The objective of this study was to compare the behavior of healthy young children around feeding and mealtimes to the behavior of two clinical groups, children referred for feeding problems without related medical issues and those with medical issues associated with the feeding problems. Using the Behavioral Pediatrics Feeding Assessment Scale, data were obtained for 96 healthy children between the ages of 9 months and 7 years, and descriptive information is presented in the paper on these normal mealtime behaviors. In comparing this normative data to similar data obtained from the clinical groups, our primary purpose was to investigate whether children with feeding problems engage in fundamentally different behaviors (maladaptive) or similar behaviors, but at an increased frequency to normal children. Factor analysis identified five common patterns of behavior across the three groups. The difference in parental report of feeding difficulties between healthy and clinical groups appears to reflect the frequency in which the child with feeding difficulties engages in the problematic behavior, rather than fundamental differences in behaviors exhibited during mealtimes.

The validity and reliability of the Pediatric Assessment Scale for Severe Feeding Problems appears to be adequate. The new measure should allow clinicians to better rate initial severity of feeding difficulties and to track the progress of children as they advance from being totally tube-fed to completely orally fed.

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