Predictive validity and cut-off score of the Mealtime Behavior Questionnaire for children with autism spectrum disorder

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This study examined the predictive validity of the Autism Spectrum Disorder Mealtime Behavior Questionnaire (ASD-MBQ) and determined the optimal cutoffs to differentiate problematic mealtime behaviors related to autism spectrum disorder (ASD) in children with ASD and non-autistic children in early childhood. The participants were parents/caregivers of children aged 3–6 years. The ASD-MBQ and a demographic data sheet were mailed to parents/caregivers who consented to participate in this study. Descriptive statistics were used to characterize ASD and non-autistic groups. Group differences were calculated using the Mann-Whitney U test. Receiver operating characteristic (ROC) analysis was performed to determine the sensitivity, specificity, and area under the curve (AUC). The sample comprised 128 children with ASD and 128 non-autistic children (3–6 years). The mean total and all subdomain scores of the ASD-MBQ obtained from children with ASD were significantly higher than the scores of those non-autistic children (P < 0.001). The total mean score of the ASD-MBQ differentiated children with ASD from non-autistic children with an excellent ROC-AUC of 0.885 (95% CI 0.845–0.942). A total mean score of 2.04, calculated using the Youden score showed the best sensitivity (0.648) and specificity (0.953). These results indicate that the ASD-MBQ is a promising tool for identifying problematic mealtime behavior in 3–6 year old children with ASD, in Japan.