Instruments for assessing eating behavior in individuals with autism spectrum disorder, psychometric properties and applicability

Abstract

This study aimed to analyze the instruments used to assess eating behavior in individuals with Autism Spectrum Disorder (ASD), considering their psychometric properties and applicability. This descriptive bibliographic research systematically consulted the Scopus, PubMed, Web of Science, and Bireme databases to identify and describe assessment instruments used in studies published between 2018 and 2024. After applying the inclusion and exclusion criteria, 51 relevant studies were selected and analyzed regarding the identified instruments’ structure, psychometric quality, and applicability. The results indicated that most instruments were initially developed for general populations and require adaptations to reflect the specificities of ASD adequately. The Child Eating Behavior Questionnaire (CEBQ) was the most frequently used instrument, followed by the Brief Autism Mealtime Behavior Inventory (BAMBI), the Screening Tool for Feeding Problems Applied to Children (STEP-CHILD), and the Swedish Eating Assessment for Autism Spectrum Disorders (SWEAA). However, many instruments—particularly those recently developed or adapted ad hoc by researchers—showed limited validation, compromising their reliability for clinical and research purposes. The findings reinforce the importance of developing and validating culturally sensitive and ASD-specific instruments that address sensory, behavioral, and contextual influences on eating behavior. Strengthening the psychometric foundation of these tools is essential to enhance their usefulness in guiding nutritional, therapeutic, and educational strategies. It is concluded that, although several instruments are available to assess eating behavior in children and adolescents, the lack of standardization and cross-cultural validation limits comparability between studies, highlighting the need for adaptations that consider the cultural and developmental contexts of the assessed populations.