General and Feeding Specific Behavior Problems in a Community Sample of Children Amy J. Majewski, Kathryn S. Holman & W. Hobart Davies University of Wisconsin-Milwaukee Pediatric feeding disorders are one of the most common developmental problems brought to pediatricians (Linscheid, 2006). There is substantial heterogeneity in children who present with feeding problems; however, the cause of feeding difficulties can rarely be attributed to a single, specific etiology but is rather due to a combination of environmental, developmental, behavioral and medical factors (Kedesdy & Budd, 1998). Research has suggested that general behavioral problems are associated with the etiology and maintenance of feeding problems. The results are mixed as to whether problematic behaviors in children with feeding problems are global or are mealtime specific. PARTICIPANTS N =508: parents of young children were recruited from the community. Parents: Mothers: 74.6% Age: 19 to 55 years (M = 34.66; SD=7.71) Education: 61.7% College-educated Ethnicity: 83.9% Caucasian Children Gender: 50.7% female Age: 2 to 12 years (M = 6.90, SD = 3.92) 36.3% reported as having a chronic medical condition PROCEDURE Participants completed an online questionnaire pertaining to their child’s health status, general behavioral presentation and feeding behaviors. DISCUSSION and SUMMARY MEASURES Mealtime Behavior Questionnaire (MBQ: Davies, et al., 2005). The MBQ is a 33- item, parent- report measure used to assess the level of problematic child behaviors present during mealtimes. The MBQ measures at Total Score from four subscales: Distraction/Avoidance, Food Manipulation, Mealtime Aggression, and Choking, Gagging, and Vomiting. Pediatric Symptoms Checklist (PSC: Jellinek et al., 1998). The PSC is a 35-item, parent-report measure used to assess child cognitive, emotional and behavioral problems. The PSC generates a Total Score based on the frequency of each behavior item. A higher score indicates increased behavioral problems. ANALYSIS Independent samples t-tests were conducted to assess whether there is a difference in the occurrence of problematic mealtime behaviors (MBQ) between children with clinical and sub- clinical levels of general behavior problems (PSC). A stepwise multiple regression was conducted to identify the individual contribution of general behavior problems (PSC) on problematic mealtime behaviors (MBQ). The variables of child age and health status were controlled for as younger children and children with chronic medical conditions are more commonly found to have problems associated with feeding. INTRODUCTION METHODS SPECIFIC OBJECTIVES The primary objective of the current investigation is to further examine whether general behavior problems are associated with feeding problems in a community sample. RESULTS Seven percent of children were reported to have clinical levels of behavioral problems based on the PSC Total Score clinical cut-offs. Independent samples t-tests demonstrated that children with scores falling into the clinical range on the PSC were found to have significantly higher scores on the MBQ, t(506) = , p <.001. The results of the multiple regression analyses suggest that when controlling for child age and health status, general behavioral problems were found to be a significant predictor of problematic mealtime behaviors (R 2 =.464, F(1, 500) = , p <.001). Additionally, child age was found to have a significant, negative correlation with problematic mealtime behaviors (r = -.396, p <.001). The current study suggests that general behavioral problems are associated with problematic mealtime behaviors. These findings demonstrate that children who exhibit general behavioral problems may be at greater risk for developing clinically significant feeding problems. Pediatric providers should be aware of the co-association of feeding problems and general behavior problems in young children and assess the need for intervention around both conditions whenever either is brought up by parents. Future investigations should further examine the overall significance of behavioral problems in the development of feeding problems as well as the level of variability that behavioral problems contribute to the etiology and maintenance of these problems. Additionally, the current study was conducted using a community sample. Future studies should examine whether these findings are replicated within a sample of children with diagnosed clinical feeding problems. Poster presented to the 2011 National Conference of Pediatric Psychology, San Antonio, TX. Correspondence to Figure 1. MBQ Scores by Behavior Level Table 2. Multiple Regression _______________________________________________________________________________________ Variable ß r 2 F Sig. _______________________________________________________________________________________ Model 1Child Age Chronic Condition Model 2Child Age Chronic Condition PSC Total Child Age Medical Condition PSC Total _______________________________________________________ MBQ Total -.396* * Child Age Medical Condition -.229* _______________________________________________________ * indicates significance levels of p <.05 Table 1. Pearson Correlation Table