Evaluation of the diagnostic utility of the Spanish version of the pediatric eating assessment tool (Pedi-EAT) questionnaire

Research into eating difficulties in children is limited due to the lack of consensus in diagnosis and scarcity of valid and reliable measures. PediEAT is a questionnaire for parents intended to assess feeding problems in children aged six months to seven years. It is composed of four subscales.

Executive Summary
Parents of 6- to 7-year-old children selected in two groups were included: with feeding difficulties and without difficulties. Relatives completed the adapted questionnaire online. The discriminative capacity, sensitivity and specificity, reliability, average completion time and degree of perceived difficulty of the questionnaire were evaluated. Possible variables associated with the PediEAT score were studied.

Context and Justification
The Spanish version of the PediEAT is a useful instrument for detecting feeding difficulties in children of the studied age group, applicable to clinical practice and research.

General Objective
To determine the diagnostic utility of the Spanish version of the pediatric eating assessment questionnaire (Pediatric Eating Assessment Tool PediEAT) to detect children with feeding difficulties.

Specific Objectives

• Identify the clinical and socioeconomic characteristics of children with feeding difficulties compared to children without feeding difficulties.
• Know the main food problems in the study population.
• To know the usefulness of the PediEAT questionnaire to classify the study population according to whether or not they are children with feeding difficulties.
• Estimate the average time to complete the PediEAT questionnaire
• To know the perception of the degree of difficulty of the PediEAT questionnaire.
• To study the possible variables associated with the total score of the PediEAT questionnaire.

The study was carried out at Fundació Aspace Catalunya for a period of 5 months from May to September 2023, with the recruitment and data collection period being between June and July 2023.

For the selection of participants from the group with feeding difficulties, a list of candidate participants visited at Fundació Aspace Catalunya was obtained. The principal investigator reviewed the inclusion and exclusion criteria through the medical records and contacted the selected families by telephone informing them about the study. Only families interested in participating were included.

The recruitment of participants for the group without feeding difficulties was carried out with the collaboration of professionals from Fundació Aspace Catalunya and professionals from working groups in the field of speech therapy. Acquaintances, relatives, education professionals and relatives of patients were contacted, informing them about the study and inviting them to participate.

For data collection, the PediEAT tool was adapted in electronic questionnaire format using Clinpasis© and a link to the online questionnaire was sent. In order to avoid missing data, the questions were set so that they were all mandatory. The researcher called the parents as a reminder and offered support when they had questions.

Participants were asked to provide information on the child's gender and age, birth weight, relationship with the child, level of annual family income, level of education, family unit style, and whether they were concerned about feeding their children. Target group participants were also asked the child's diagnosis or condition according to ICD-10 if they had a neurodevelopmental disability or disorder and if they were currently tube fed (enteral nutrition). Subsequently, all participants could access to complete the tool if they had answered all the questions. At the end of the questionnaire, they were asked about the degree of perceived difficulty in answering the tool and the approximate time to complete it.

Pediatric eating disorders can affect a child's physical, social, emotional, or cognitive function and increase caregiver stress. They can cause dependence on oral nutritional supplements and interfere with psychosocial functioning. Permanent problem behaviors can get worse and be harder to change.

Families with children with feeding difficulties are likely to suffer greater economic repercussions and need greater community resources compared to children without difficulties. Families are often affected by parental concerns and family dynamics.