Screening Tool Of Feeding Problems Research Articles

Adaptation and validation of Arabic version of the screening tool of feeding problems applied to children (STEP-CHILD)

Objectives Early identification of pediatric feeding problems is crucial to preventing their subsequent negative impact on children's quality of life. This study aimed to create and validate an Arabic-modified version of the Screening Tool of Feeding Problems Applied to Children (STEP-CHILD) to identify feeding problems in Arabic-speaking children. Methods The STEP-CHILD Arabic was created and administered to the parents/caregivers of 390 Arabic-speaking children aged 2-18 years. 89 typically developing children without feeding/swallowing problems and 301 children with developmental disabilities were included in the study. The data was statistically analyzed to examine the validity and reliability of the questionnaire. Results The STEP-CHILD Arabic demonstrated excellent content validity, face validity, discriminant validity, and convergent validity. Predictive validity showed that the questionnaire has moderate to high accuracy in identifying pediatric feeding problems. It also showed excellent reliability and allowed for determining the specific feeding problems that would be targeted in the intervention. Conclusions The STEP-CHILD Arabic is a valid, reliable, and easily applicable tool that can be used as a routine evaluation for Arabic-speaking children at high risk of feeding problems.

Socio-demographic factors and parental feeding practices predicted body mass index of Malaysian children with learning disabilities

Introduction: Overweight and obesity have emerged as significant global health concerns among children. Previous studies have provided evidence that children with intellectual and learning disabilities (LD) are at a higher risk of obesity compared to their peers without disabilities. Methods: This study aimed to predict body weight status of children with LD who attended Special Education Integration Program in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a self-administered questionnaire in Malay language, which included “Screening Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive Feeding Practice Questionnaire (CFPQ). The children’s body weight and height were measured to determine body mass index (BMI). Research hypothesis was tested through stepwise multiple linear regression analysis. Results: This study recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9 kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while overweight and obesity was 29.0%. Male children with LD (β=0.109, p<0.044), older age (β=0.226, p<0.001), higher child birth weight (β=0.119, p<0.029), lack of parental modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p<0.001), and higher restriction for weight control (β=0.361, p<0.001) were found to predict higher BMI values. Conclusion: Positive parental feeding practices during mealtime are crucial for addressing the poor nutritional status of children with LD.

The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status.

Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5±7years (range 18-60years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5kg/m2 ), normal weight (18.5-24.9kg/m2 ), overweight (25.0-29.9kg/m2 ) and obese (≥30kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. Participants had mild (42.3%; n=30), moderate (29.6%; n=21) or severe IDD (28.2%; n=20). They were underweight (12.7%; n=9), normal weight (59.2%; n=42) or overweight and/or obese (28.2%; n=20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.

Investigation of the relationship between feeding problems and cognitive functions in premature children

Children with a history of premature birth may show various problems in feeding, and these problems may continue at school age. It is necessary to examine the role of cognitive functions in children's feeding with more detailed studies.Comparison of feeding problems and cognitive functions of premature and full-term children and examining the relationship between them. The parents of 60 children aged 6–10 completed the Screening Tool of Feeding Problems, and the cognitive functions of the children were evaluated with the Dynamic Occupational Therapy Cognitive Assessment. Results are compared and correlations between feeding problems and cognitive functions were examıned. Feeding problems of premature children are statistically higher than those born at term; their cognitive functions were statistically weaker (p < 0.001). It was found that feeding problems and cognitive functions were statistically related in premature children (p < 0.05). Feeding problems seen in premature children may be related to their weaker cognitive functions compared to their peers. It is important to evaluate cognitive functions and include them in the intervention in rehabilitation programs to be prepared for premature children with feeding problems.

Unsafe Chewing: Choking and Other Risks

Unsafe Chewing: Choking and Other Risks

Parent-report instruments for assessing feeding difficulties in children with neurological impairments: a systematic review.

