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Parent questionnaires measuring feeding disorders in preschool children: a systematic review
Katherine Sanchez1,2, Alicia J Spittle1,2,3, Leesa Allinson1,2,3
1Murdoch Children's Research Institute, Parkville, Vic., Australia.
Insights
Parent questionnaires assessing preschool feeding disorders are crucial for naturalistic evaluation. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) demonstrates the most robust reliability and validity among reviewed measures.
Area of Science:
- Pediatric feeding disorders
- Child development
- Clinical assessment tools
Background:
- Preschool feeding disorders present significant challenges, impacting development and health.
- Parent-report measures offer ecological validity for assessing feeding behaviors over time.
- Understanding the psychometric properties of these measures is essential for accurate evaluation.
Purpose of the Study:
- To systematically review the psychometric and clinometric properties of parent-administered feeding questionnaires for preschool children.
- To identify the strengths and limitations of current parent-report feeding measures.
- To guide the selection of reliable and valid assessment tools.
Main Methods:
- Systematic literature search across five databases.
- Inclusion criteria: norm/criterion-referenced, child-focused, preschool-appropriate, assessing ≥2 feeding domains.
- Evaluation of 3535 identified abstracts and 215 full-text articles.
Main Results:
- Five feeding questionnaires met the inclusion criteria.
- The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) exhibited the highest reliability (test-retest, internal consistency).
- BPFAS, Mealtime Behavior Questionnaire, and Montreal Children's Hospital Feeding Scale showed stronger validity data.
Conclusions:
- Further research is necessary to fully establish the psychometric properties of feeding questionnaires.
- The BPFAS currently offers the most comprehensive reliability and validity data for parent-administered preschool feeding assessments.
- Informed selection of validated tools is critical for research and clinical practice.
Aim:
Preschool feeding disorders are common and debilitating and are associated with a range of developmental and medical issues. Parent report allows assessment of feeding in a naturalistic environment over time, with advantages over time-limited, clinic-based observations. However, little is understood about the limitations and advantages of current parent-report measures. We aimed to systematically review the psychometrics and clinometrics of parent-administered feeding questionnaires.
Method:
Five search engines were used to identify questionnaires that met inclusion criteria, i.e. being norm-or criterion-referenced, child focused, appropriate for preschool children, and measured two or more feeding domains (e.g. dysphagia/oral motor delay, food refusal).
Results:
In total 3535 abstracts were identified and 215 full-text articles were evaluated. Five questionnaires met the criteria. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was the most reliable questionnaire identified, with good test-retest reliability and internal consistency. More predictive and concurrent validity data was available for the BPFAS, the Mealtime Behavior Questionnaire, and the Montreal Children's Hospital Feeding Scale than for other measures.
Interpretation:
Further research is needed on the psychometric properties of feeding questionnaires used in research and clinical practice. To date, the BPFAS has the most comprehensive reliability and validity data of any parent-administered feeding questionnaire for preschool children.
