Convergent Validity of the Feeding and Eating in AutiSm Together Assessment (FEAST)

Abstract

Importance: Comprehensive and validated assessments for use in clinical and research settings are needed to identify and address the complexities of feeding challenges for autistic children.

Objective: To establish the convergent validity of the Feeding and Eating in AutiSm Together (FEAST) questionnaire compared with two other validated parent-reported feeding assessments with similar constructs, the Behavior and Mealtime Behavior Index of Children (BAMBIC) and Screening Tool of Feeding Problems applied to Children (STEP-CHILD).

Method: Data from the Survey for Characterization of Feeding Challenges in Autistic Children-US (N = 349) were used to determine the convergence between the FEAST, BAMBIC, and STEP-CHILD using Pearson's correlation tests.

Design: Cross-sectional validation study.

Results: The FEAST total score and FEAST Behavior subscale were found to have moderate, positive correlations with comparison measures, supporting the convergent validity of the FEAST. Relationships between the remaining FEAST subscales and BAMBIC and STEP-CHILD subscales were primarily weak or nonsignificant, demonstrating that their respective scores are capturing distinct factors related to feeding. One expected exception was a moderate positive correlation between the FEAST Oral Motor subscale and the STEP-CHILD Chewing Problems subscale.

Conclusions and relevance: The FEAST demonstrates adequate convergent validity the BAMBIC and STEP-CHILD. The weak correlations of the FEAST Gastrointestinal Health, Sensory Processing, and Oral Motor Skills subscales provide evidence that FEAST may capture additional information about the factors that influence feeding challenges. The FEAST provides clinicians and researchers with a new comprehensive assessment of feeding challenges for autistic children. Plain Language Summary: This study tested how well the Feeding and Eating in AutiSm Together (FEAST) questionnaire, used to assess feeding and eating challenges among autistic children, matches up with two established feeding assessments, the Behavior and Mealtime Behavior Index of Children (BAMBIC) and the Screening Tool of Feeding Problems applied to Children (STEP-CHILD). Researchers used data from a survey about feeding challenges in autistic kids to compare these feeding assessment tools. They found that the FEAST questionnaire's total score and Behavior subscale scores showed good agreement with the other assessments. Other FEAST subscales (Sensory, Oral-Motor, and Gastrointestinal) were not as related to the BAMBIC or STEP-CHILD scores. This suggests that although FEAST aligns well with general feeding and behavioral concerns, it may offer extra insights into more specific feeding issues. Overall, the FEAST questionnaire could give a more detailed view of feeding challenges among autistic children compared with the other tools. Positionality Statement: Identity-first language is used throughout this article to align with the preferences of our research laboratory's autistic collaborators as well as the majority of autistic adults and parents of autistic children in a recent U.S. sample (Taboas et al., 2023).