas wooden, paper-based, plastic, and hybrid designs (e.g. the spork) were consistently rejected. While participants shared many sensory constraints, there was also marked individual variation. Qualitative findings indicated that cutlery functioned as an active sensory interface, influencing comfort, predictability, and readiness to eat. Judgements were grounded in embodied evaluations of weight, balance, texture, mouth fit, and material neutrality. Preferences remained consistent across treatment contexts, with participants describing coping strategies and sensory compromises rather than changes in sensory preferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cutlery plays an important role in mealtime experience within ED treatment settings. Sensory object elicitation provides a practical method for identifying sensory preferences and translating these into design-relevant insights. These findings support the development of sensory-informed, neurodivergent-affirming adaptations in ED care environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1827308","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:51Z","timestamp":1781156871000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring sensory aspects of cutlery in neurodivergent-informed eating disorder care"],"prefix":"10.3389","volume":"17","author":[{"given":"Dimitri","family":"Chubinidze","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London","place":["London, United Kingdom"]},{"name":"National Eating Disorders Service, South London and Maudsley National Health Service (NHS) Foundation Trust","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adia","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London","place":["London, United Kingdom"]},{"name":"National Eating Disorders Service, South London and Maudsley National Health Service (NHS) Foundation Trust","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Makin","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendal","family":"Sterling","sequence":"additional","affiliation":[{"name":"National Eating Disorders Service, South London and Maudsley National Health Service (NHS) Foundation Trust","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Tchanturia","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London","place":["London, United Kingdom"]},{"name":"National Eating Disorders Service, South London and Maudsley National Health Service (NHS) Foundation Trust","place":["London, United Kingdom"]},{"name":"Department of Culture and Communication, Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2529","article-title":"Self\u2010disgust within eating disordered groups: Associations with anxiety, disgust sensitivity and sensory processing","volume":"25","author":"Bell","year":"2017","journal-title":"Eur Eating Disord Rev"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9041182","article-title":"Pragmatic sensory screening in anorexia nervosa and associations with autistic traits","volume":"9","author":"Kinnaird","year":"2020","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1002\/eat.22460","article-title":"Sensory modulation disorder symptoms in anorexia nervosa and bulimia nervosa: A pilot study","volume":"49","author":"Brand-Gothelf","year":"2016","journal-title":"Int J Eating Disord"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/02699931.2012.719003","article-title":"Emotion regulation difficulties in anorexia nervosa: Relationship to self-perceived sensory sensitivity","volume":"27","author":"Merwin","year":"2013","journal-title":"Cognit Emot"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2013.01.010","article-title":"Subjective experience of sensation in anorexia nervosa","volume":"51","author":"Zucker","year":"2013","journal-title":"Behav Res Ther"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s007870050129","article-title":"Obsessive compulsive symptoms at initial presentation of adolescent eating disorders","volume":"8","author":"Cassidy","year":"1999","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40337-025-01493-7","article-title":"Regulating with food: a qualitative study of neurodivergent experiences in adults with binge eating disorder","volume":"14","author":"Makin","year":"2026","journal-title":"J Eating Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s40519-025-01804-6","article-title":"Bingeing as an ADHD-related strategy: a qualitative study of experiences of neurodivergent and potentially neurodivergent adults with bulimic-spectrum eating disorders","volume":"31","author":"Makin","year":"2025","journal-title":"Eating Weight Disorders-Studies Anorexia Bulimia Obes"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22886","article-title":"Taste sensitivity in anorexia nervosa: A systematic review","volume":"51","author":"Kinnaird","year":"2018","journal-title":"Int J Eating Disord"},{"key":"B10","doi-asserted-by":"crossref","first-page":"272","DOI":"10.5040\/9781805015598.ch-012","article-title":"Sensory sensitivities: Assessing, understanding and adapting","volume-title":"Supporting autistic people with eating disorders: A guide to adapting treatment and supporting recovery","author":"Kinnaird","year":"2021"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221937","article-title":"Eating as an autistic adult: An exploratory qualitative study","volume":"14","author":"Kinnaird","year":"2019","journal-title":"PloS One"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2920","article-title":"Sensory processing and eating behaviours in autism: A systematic review","volume":"30","author":"Nimbley","year":"2022","journal-title":"Eur Eating Disord Rev"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cofs.2021.04.015","article-title":"Eating behavior in autism: Senses as a window towards food acceptance","volume":"41","author":"Petitpierre","year":"2021","journal-title":"Curr Opin Food Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13237172","article-title":"The sensory landscape and embodied experiences in anorexia nervosa treatment: An inpatient sensory ethnography","volume":"13","author":"Chubinidze","year":"2024","journal-title":"J Clin Med"},{"key":"B15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2307\/jj.42468488.22","article-title":"Cutlery: The Science and Sensory Experience","volume-title":"Culinary Psychology: Food Choices and the Mind-Body Connection","author":"Rippington","year":"2026"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-459x.2011.00351.x","article-title":"Do the material properties of cutlery affect the perception of the food you eat? An exploratory study","volume":"26","author":"Piqueras-Fiszman","year":"2011","journal-title":"J Sens Stud"},{"key":"B17","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s13411-015-0036-y","article-title":"Cutlery matters: Heavy cutlery enhances diners\u2019 enjoyment of the food served in a realistic dining environment","volume":"4","author":"Michel","year":"2015","journal-title":"Flavour"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/2044-7248-2-21","article-title":"The taste of