This study aimed to review the psychometric properties and clinical application of parent-report instruments that assess feeding difficulties in children with neurological impairments. Papers were identified through five electronic databases based on 15 keywords and were included if they met the following criteria: published in English, described the implementation of parent-report instruments, and included children with neurological impairments (either in the report or a related study population). In total, 1220 relevant abstracts were screened and 22 full-text articles were evaluated. The following six parent-report instruments met the inclusion criteria: (1) Screening Tool of Feeding Problems applied to children, (2) Paediatric Eating Assessment Tool, (3) Paediatric Assessment Scale for Severe Feeding Problems, (4) Montreal Children's Hospital Feeding Scale, (5) Children's Eating Behaviour Inventory, and (6) Behavioural Paediatric Feeding Assessment Scale (BPFAS). Based on comprehensive psychometric testing and consistently good results, the BPFAS was considered the most valid and reliable instrument. The BPFAS also showed good clinical applicability because it was readily available, required a short administration time, and used a simple scoring system. We reviewed the available parent-report instruments for assessing feeding difficulties in children with neurological impairments. The BPFAS had the best psychometric properties and clinical applicability. Six parent-report instruments were suitable for assessing feeding in children with neurological impairments. The Behavioural Paediatric Feeding Assessment Scale (BPFAS) has the strongest psychometric properties. The BPFAS also has good clinical applicability.

Measuring the impact of feeding covariates on health-related quality of life in children with autism spectrum disorder

PurposeThe purpose of the study was to examine the impact of feeding covariates (feeding problems, mealtime problems and feeding strategies/practices) on the health-related quality of life (HRQoL) in children with autism spectrum disorder (ASD). MethodThe valid data were obtained from a convenience sample of 379 mothers, on behalf of their children with ASD. Four assessment tools were used to collect data: KIDSCREEN health-related quality of life questionnaire short version (KIDSCREEN-SV), to assess HRQoL; screening tool of feeding problems (STEP), to assess the feeding problems; brief autism mealtime behaviour inventory (BAMBI), to assess mealtime problems; and feeding strategies questionnaire (FSQ), to assess parental feeding strategies/practices. A stepwise multiple regression analysis was run to determine the effects of predictor parameters (feeding problems, mealtime problems and feeding strategies/practices) on the HRQoL of children with ASD. ResultsThe multiple-regression analysis yielded three regression models. BAMBI (mealtime problems), FSQ (feeding strategies) and STEP (feeding problems) explained 11% of the total variance of HRQoL in a significant way. The amount of explained variance, beta score and correlation value suggest that BAMBI (mealtime problems) is the most significant predictor of HRQoL of children with ASD. ConclusionThe study provides evidence that feeding problems, mealtime problems and feeding strategies, play a significant and predictive role on HRQoL. Consequently, eliminating feeding and mealtime problems and ameliorating parental feeding strategies/practices may promote the HRQoL of children with ASD.

Psychometric properties of the screening tool of feeding problems (STEP) in Turkish children with ASD

The purpose of this study is to determine the psychometric properties of the screening tool of feeding problems (STEP) in Turkish children with autism spectrum disorders (ASD). After providing linguistic equivalence of the scale, STEP was applied to 360 mothers on behalf of their children with ASD in order to determine the associated feeding problems. The scale which has 5 sub-domains and 3 Likert-type questions originally consisted of 23 items. Item-total correlations of the scale were acceptable, with the exception of item 8 and the differences between the item averages of the upper 27% and the lower 27% groups were significant (p<0.001). The internal consistency coefficient (α=0.81) and the split-half reliability (Spearman's rho=0.69**) were high. The STEP achieved criterion-related validity. The results of Confirmatory Factor Analysis (χ(2)/df=3.2, RMSEA=0.08, SRMR=0.08, GFI=0.85, AGFI=0.81, CFI=0.86) showed that the scale has an acceptable goodness of fit. This study suggests that the Turkish version of the STEP could be a useful assessment tool when it comes to measuring feeding problems in children with ASD.

