2 - (SYM 124) Food Selectivity Inventory: Proof of Concept of a Novel Self-report Measure

Background. Food selectivity is a critical concern for many autistic school-age children and adolescents. As treatments for food selectivity are developed and refined for autistic youth, meaningful, sensitive, and developmentally appropriate outcome measures are crucial. Existing measures do not capture incremental changes observed when treatment focuses on expanding flexibility with new or nonpreferred foods. 

Objectives:  (1)  Develop the Food Selectivity Inventory (FSI), an online, picture-based child self-report assessment tool. (2)   Explore novel outcome variables for food selectivity treatment trials. (3)  Evaluate preliminary psychometrics of the FSI.  Methods. Eighty-seven autistic youth (7-16 years, M=10.8, SD=2.8; 26F:61M) and their parents completed the online FSI. Data collection is underway for a matched group of non-autistic youth. Participants viewed food pictures and indicated which foods they eat (food repertoire). Ratings characterized novel possible outcome variables: cognitive willingness, idiosyncratic eating, eating accommodations, and domain-specific impact. Results. Participants reported a food repertoire ranging from 3 to 53 (M=26.8, SD=26.8) of 55 foods within food categories (e.g., berries, tropical fruit). Participants then indicated a willingness, if asked, to taste an additional 0 to 24 foods (M=6.5, SD=4.6). Thirty-two (36.8%) participants reported that they have idiosyncrasies about eating the foods they eat (range 0-100%; M=29.6%, SD=28.8%). Most (90%) of parents reported using accommodation strategies to get their child to eat (e.g., sending separate foods with their child; mean=4.6, SD=3.2; of 15 accommodations). Both children and parents reported eating to interfere with emotional well-being, relationships, daily life activities, social experiences, and health/nutrition, at an average of a few times a week. Psychometric evaluation of the FSI suggests criterion validity. 66 parents (76%) reported their child to be a picky eater; picky eaters had a significantly smaller FSI food repertoire, F(1,85)=55.4, p< .001 and significantly more food idiosyncrasies than those described as not picky. Conclusions. The FSI offers promise as a food selectivity intervention outcome measure. Results document children’s cognitive willingness to eat foods not currently in their food repertoire, identifying a food flexibility measure. Use of the full response range suggests measurement granularity. Finally, preliminary evidence of criterion validity is a first step toward measure validation.