cutlery: How the taste of food is affected by the weight, size, shape, and colour of the cutlery used to eat it","volume":"2","author":"Harrar","year":"2013","journal-title":"Flavour"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/inm.70212","article-title":"Patient perspectives on inpatient mealtimes: Insights on swallowing, mental wellbeing and recovery","volume":"35","author":"Guthrie","year":"2026","journal-title":"Int J Ment Health Nurs"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.rasd.2024.102362","article-title":"Use of sensory adaptive environments with autistic children: A scoping review","volume":"114","author":"Williams","year":"2024","journal-title":"Res Autism Spectr Disord"},{"key":"B21","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s40337-023-00834-8","article-title":"In-person and online sensory wellbeing workshop for eating disorders: Updated case series","volume":"11","author":"Li","year":"2023","journal-title":"J Eating Disord"},{"key":"B22","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s40337-025-01283-1","article-title":"A call for a trauma-informed approach during compulsory care for enduring anorexia nervosa with combined PTSD\u2013an autoethnographic perspective","volume":"13","author":"Moberg","year":"2025","journal-title":"J Eating Disord"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2007.01.018","article-title":"Eating disorder patients\u2019 opinions of cafeteria-style vs hospital-style presentation of meals","volume":"107","author":"Sandy","year":"2007","journal-title":"J Am Dietetic Assoc"},{"key":"B24","doi-asserted-by":"publisher","first-page":"75","DOI":"10.5014\/ajot.55.1.75","article-title":"The adult sensory profile: Measuring patterns of sensory processing","volume":"55","author":"Brown","year":"2001","journal-title":"Am J Occup Ther"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/nu17091532","article-title":"Implementation insights from the PEACE pathway across UK eating disorder services","volume":"17","author":"Tchanturia","year":"2025","journal-title":"Nutrients"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/medu.15555","article-title":"When words fail us: An integrative review of innovative elicitation techniques for qualitative interviews","volume":"59","author":"Kahlke","year":"2025","journal-title":"Med Educ"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2007.01.018","article-title":"Visual elicitation: Methods for enhancing the quality and depth of interview data in applied qualitative health research","volume":"43","author":"Orr","year":"2020","journal-title":"Adv Nurs Sci"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s40211-021-00392-y","article-title":"Sensory wellbeing workshops for inpatient and day-care patients with anorexia nervosa","volume":"36","author":"Tchanturia","year":"2022","journal-title":"Neuropsychiatrie"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"B30","article-title":"Qualitative data analysis for applied policy research","volume-title":"Analyzing Qualitative Data","author":"Ritchie","year":"2002"},{"key":"B31","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1525\/gfc.2016.16.3.56","article-title":"Food, bodies, and the \u201cstuff\u201d of (not) eating in anorexia","volume":"16","author":"Lavis","year":"2016","journal-title":"Gastronomica"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1348\/014466505x53579","article-title":"Obsessive-compulsive beliefs and magical ideation in eating disorders","volume":"45","author":"Lavender","year":"2006","journal-title":"Br J Clin Psychol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295x.94.1.23","article-title":"A perspective on disgust","volume":"94","author":"Rozin","year":"1987","journal-title":"psychol Rev"},{"key":"B34","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.cpr.2008.09.007","article-title":"Disgust, fear, and the anxiety disorders: A critical review","volume":"29","author":"Cisler","year":"2009","journal-title":"Clin Psychol Rev"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1002\/erv.444","article-title":"A further exploration of disgust in eating disorders","volume":"10","author":"Troop","year":"2002","journal-title":"Eur Eating Disord Rev"},{"key":"B36","first-page":"45","article-title":"Making sense of touch: A multisensory approach to the perception of objects","volume-title":"The Power of Touch","author":"Spence","year":"2016"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3081","article-title":"Patient and clinician perspectives on supported mealtimes as part of anorexia nervosa treatment: A systematic review and qualitative synthesis","volume":"32","author":"Komarova","year":"2024","journal-title":"Eur Eat Disord Rev"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23589","article-title":"Associations between mealtime anxiety and food intake in anorexia nervosa","volume":"54","author":"Lloyd","year":"2021","journal-title":"Int J Eat Disord"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.13132","article-title":"The loss of autonomy in eating disorder treatment: A patient perspective","volume":"32","author":"Healey","year":"2025","journal-title":"J Psychiatr Ment Health Nurs"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3181","article-title":"Understanding the autistic experience of restrictive eating disorders\u2014a systematic review and qualitative\u2010synthesis","volume":"33","author":"Loomes","year":"2025","journal-title":"Eur Eating Disord Rev"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24184","article-title":"Sensory processing across eating disorders: A systematic review and meta-analysis of self-report inventories","volume":"57","author":"Cobbaert","year":"2024","journal-title":"Int J Eat Disord"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2760","article-title":"A novel approach for autism spectrum condition patients with eating disorders: Analysis of treatment cost\u2010savings","volume":"29","author":"Tchanturia","year":"2021","journal-title":"Eur Eating Disord Rev"},{"key":"B43","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.psc.2025.08.005","article-title":"Managing suicidality and nonsuicidal self-injury in eating disorder treatment","volume":"49","author":"Dodd","year":"2026","journal-title":"Psychiatr Clinics"},{"key":"B44","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s11126-023-10063-6","article-title":"The sensory profiles, eating behaviors, and quality of life of children with autism spectrum disorder and avoidant\/restrictive food intake disorder","volume":"95","author":"Calisan Kinter","year":"2024","journal-title":"Psychiatr Q"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1827308\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:47:52Z","timestamp":1781156872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1827308\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":44,"alternative-id":["10.3389\/fpsyt.2026.1827308"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1827308","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"article-number":"1827308"}}