Nutrition Related Behavior Problems in Autism Spectrum Disorders

Feeding is an essential function which affects life quality of children with autism spectrum disorder (ASD). Approximately, 80% of the ASD patients have some feeding difficulties. This study aimed to determine the prevalence of behavioral feeding problems in ASD. In this cross-sectional descriptive study, 30 individuals with ASD referred to speech and language pathol- ogy clinic were included using random sampling. To gather the data, Screening Tool of feeding Problems (STEP) was used. Data analysis was done through SPSS. The findings of the study indicated that all subjects were somehow involved with behavioral feeding problems Findings indicate that in autism children, behavioral feeding problems were prevalent. These problems will be treated by opportune identification.

What is the evidence for atypical feeding behaviour assessment tools in children with an autistic spectrum disorder?

AimsThis study systematically reviews the literature on assessment tools for atypical feeding behaviour (AFB) in children and adolescents with autistic spectrum disorder (ASD).MethodArticles were identified by electronic database and manual...

The Screening Tool of Feeding Problems applied to children (STEP-CHILD): Psychometric characteristics and associations with child and parent variables

The present study evaluated the 23-item Screening Tool for Feeding Problems (STEP; Matson & Kuhn, 2001) with a sample of children referred to a hospital-based feeding clinic to examine the scale's psychometric characteristics and then demonstrate how a children's revision of the STEP, the STEP-CHILD is associated with child and parent variables. Participants included 142 children (95 boys, 47 girls; mean age = 61.4 months; 43 with autism, 51 with other special needs, 48 with no special needs). Children ranged in age from 24 months to 18 years. Factor analysis revealed a 15-item STEP-CHILD with six subscales of child feeding problems: CHEWING PROBLEMS, RAPID EATING, FOOD REFUSAL, FOOD SELECTIVITY, VOMITING, and STEALING FOOD. Mediation analysis documented that “overly permissive” actions by parents (such as infrequent insistence on eating during meals, or frequent preparation of Special Meals for children different than the family meal) explained over 34% of the links between children's feeding problems and poor weight and diet outcomes.

A Comparison of Feeding and Mealtime Problems in Adults with Intellectual Disabilities with and Without Autism

Feeding and mealtime behavior problems are an area of concern for those with autism spectrum disorders (ASD) because of their impact on daily functioning, as well as the potential for causing severe medical conditions (e.g., poor nutrition, choking, aspiration) and even death. Due to the importance of this topic for proper diagnosis and treatment planning, a better understanding of these behaviors in persons with ASD and intellectual disabilities (ID) is important. Participants in this study were 60 adults with ASD and ID (group 1) or ID only (group 2). Individuals with ASD and ID evinced more behaviorally-based feeding problems, such as food selectivity and refusal related difficulties relative to their peers with ID alone as assessed with the Screening Tool of fEeding Problems (STEP). Those with ID only had more feeding skill difficulties than persons with ASD and ID. Overall, the ASD and ID group evinced more, and more severe feeding and mealtime problems. Implications of these data are discussed.

Cutoff scores, norms and patterns of feeding problems for the Screening Tool of fEeding Problems (STEP) for adults with intellectual disabilities

Independent living is a goal for everyone, but often persons with intellectual disabilities (ID) have major challenges in this respect. In fact, deficits in daily living skills are a hallmark of the condition. One of the most serious and potentially problematic of the independent living skills is difficulties or irregularities in eating. These problems can not only effect independence but they can result in more restrictive living conditions, poor nutrition, choking, aspiration, or even death. Given the serious nature of the disorder, it points to the need for adequate screening and diagnosis of such problems. The present study reports on the STEP and the development of cutoff scores and norms for the scale. Possible applications of these data for real world problems of person with ID are discussed.

