Nutritional status of people with intellectual disability (PWID) is always at risk and developing a dietary assessment tool is important. This study aims to test reliability (inter-rater reliability and test-retest reliability) and comparable validity (limit of agreement against a multiple pass 24-hour diet recall recorded by a professional dietitian) of a recently developed dietary assessment kit, CIDDIE Kit©, that specialised for a more dependent group of PWID, focusing on preschool aged children. The CIDDIE Kit© was given to 26 parents or caretakers of children with intellectual disabilities (ID) registered with three selected Community Based Rehabilitation Centre in the Klang Valley area. Each subject was asked to complete two sets of CIDDIE Kit© in a two-week interval session. Meanwhile, a certified dietitian conducted a 24-Hour Diet Recall among the same 26 subjects. The validity and reliability of CIDDIE Kit© were analysed using Bland-Altman method, percentage of correctly classified quartile, Intra-class Correlation Coefficient (ICC) value and Pearson’s correlation coefficient. For comparable validity test, the estimated intake from CIDDIE Kit© and Multiple Pass 24-Hour Diet Recall were considerably in agreement to each other. The test-retest reliability analysis showed significant high similarity (p < 0.001) between the estimated intake from both phases of CIDDIE Kit© where the ICC value ranged approximately 0.9 (R = 0.889 - 0.930). The inter-rater reliability analysis was significantly positive (p < 0.001) and strong correlation (indicating internal consistency), r (0.706 – 0.853). The specially designed CIDDIE Kit© can provide a considerably valid and reliable assessment.
Autism Spectrum Disorder (ASD) is a developmental disorder that comes with co-occurring eating behavior such as limited food varieties, selective food intake, and repetitive eating patterns, contributing to significant challenges for their parents. Many parents find mealtimes difficult and develop anxiety or stress about their child’s nutrition, health, and overall well-being. Hence, parents must equip themselves with the correct awareness and nutrition knowledge. An online open-ended semi-structured interview was conducted among fifteen parents from the community-rehabilitation program center to explore their understanding of nutrition’s importance and the possible coping strategies when facing challenges. The interview sessions were recorded, followed by three researchers’ coding processes. Data were then subjected to thematic analysis. The interview sessions suggested that the parents were aware of the autism trait eating behavior and had a general knowledge about nutrition. However, it was quite challenging when it came to preparation. Nevertheless, the parents are able to manage the challenges with unique kinds of coping strategies. In addition, a complete educational dietary intervention program including psychosocial aspects for parents is recommended for better effectiveness.
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