Psychometric evaluation of the Screening Tool for Feeding Problems (STEP) in Saudi children with developmental disabilities aged 4-18 years.

Background and objectives: Children with developmental disabilities commonly experience feeding problems; however, tools to assess the nature and extent of these difficulties are not available in Arabic. This study aims to validate the Arabic version of the Screening Tool for Feeding Problems (STEP) and evaluate its factorial structure in children with developmental disabilities.

Methods and study design: This cross-sectional study involved 167 children with developmental disabilities, recruited from nine disability centers and schools in Madinah, Saudi Arabia. Data were collected from caregivers using a paper version of the Arabic version of STEP, which was sent home with the child along with a consent form for signature. The English-to-Arabic translation of the tool was conducted by a bilingual professional using the forward-backward translation method.

Results: Confirmatory factor analysis was performed to evaluate the factorial structure of the Arabic version of STEP using two models. Model 1 included all 23 items; Model 2 excluded six items with low factor loadings, resulting in a 17-item version. Model 2 demonstrated improved goodness of fit indices, supporting a modified five-factor structure. Reliability analysis showed acceptable internal reliability for the total scale in both models, with Cronbach's alpha of 0.80 and McDonald's omega of 0.79 for Model 1, and alpha of 0.83 and omega of 0.82 for Model 2. Internal consistency for individual factors ranged from 0.31 to 0.70.

Conclusions: The Arabic version of STEP demonstrates satisfactory psychometric properties and appears to be a valid and reliable tool for screening feeding difficulties in children with developmental disabilities in the Saudi Arabian context.