Screening tool for eating problems–child version (STEP-C) development of cut-off scores and examination of validity

Objectives: The goal of this study was to develop cut-off scores for the Screening Tool for Eating Problems–Child Version (STEP-C) and demonstrate the validity of these scores. Methods: Participants included children referred to a feeding clinic (15-226 months) and a comparison group of children (15-215 months) seen for well-child visits who had not received feeding therapy. ROC analysis was used to develop cut-off scores to differentiate children into clinical and non-clinical groupings. Validity testing was also conducted by comparing the scores of the STEP-C clinical and non-clinical groups on four additional measures including a measure of diet variety, a texture measure, an oral behavior measure, and a sensory measure specific to feeding. Results: Using the STEP-C cut-off scores, 88% of the children referred for feeding problems and 18.8% of the comparison group had scores that met or exceeded the cut-off and identified with a feeding problem. The children in the clinical group, consisting of children whose STEP-C scores met or exceeded the cut-off, ate a more limited variety of foods, consumed fewer textures, had more sensory feeding problems, and had more oral behavior problems than children in the non-clinical comparison group. Conclusions: The STEP-C, a screening measure of children’s feeding problems, was able to accurately identify children with feeding problems.