Nutr Rev. 2025 Jul 31:nuaf128. doi: 10.1093/nutrit/nuaf128. Online ahead of print.
ABSTRACT
CONTEXT: Pediatric feeding disorders (PFDs) present challenges involving food intake, feeding skills, and psychosocial or clinical dysfunctions affecting children and caregivers. Early identification and accurate evaluation are essential for improving outcomes. Despite the availability of various instruments, evidence for their reliability and validity in clinical practice and research remains limited.
OBJECTIVE: The aim for this systematic review was to assess the evidence of the validity of instruments used to evaluate PFDs.
DATA SOURCES: Articles were searched across Medline, Embase, APA PsycInfo, Centre for Agricultural Bioscience International, Web of Science, and Cochrane Library databases, and grey literature up to August 2024, including studies without restrictions on date or language.
DATA EXTRACTION: Studies on PFD assessment instruments were included. Two independent reviewers assessed eligibility, extracted data (covering study and instrument characteristics, domains, psychometric properties, validation outcomes), and evaluated methodological quality.
DATA ANALYSIS: Narrative synthesis was used to describe the psychometric properties of the instruments. The methodological quality of the included studies was evaluated using the COSMIN Risk of Bias checklist. Instrument validity was primarily assessed using minimum adequacy criteria (content, criterion, and construct validity or diagnostic performance) based on previously published cutoff points. COSMIN criteria for good measurement properties were also applied to assess the instruments. A total of 19 instruments for evaluating PFDs were reviewed across 40 studies. Among these, 10 met the minimum adequacy criteria, including 8 for feeding problems and 2 for dysphagia, regardless of their original language or cultural context.
CONCLUSION: This review underscores the lack of instruments with adequate psychometric properties to evaluate PFDs. Although some instruments meet minimum adequacy criteria, limitations in validation methods and insufficient robustness highlight the need for further research and standardization to improve their use in clinical and research contexts.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42023411223.
PMID:40743463 | DOI:10.1093/nutrit/nuaf128
