Exploring sensory aspects of cutlery in neurodivergent-informed eating disorder care.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.