Cross-Cultural Adaptation and Validation of the Montreal Children’s Hospital Feeding Scale Into Brazilian Portuguese

Abstract

Objective: To cross-culturally adapt and validate the Montreal Children’s Hospital Feeding Scale (MCH-FS) into Brazilian Portuguese. Methods: The MCH-FS, originally validated in Canada, was validated in Brazil as Escala Brasileira de Alimentação Infantil (EBAI) and developed according to the following steps: translation, production of the Brazilian Portuguese version, testing of the original and the Brazilian Portuguese versions, back-translation, analysis by experts and by the developer of the original questionnaire, and application of the final version. The EBAI was applied to 242 parents/caregivers responsible for feeding children from 6 months to 6 years and 11 months of age between February and May 2018, with 174 subjects in the control group and 68 ones in the case group. The psychometric properties evaluated were validity and reliability. Results: In the case group, 79% of children were reported to have feeding difficulties, against 13% in the control group. The EBAI had good internal consistency (Cronbach’s alpha=0.79). Using the suggested cutoff point of 45, the raw score discriminated between cases and controls with a sensitivity of 79.4% and specificity of 86.8% (area under the ROC curve=0.87). Conclusions: The results obtained in the validation process of the EBAI demonstrate that the questionnaire has adequate psychometric properties and, thus, can be used to identify feeding difficulties in Brazilian children from 6 months to 6 years and 11 months of age.

Feeding Difficulty Among Chinese Toddlers Aged 1–3 Years and Its Association With Health and Development

“…However, (20). In addition, the lowest average score (1.71 ± 1.21) in our sample was obtained from the item concerning the presence of gagging, spitting or vomiting, but regarding child's chewing or sucking abilities (scored around 1.33-1.49) in the other four countries mentioned above (4,17,18,20). These findings demonstrated the heterogeneity of feeding problems, regardless of the good acceptability of the MCH-FS in different countries.…”

“…For example, the highest item in the normative sample in Canada was about mealtime refusal (3.14 ± 2.02) ( 4 ), but feeding distraction (3.30 ± 2.10) in Thailand ( 17 ), concern with child's eating (3.68 ± 2.05) in Brazil ( 18 ) or parent–child feeding relationship (6.54 ± 2.02) in Poland ( 20 ). In addition, the lowest average score (1.71 ± 1.21) in our sample was obtained from the item concerning the presence of gagging, spitting or vomiting, but regarding child's chewing or sucking abilities (scored around 1.33–1.49) in the other four countries mentioned above ( 4 , 17 , 18 , 20 ). These findings demonstrated the heterogeneity of feeding problems, regardless of the good acceptability of the MCH-FS in different countries.…”

“…This stool is suitable for children of a wide range of ages, from 6 months to 6 years old and is primarily based on parent report, which can offer a "holistic" perspective efficiently (3). Further, it has been confirmed to have excellent construct validity and reliability (4,(16)(17)(18)(19)(20)(21).…”

Cross‐cultural adaptation and validation of the Italian version of the Montreal Children's Hospital Feeding Scale in a special healthcare needs population

“…The original source, developed for French and English speakers, had previously been translated into Brazilian Portuguese (Diniz et al., 2021) following the International Test Commission (ITC) Guidelines for Translating and Adapting Tests, into Polish (Bąbik et al., 2019) following the Sousa et al. guideline (Sforza et al., 2022) and into Thai (Benjasuwantep et al., 2015) though translation guidelines were not referenced.…”

“…The MCH‐FS was initially validated in Canada in English and French (Ramsay et al., 2011). So far it has already been validated in other languages—e.g., Brazilian Portuguese (Diniz et al., 2021), Polish (Bąbik et al., 2019) and Thai (Benjasuwantep et al., 2015)—but still need to be validated for the Italian‐speaking population.…”