Assessment Resource Sheet: Pediatric Gastroenterology

Assessment of pediatric gastroenterological conditions can be conducted via self-report, physical examination, questionnaires, and behavioral observations. Most common assessments include those of disease severity/activity, diagnostic classification, quality of life, and parental behaviors. This list is based on measures summarized previously by the Division 54 Pediatric Gastroenterology Special Interest Group (SIG) - Assessment Working Group. It contains a summary of commonly used measures across pediatric gastroenterological conditions, including inflammatory bowel disease, functional abdominal pain, encopresis and feeding disorders. All measures are classified as well-established assessment, approaching well-established assessment, and promising assessment as detailed in the Cohen, La Greca, Blount, Kazak, Holmbeck & Lemanek (2008) paper. Age ranges (when available) are included in parentheses. Central references are included and are cited with superscripts in the tables.

Inflammatory Bowel Disease
AssessmentsWell-establishedApproaching
Well-established
Promising
Quality of Life
IMPACT-III1,2 (ages 9-17)X
Family Functioning-Responsibility
Inflammatory Bowel Disease Family Responsibility Questionnaire (IBD-FRQ)3 (ages 11-18)X
Disease Activity
Harvey-Bradshaw Index4,5 (all ages, including adults; Crohn’s disease)X
Pediatric Crohn’s Disease Activity Index (PCDAI)6,7(ages 0-19)X
Pediatric Ulcerative Colitis Activity Index (PUCAI)8,9 (ages 2-18)X
Lichtinger Ulcerative Colitis Clinical Activity Index (LCAI)10 (all ages)X
Functional Abdominal Pain
AssessmentsWell-establishedApproaching
Well-established
Promising
Diagnosis/Classification
The Questionnaire on Pediatric Gastrointestinal Symptoms- Rome III version (QPGS-RIII), Parent Report11,12 (ages 4 -18)X
Symptom Severity
Abdominal Pain Index (API)13,14,15 (ages 8 – 18)X
Coping
Pain Response Inventory (PRI)13,16,17 (ages 8 – 18)X
Parental Responses to Child Pain Behavior
Illness Behavior Encouragement Scale (IBES)18,19,20 (ages 6-16)X
Adult Responses to Children’s Symptoms (ARCS)21,22 (ages 8-18)X
Functional Disability/Impairment
Functional Disability Inventory (FDI)17,23,24 (ages 8-17)*X
Encopresis
AssessmentsWell-establishedApproaching
Well-established
Promising
Symptom Assessment
Virginia Encopresis-Constipation Apperception Test (VECAT)25X
Diagnosis/Classification
Profile of Toileting Issues (POTI)26,27,28X
Pediatric Feeding Disorders
AssessmentsWell-establishedApproaching Well-establishedPromising
Observational Coding Systems
Mealtime Observation Schedule (MOS)29,30,31,32X
Dyadic Interaction Nomenclature for Eating (DINE)33,34,35,36,37,38X
Caregiver Report Inventories
Behavioral Pediatric Feeding Assessment Scale (BPFAS)35,39,40X
Children’s Eating Behavior Inventory (CEBI)41X
Screening Tool of Feeding Problems (STEP)42,43,44X
Brief Autism Mealtime Behavior Inventory (BAMBI)45,46X
Feeding Strategies Questionnaire (FSQ)47X
About Your Child’s Eating (AYCE)48X
Parent Mealtime Action Scale (PMAS)49,50X
Mealtime Behavior Questionnaire (MBQ)51X
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8. Turner D, Otley AR, Mack D, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology. 2007;133(2):423-432.
9. Turner D, Hyams J, Markowitz J, et al. Appraisal of the pediatric ulcerative colitis activity index (PUCAI). Inflamm Bowel Dis. 2009;15(8):1218-1223.
10. Lichtiger S, Present DH, Kornbluth A, et al. Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med. 1994;330(26):1841-1845.
11. Caplan A, Walker LS, Rasquin A. Development and preliminary validation of the Questionnaire on Pediatric Gastrointestinal Symptoms to assess functional gastrointestinal disorders in children and adolescents. J Pediatr Gastroenterol Nutr, 2005;4:296–304.
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13. Walker LS, Smith CA, Garber J, Van Slyke DA. Development and validation of the pain response inventory for children. Psychol Assess, 1997; 9(4): 392-405.
14. Greco LA, Freeman KE, & Dufton L. Overt and relational victimization among children with frequent abdominal pain: links to social skills, academic functioning, and health service use. J Pediatr Psychol, 2007; 32(3):319-329.
15. Robins PM, Smith SM, Glutting JJ, Bishop CT. A randomized controlled trial of cognitive-behavioral family intervention for pediatric recurrent abdominal pain. J Pediatr Psychol, 2005;30(5):397-408.
