Cross-cultural translation and validation of the Brief Autism Mealtime Behavior Inventory (BAMBI-M) in Malay

Che Daud Ahmad Zamir; Nor Ermalina Hanita  Md Tajuddin; Noor Aziella  Mohd Nayan; Mohammed  Alrashdi; Mohamad Qayum Mohamad Sabri; Hasrul Hosshan

doi:10.23750/abm.v96i6.17082

Cross-cultural translation and validation of the Brief Autism Mealtime Behavior Inventory (BAMBI-M) in Malay

Authors

Che Daud Ahmad Zamir Centre for Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia; Special Population Research, Innovation and Knowledge (SPaRK), Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
Nor Ermalina Hanita Md Tajuddin Centre for Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia; Occupational Therapy Program, Institut Latihan Kementerian Kesihatan Malaysia, Malaysia
Noor Aziella Mohd Nayan Centre for Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia; Occupational Therapy Program, Institut Latihan Kementerian Kesihatan Malaysia, Malaysia
Mohammed Alrashdi College of Medical Rehabilitation Sciences, Taibah University, Medina, Saudi Arabia
Mohamad Qayum Mohamad Sabri Centre for Healthy Ageing & Wellness (H-Care), Occupational Therapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Hasrul Hosshan Faculty of Human Development, Universiti Pendidikan Sultan Idris (UPSI), Tanjung Malim, Perak, Malaysia

Keywords:

autism spectrum disorder, feeding difficulties, mealtime behaviours, BAMBI, validation

Abstract

Background and aim: The Brief Autism Mealtime Behavior Inventory (BAMBI) is extensively utilized for evaluating feeding challenges among children with autism spectrum disorder (ASD). However, its absence in Malay restricts its application within Malaysia. This study aimed to translate and validate the Malay version of BAMBI (BAMBI-M), ensuring both linguistic and conceptual appropriateness for Malay-speaking populations.

Methods: The translation followed a structured protocol involving forward and backward translations, reviews by experts and parents, and comprehensive psychometric evaluations. Ten experts and ten parents assessed content and face validity. A total of 180 parents participated in the psychometric validation stage, comprising 90 parents of children with ASD and 90 parents of typically developing children. Reliability was determined through internal consistency using Cronbach’s alpha, test-retest reliability, and validity was confirmed through known-groups analysis.

Results: Content validity demonstrated robust agreement among experts, and face validity assessments confirmed item relevance through favorable item impact scores. The internal consistency of BAMBI-M showed excellent reliability, with a Cronbach’s alpha of 0.97. Test-retest reliability coefficients ranged from 0.82 to 0.89, confirming temporal stability. Known-groups validity indicated significant differences between the scores of children with ASD and typically developing children (p < 0.001).

Conclusions: BAMBI-M is a reliable and valid instrument for evaluating feeding difficulties in Malaysian children with ASD. Future research should further investigate additional psychometric properties and explore the scale's applicability across diverse Malaysian populations.

References

1. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR). 5th ed. Washington, DC: American Psychiatric Association Publishing; 2023.

2. Cermak SA, Curtin C, Bandini LG. Food Selectivity and Sensory Sensitivity in Children with Autism Spectrum Disorders. J Am Diet Assoc. 2010 Feb;110(2):238–46.

3. Ledford JR, Gast DL. Feeding Problems in Children With Autism Spectrum Disorders: A Review. Focus Autism Other Dev Disabl. 2006;21(3):153–66.

4. Sharp WG, Berry RC, McCracken C, Nuhu NN, Marvel E, Saulnier CA, et al. Feeding problems and nutrient intake in children with autism spectrum disorders: A meta-analysis and comprehensive review of the literature. J Autism Dev Disord. 2013 Sep 1;43(9):2159–73.

5. Lockner DW, Crowe TK, Skipper BJ. Dietary Intake and Parents’ Perception of Mealtime Behaviors in Preschool-Age Children with Autism Spectrum Disorder and in Typically Developing Children. J Am Diet Assoc. 2008 Aug;108(8):1360–3.

6. Schreck KA, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Res Dev Disabil. 2006 Jul;27(4):353–63.

7. Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders. Vol. 12, Research in Autism Spectrum Disorders. Elsevier Ltd; 2015. p. 10–21.

8. Raj NM, Veena KD, Rajashekhar B, Sreelakshmi ACA. Oral Sensory Issues with Feeding and Communication Skills in Autistic Children. Adv Neurodev Disord. 2024 Jun 1;8(2):271–80.