The relationship between food refusal and social skills in persons with intellectual disabilities

Background Feeding problems are common among individuals with intellectual disabilities. The aim of the current study was to determine the relationship between food refusal and social skills in people with intellectual disability.Method The Screening Tool of Feeding Problems (STEP) was administered to all residents of a large developmental centre. This screening tool identified 82 residents who exhibited food refusal, and 81 residents who did not exhibit food refusal. The Matson Evaluation of Social Skills in Persons with Severe Retardation (MESSIER) was administered to the 163 participants.Results People who exhibited food refusal displayed significantly more negative nonverbal and general negative social skills when compared to controls. Food refusal was prevalent across all ages, genders, and levels of intellectual disability.Conclusions As social skill deficits are associated with deficits in feeding skills, social skills training should be considered as a major component of behavioural interventions targeting food refusal in people with intellectual disability.

The relationship between manic symptoms on the DASH II and YMRS and feeding/mealtime behavior problems

This study represents the first to assess whether a relationship between manic symptoms and feeding/mealtime behavior problems exists in individuals with ID. Participants were compared across three groups (manic, non-manic psychiatrically impaired, and controls) on the diagnostic assessment for the severely handicapped–revised (DASH-II) and young mania rating scale (YMRS) and items of the screening tool of feeding problems (STEP). Individuals in the manic group exhibited clinically significant symptoms of mania ( n = 18), those in the non-manic psychiatrically impaired group exhibited symptoms of psychopathology other than mania ( n = 18), and those in the control group did not exhibit symptoms of mania or any other psychopathology ( n = 18). Significant differences were found across the groups for a number of items. Specifically, individuals exhibiting symptoms of mania were significantly more likely to ‘continue to eat as long as food was available’, ‘to require special positioning during feeding, and ‘to engage in problem behaviors during mealtime (e.g., aggression)’. These individuals were also significantly less likely to ‘eat foods of only certain textures’. Implications of these data are discussed.

The Relationship Between Depression and Feeding Disorder Symptoms Among Persons with Severe and Profound Mental Retardation

Among the population at-large, the effect of depression on appetite and feeding behavior is well documented. Despite the prevalent nature of psychopathology among those with severe and profound mental retardation, little has been reported about the relationship between depression and problematic feeding behavior. Consequently, we assessed the relationship of depression and feeding problems across 54 participants diagnosed with either a mood disorder, pervasive developmental disorder, or no Axis I diagnosis. All participants were classified in the severe to profound range of mental retardation. Significant differences on the Screening Tool of Feeding Problems (STEP) were found across feeding problems, indicating that feeding problems may vary as a function of Axis I diagnostic classification.

A validity study of the Screening Tool of Feeding Problems (STEP)

The Screening Tool of fEeding Problems (STEP) was developed as a means to identify feeding problems presented by persons with an intellectual disability, for diagnosis, treatment and evaluating treatment outcome. Rarely is assessment comprehensive and often problems are not identified until they are severe. Items for the scale were developed to target feeding problems identified in the literature in the areas of risk of aspiration, food selectivity, feeding skills deficits, food refusal and associated behaviour problems, and nutrition related behavior problems. The current study examines the validity of the STEP as a means to identify feeding problems. Convergent validity was demonstrated by comparing STEP items targeting rumination and pica (items 18 and 9, respectively) to DSM-IV diagnoses of these disorders. Implications of the results are discussed.

Identifying feeding problems in mentally retarded persons: development and reliability of the screening tool of feeding problems (STEP)

Feeding problems are extremely common among individuals with mental retardation. Palmer, Thompson, and Linscheid (1975) estimate that 33% of persons with mental retardation have severe feeding difficulties or problems. Furthermore, the consequences of untreated feeding problems can be severe if not fatal. Despite these numbers, little has been done to systematically identify these problems. The Screening Tool of Feeding Problems (STEP) was developed as a means to identify feeding problems presented by persons with mental retardation, and thus facilitate the process of identifying who would benefit from some type of behavioral or medical intervention. Items included in the STEP target feeding problems identified in the literature, in the areas of risk of aspiration, food selectivity, feeding skills deficits, food refusal and associated behavior problems, and nutrition related behavior problems. The current study describes the construction of this scale, provides psychometric data including test-retest and cross rater reliability, and factor analysis data.