16. Walker LS, Smith CA, Garber J, Claar RL. Testing a model of pain appraisal and coping in children with abdominal pain. Health Psychol, 2005;24:364-374.
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18. Walker LS, Zeman JL. Parental response to child illness behavior. J Pediatr Psychol, 1992;17(1), 49-71.
19. Bijttebier P, Vertommen H. Antecedents, concomitants, and consequences of pediatric headache: confirmatory construct validation of two parent-report scales. J Behav Med; 1999;22(5):437-456.
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21. Van Slyke DA, Walker LS. Mother’s responses to children’s pain. Clin J Pain, 2006;22:387-391.
22. Claar RL, Guite JW, Kaczynski KJ, Logan DE. Factor structure of the Adult Responses to Children's Symptoms: Validation in children and adolescents with diverse chronic pain conditions. Clin J Pain, 2010;26(5):410-417.
23. Walker LS, Greene JW. The Functional Disability Inventory: Measuring a neglected dimension of child health status. J Pediatr Psychol,1991;16(1):39-58.
24. Claar RL, Walker LS. Functional assessment of pediatric pain patients: Psychometric properties of the Functional Disability Inventory. Pain, 2006;121(1-2):77-84.
25. Cox DJ, Ritterband LM, Quillian W, Kovatchev B, Morris J, et al. Assessment of behavioral mechanisms maintaining encopresis: Virginia Encopresis-Constipation Apperception Test. J Pediatr Pyschol. 2003; 28(6): 375-382.
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28. Matson JL, Dempsey T, Fodstad JC. The Profile of Toileting Issues (POTI). Baton Rouge: Disability Consultants, LLC; 2010.
29. Sanders MR, Patel RK, LeGrice B, Shepherd RW. Children with persistent feeding difficulties: An observational analysis of the feeding interactions of problem and non-problem eaters. Health Psychol. 1993; 12(1): 64-73.
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38. Powers SW, Mitchell MJ, Patton SR, Byars KC, Jelalian E, Mulvihill MM, et al. Mealtime behaviors in families of infants and toddlers with cystic fibrosis. J Cyst Fibros. 2005; 4: 175-182.
39. Crist W, McDonnell P, Beck M. Behavior at mealtimes and the young child with cystic fibrosis. J Dev Behav Pediatr. 1994; 15:157-161.
40. Crist W, Napier-Phillips A. Mealtime behaviors of young children: A comparison of normative and clinical data. J Dev Behav Pediatr. 2001; 22(5): 279-286.
41. Archer LA, Rosenbaum PL, Streiner DL. The Children’s Eating Behavior Inventory: Reliability and validity results. J Pediatr Psychol. 1991; 16(5): 629-642.
42. Matson JL, Kuhn DE. Identifying feeding problems in mentally retarded persons: Development and reliability of the screening tool of feeding problems (STEP). Res Dev Disabil. 2001; 22(2): 165-172.
43. Kuhn DE, Matson JL. A validity study of the Screening Tool of Feeding Problems (STEP). J Intellect Dev Disabil. 2002; 27(3): 161-167.
44. Matson JL, Kuhn DE. Screening Tool of Feeding Problems (STEP). Baton Rouge: Disability Consultants, LLC; 2001.
45. Lukens CT, Linscheid TR. Development and validation of an inventory to assess mealtime behavior problems in children with autism. J Autism Dev Disord. 2008; 38(2): 342-352.
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47. Berlin KS, Davies WH, Silverman AH, Rudolph CD. Assessing family-based feeding strategies, strengths, and mealtime structure with the Feeding Strategies Questionnaire. J Pediatr Psychol. 2011; 36(5): 586-595.
48. Davies WH, Ackerman LK, Davies CM, Vannatta K, Noll RB. About Your Child's Eating: Factor structure and psychometric properties of a feeding relationship measure. Eat Behav. 2007; 8(4): 457-463.
49. Hendy HM, Williams KE, Camise TS, Eckman N, Hedemann A. The Parent Mealtime Action Scale (PMAS): Development and association with children’s diet and weight. Appetite. 2009; 52(2): 328-339.
50. Williams KE, Hendy HM, Seiverling LJ, Can SH. Validation of the Parent Mealtime Action Scale (PMAS) when applied to children referred to a hospital-based feeding clinic. Appetite. 2011; 56(3): 553-557.
51. Berlin KS, Davies WH, Silverman AH, Woods DW, Fischer EA, Rudolph CD. Assessing children's mealtime problems with the Mealtime Behavior Questionnaire. Child Health Care. 2010; 39(2): 142-156.
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