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Updated: Oct 17, 2025
Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method
Published on: February 19, 2021
Development of a parent-reported screening tool for avoidant/restrictive food intake disorder (ARFID): Initial
Lisa Dinkler1, Kahoko Yasumitsu-Lovell1, Masamitsu Eitoku2
1Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, Japan.
Insights
This study screened 3728 children for avoidant/restrictive food intake disorder (ARFID), finding a prevalence of 1.3%. The new screening tool showed preliminary validity, identifying both physical and psychosocial consequences of ARFID in young children.
Area of Science:
- Pediatric Nutrition
- Child Psychology
- Public Health Screening
Background:
- Avoidant/Restrictive Food Intake Disorder (ARFID) prevalence in children is largely unknown.
- Validated screening instruments for pediatric ARFID are scarce.
- Early identification and intervention are crucial for children with feeding disorders.
Purpose of the Study:
- Investigate ARFID prevalence in a Japanese birth cohort using a novel parent-reported screening tool.
- Estimate the proportion of children with ARFID experiencing physical versus psychosocial consequences.
- Provide preliminary evidence for the validity of the new ARFID screening tool.
Main Methods:
- A cohort of 3728 children aged 4-7 years in Japan participated.
- Parents completed a questionnaire including the new ARFID screener and convergent validity measures.
- Data were collected from a sub-sample of the Japan Environment and Children's Study (JECS).
Main Results:
- The point prevalence of children screening positive for ARFID was 1.3%.
- Half of positive screens indicated psychosocial impairment, the other half indicated physical impairment.
- Sensory sensitivity and lack of interest in eating were common drivers; screened children were lighter/shorter and exhibited more mealtime/nutritional problems.
Conclusions:
- The study provides the largest screening data for ARFID in children up to 7 years.
- The newly developed ARFID screener demonstrates preliminary validity.
- Further research is needed to confirm diagnostic validity and explore ARFID prevalence in the general population.
Abstract:
The prevalence of avoidant/restrictive food intake disorder (ARFID) in the general child population is still largely unknown and validated screening instruments are lacking. The aims of this study were (1) to investigate the prevalence of children screening positive for ARFID in a Japanese birth cohort using a newly developed parent-reported screening tool, (2) to estimate the prevalence of children with ARFID experiencing physical versus psychosocial consequences of their eating pattern, and (3) to provide preliminary evidence for the validity of the new screening tool. Data were collected from 3728 4-7-year-old children born between 2011 and 2014 in Kochi prefecture, Japan (response rate was 56.5%); a sub-sample of the Japan Environment and Children's Study (JECS). Parents completed a questionnaire including the ARFID screener and several other measures to assess convergent validity. The point prevalence of children screening positive for ARFID was 1.3%; half of them met criteria for ARFID based on psychosocial impairment alone, while the other half met diagnostic criteria relating to physical impairment (and additional psychosocial impairment in many cases). Sensory sensitivity to food characteristics (63%) and/or lack of interest in eating (51%) were the most prevalent drivers of food avoidance. Children screening positive for ARFID were lighter in weight and shorter in height, they showed more problem behaviors related to mealtimes and nutritional intake, and they were more often selective eaters and more responsive to satiety, which together provides preliminary support for the validity of the new screening tool. This is the largest screening study to date of ARFID in children up to 7 years. Future studies should examine the diagnostic validity of the new ARFID screener using clinically ascertained cases. Further research on ARFID prevalence in the general population is needed.