9. Zobel-Lachiusa J, Andrianopoulos M V., Mailloux Z, Cermak SA. Sensory Differences and Mealtime Behavior in Children With Autism. The American Journal of Occupational Therapy. 2015 Sep 1;69(5):6905185050p1–8.

10. Esposito M, Napoli E, Pediatrico O, Gesù B. Sensory Processing, Gastrointestinal Symptoms and Parental Feeding Practices in The Explanation of Food Selectivity: Clustering Children with and Without Autism. International Journal of Autism & Related Disabilities [Internet]. 2019;1:1–12. Available from: https://www.researchgate.net/publication/330565116

11. Johnson CR, Turner K, Stewart PA, Schmidt B, Shui A, Macklin E, et al. Relationships between feeding problems, behavioral characteristics and nutritional quality in children with ASD. J Autism Dev Disord. 2014;44(9):2175–84.

12. Hamid N, Mohamad sabri MQ, Sundara C, Lm B, Al-Sabbah S, Che Daud A. The effect of parent-mediated intervention on social-emotional skills in children with autism spectrum disorder. Journal of Health and Translational Medicine (JUMMEC). 2023;2:301–8.

13. Archer LA, Rosenbaum PL, Streiner DL. The children’s eating behavior inventory: Reliability and validity results. J Pediatr Psychol. 1991 Oct;16(5):629–42.

14. Crist W, Anne Napier-Phillips BA. Mealtime Behaviors of Young Children: A Comparison of Normative and Clinical Data Original Articles. Vol. 22, Developmental and Behavioral Pediatrics. 2001.

15. 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;22:165–72.

16. Lukens CT, Linscheid TR. Development and validation of an inventory to assess mealtime behavior problems in children with autism. J Autism Dev Disord. 2008 Feb;38(2):342–52.

17. Castro K, Perry IS, Ferreira GP, Marchezan J, Becker M, Riesgo R. Validation of the Brief Autism Mealtime Behavior Inventory (BAMBI) Questionnaire. J Autism Dev Disord. 2019 Jun 15;49(6):2536–44.

18. Meral BF, Fidan A. A Study on Turkish Adaptation, Validity and Reliability of the Brief Autism Mealtime Behavior Inventory (BAMBI). Procedia Soc Behav Sci. 2014 Feb;116:403–8.

19. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268–74.

20. Beaton DE, Bombardier C, ¶#§, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine (Phila Pa 1976). 2000;25(24):3186–91.

21. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. Upper Saddle River, NJ: Pearson/Prentice Hall.; 2009. 11–15 p.

22. Zamanzadeh V, Ghahramanian A, Rassouli M, Abbaszadeh A, Alavi-Majd H, Nikanfar AR. Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication. J Caring Sci [Internet]. 2015;4(2):165–78. Available from: http://dx.doi.org/10.15171/jcs.2015.017

23. DeMand A, Johnson C, Foldes E. Psychometric Properties of the Brief Autism Mealtime Behaviors Inventory. J Autism Dev Disord. 2015 Sep 1;45(9):2667–73.

24. Polit DF, Beck CT. The Content Validity Index : Are You Sure You Know What ’ s Being Reported ? Critique and Recommendations. Res Nurs Health. 2006;29(5):489–97.

25. Streiner DL, Norman G, Cairney J. Health Measurement Scales a practical guide to their development and use. Oxford, United Kingdom: Oxford University Press. 2015.

26. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. Vol. 19, Journal of Strength and Conditioning Research. 2005. p. 231–40.

27. Almanasreh E, Moles R, Chen TF. Evaluation of methods used for estimating content validity. Vol. 15, Research in Social and Administrative Pharmacy. Elsevier Inc.; 2019. p. 214–21.

28. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011 Jun 27;2:53–5.

29. Wang WL, Lee HL, Fetzer SJ. Challenges and Strategies of Instrument Translation. West J Nurs Res. 2006;28(3):310–21.

30. Salman FS, Ilias K, Hashim NM, Azri MA, Jamil N, Daud AZC. Parents’ Experiences in Using Telehealth to Carry out Parent-Mediated Intervention Program for Children with Autism Spectrum Disorder (ASD) during the Pandemic Covid-19. Malaysian Journal of Medicine and Health Sciences. 2022 Jun 1;18(8):237–46.