Development and validation of the new French ORALQUEST scale for evaluating feeding difficulties in young children

Feeding difficulties are common in children with and without somatic conditions. Our objective was to develop a parent-report questionnaire (ORALQUEST) designed to be administered by a professional and to assess feeding difficulties in children aged 9 months to 6 years.

The questionnaire explores four domains: eating behavior, oral skills, tactile and oral sensitivity, and family environment. A validation study was done in 338 children seen for feeding difficulties (n = 74) or receiving follow-up for conditions at risk for feeding difficulties (n = 264). We assessed the validity and reliability of the tool and we conducted a receiver operating characteristic (ROC) analysis to determine the best total-score cutoff.

The final version of the ORALQUEST has 40 items and produces a total score and four sub-scores. Structural validity, internal consistency, and reliability were excellent; convergent validity was good to acceptable but was challenging to assess given the absence of similar tools for comparisons. The optimal total-score cutoff was 27. Among children seen for feeding difficulties, 85% had a total score ≥ 27. Total scores above the cutoff were less common than expected in children with chronic conditions (esophageal atresia, 39%; autism spectrum disorder, 42%; complex congenital heart disease, 29%; Robin sequence, 31%; and cleft palate, 18%).

ORALQUEST for assessing feeding difficulties in young children demonstrated good psychometric properties in children with and without somatic conditions. The investigation by ORALQUEST of four domains may help to determine the best management strategy.