title: Screening Solid Foods Infants 1 (SSFI-1) development of a screening tool to detect problems in the transition from milk to solid food in infants from six to nine months of age.
abstract: OBJECTIVE
  To establish the psychometric properties of a newly developed screening tool Screening Solid Foods Infants 1 (SSFI-1) used by early childhood professionals, to detect problems in the transition from milk to solid food of smooth consistency in infants 6-9 months of age.
  
  
  METHODS
  The SSFI-1 score was filled out by the parents of a subgroup with term infants (n=35); healthy preterm infants (n=26); infants with comorbidity (n=17); infants with feeding problems (n=13). Internal consistency, reproducibility, construct, criterion and related validity was evaluated.
  
  
  RESULTS
  The preterm subgroup differed significantly in age when starting with fruits/vegetables and period of experience (p<0.01). The SSFI-1 was sufficiently reliable for the total group and term subgroup (α=0.78 and 0.76), but not for the preterm and comorbidity/feeding problem subgroup (α=0.51 and 0.69). Inter-rater reliability was high for the total score (n=25, ICC r=0.93), and moderate to good for individual items (weighted kappa range 0.55-0.95). Validity was confirmed by significantly higher scores for the comorbidity/feeding problem subgroups and clinically distinguishable subgroups (p<0.05) and area under the curve values>0.78. The initial 10-item screening tool was modified to a seven item screening tool. A SSFI-1 score of 4, +2 SD of the term subgroup, had 76.9% sensitivity and 82.1% specificity, for detecting the presence of a feeding problem.
  
  
  CONCLUSIONS
  The seven-item screening tool Screening Solid Foods 1 may be used as a screening tool for term infants. Further testing of the SSFI-1 in new infants is needed, to confirm reliability and validity both for term, preterm and (risk for) feeding problem infants.
authors.affiliation: Department of Otorhinolaryngology, University Medical Center Utrecht, KJ.01.521.0, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: a.m.b.vanderheul@umcutrecht.nl.
authors.forename: Marise
authors.initials: M
authors.lastname: van der Heul
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindeboom
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands; Department of Dietetics and Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Haverkort
mesh_terms: D000818:Animals; D015897:Comorbidity; D005247:Feeding Behavior; D019959:Feeding and Eating Disorders of Childhood / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005638:Fruit; D005865:Gestational Age; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007225:Infant Food; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000523:psychology; D008297:Male; D008892:Milk; D015588:Observer Variation; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014675:Vegetables
keywords: Child; Development; Feeding behaviour; Feeding difficulties; Feeding problems; Infants; Screening tool; Solid foods; Weaning