Objectives: The functional oral intake scale (FOIS), developed for adults based on the categories of consumable food has been adapted for infants. A FOIS for children is necessary as oral motor development continues after 1 year of age. This study proposed a FOIS for children and investigated the reliability and validity of the scale.
Methods: We adapted the original FOIS into a scale for children by removing 2 item levels to generate a 5-point scale. This retrospective study included 194 children ages 1 to 7 years. Their nutrition records were evaluated separately by 2 raters using the FOIS for children. Dysphagia and aspiration severity were evaluated based on the findings from a videofluoroscopic swallowing study. For children partially dependent on tube feeding, medical records were investigated to determine whether full oral feeding was accomplished within 1 year.
Results: The inter-rater reliability of FOIS for children had 97.4% agreement (weighted kappa = 0.985, intraclass correlation coefficient = 0.994). Significant associations were identified between the FOIS for children and aspiration severity (P < 0.001, r = 0.315) and dysphagia severity (P < 0.001, r = 0.287). The rate of reaching full oral feeding within 1 year was greater (71.4% vs 30%) in children at the FOIS 3 level (tube and oral feeding in parallel) than for children at FOIS 2 (tube-dependent with minimal oral intake).
Conclusions: The FOIS for children showed adequate reliability and validity and could be appropriate for documenting children's eating abilities and evaluating the effectiveness of interventions.