# Validation of the Arabic Version of Feeding Handicap Index for Children with Developmental Disabilities (A-FHI-C)

## TL;DR

This study validates an Arabic version of a tool to assess feeding and swallowing problems in children with developmental disabilities.

## Contribution

The study introduces and validates the Arabic version of the Feeding Handicap Index for Children (A-FHI-C) for use in Arabic-speaking populations.

## Key findings

- The A-FHI-C showed high internal consistency (Cronbach’s alpha of 0.986) and good test–retest reliability (intraclass correlation of 0.850).
- Children with autism, cerebral palsy, and intellectual disability had significantly higher FHI-C scores than typically developed children.
- The A-FHI-C is a reliable tool for phoniatricians to evaluate and monitor feeding problems in children with developmental disorders.

## Abstract

Children with developmental disabilities have different feeding and swallowing problems. The purposes of the present study were to develop an Arabic version of the FHI-C and to evaluate its validity, consistency, and reliability in Arabic children with developmental disabilities for assessing how feeding and swallowing problems impair the physical, functional, and emotional aspects of children’s lives. A prospective study including 113 children [62 children with autism spectrum disorder (ASD), 24 with cerebral palsy (CP), 27 with intellectual disability (ID)], in the age range of 2 to 10 years, selected randomly from the swallowing clinic, phoniatrics unit, Otorhinolaryngology department, University hospital between September 2023 and December 2023 complaining of feeding and swallowing problems. Validity was established by comparing patients` scores to typically developed controls (31 children). For test–retest reliability, forty parents filled out the A-FHI-C again two weeks after their initial visit. Cronbach’s alpha for A-FHI-C was 0.986, indicating good internal consistency. Intraclass correlation showed 0.850 with a 95% confidence interval from 0.779 to 0.898. All three clinical groups had significantly higher total FHI-C and FHI-C domain scores than the control group, indicating good validation. A-FHI-C was found to have significantly high test–retest reliability. The current study indicates that in children with ASD, CP, ID, feeding problems are more prevalent than children who are typically developed. The scores obtained can be used by phoniatricans to evaluate feeding problems and monitor the progress of the therapy plan in children with developmental disorders.