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1. Cross-Cultural Adaptation and Validation of the Italian Version of the Montreal Children's Hospital Feeding Scale in a Special Healthcare Needs Population

Author

Sforza, Elisabetta, Onesimo, Roberta, Triumbari, Elizabeth Katherine, Leoni, Chiara, Giorgio, Valentina, Rigante, Donato, Proli, Francesco, Kuczynska, Eliza Maria, Ramsay, Maria, and Zampino, Giuseppe

Abstract

Background: The Montreal Children's Hospital Feeding Scale (MCH-FS) allows paediatricians and other health care professionals to identify feeding difficulties among children. Aim: To translate and adapt the MCH-FS into Italian, and to evaluate the validity and reliability of this Italian version of the Montreal Children's Hospital Feeding Scale (I-MCH-FS). Methods & Procedures: A total of 150 children with special healthcare needs were admitted to the Rare Disease Unit of the Paediatrics Department at the Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy, between March 2021 and March 2022 (74 males; mean age = 3.85 ± 1.96 years; median age = 4 years; age range = 6 months-6 years and 11 months) and 150 healthy participants (83 males; mean age = 3.5 ± 1.98 years; median age = 3 years; age range = 6 months-6 years and 11 months) were included in the study, which was approved by the local ethics committee. The original version of the MCH-FS was translated and cross-cultural adapted through five stages: (1) initial translation, (2) synthesis of the translations, (3) back translation, (4) expert committee and (5) test of the prefinal version. Test-retest reliability and internal consistency were assessed using Pearson r, Spearman r and Cronbach's alpha, respectively. Construct validity was established by comparing data obtained from patients with those of healthy participants using the Mann-Whitney U-test. Outcomes & Results: A Pearson "r" of 0.98, a Spearman "r" of 0.95 and Cronbach's alpha value of 0.86 were obtained. In the clinical group, 40.6% children were classified as having feeding disorders (n = 61), while in the normative group 4.7% were diagnosed with feeding problems (n = 7). Mean total score of the clinical group was significatively different from the normative's. Conclusions & Implications: The I-MCH-FS is a valid and reliable one-page, quick screening tool used to identify feeding disorders among children with special needs in outpatient paediatric setting.

Published
2023
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6. Effects of Early Home Environment on the Mental Development of Down Syndrome Infants.

Author

Piper, Martha C. and Ramsay, Maria K.

Abstract

Changes in the mental development as assessed with the Griffiths Mental Development Scales, of 37 Down's syndrome infants (mean age 8.9 months at outset of study) over a 6-month period were correlated with scores obtained on the Home Observation for Measurement of the Environment (HOME) Inventory. (Author/PHR)

Published
1980

7. The Montreal Children’s Hospital Feeding Scale:relationships with parental report of child eating behaviours and observed feeding interactions

Author

Rogers, Samantha, Ramsay, Maria, Blissett, Jackie, Rogers, Samantha, Ramsay, Maria, and Blissett, Jackie

Abstract

Feeding problems are common, with implications for nutrition, growth and family stress, placing burden on primary care services. The Montreal Children's Hospital Feeding Scale (MCHFS) is a quick and reliable measure of feeding problems for clinical settings, but there is little examination of its relationship to commonly used research measures of parental feeding practice, child eating behaviour and observations of parent-infant interaction at mealtimes. We examined the relationships between the MCHFS, demographics and early feeding history, weight across the first year, parental report of feeding practices and child eating behaviours, and observations of maternal-infant feeding interaction at 1 year. The MCHFS, Comprehensive Feeding Practices Questionnaire (CFPQ) and Child Eating Behaviour Questionnaire (CEBQ) were completed by 69 mothers when their infants were 1-year-old (37 male, 32 female). Infant weight was measured at 1 week, 1 month, 6 months and 1 year. Mothers were observed feeding their infants at 1 year. The MCHFS was reliable (Cronbach's alpha = .90) and showed significant overlap with other measures of feeding and eating. Potential feeding problems were identified in 10 of the children (14%) reflecting similar rates in other community samples. Higher MCHFS scores were associated with lower birthweight and weight across the first year, greater satiety responsiveness, fussiness and slowness in eating, lower enjoyment of food and food responsiveness, and less observed infant food acceptance. Parents of infants with more feeding problems reported less encouragement of balance and variety in their children's diets. Conclusion: MCHFS showed good criterion validity with other parental report measures of eating and observations of mealtime interactions. MCHFS may be a useful tool for researching feeding problems in community samples.

Published
2018

8. The singular power of our repeated preformances of race

Author

Estrada Ramsay, Maria Cecilia

Subjects
Race, Performance, Performativity, Bakhtin
Abstract

This dissertation examines race as cultural identity and specifically what is produced and legitimated when race is expressed on the surface of the body through our daily discourses and repeated performances of those discourses. The framework defines identity as daily and repeated communicative, linguistic and corporeal enactments. It also asks whether there is power in these expressions and whether a self-reflexive approach to these expressions of race as culture could be subversive or transformative. The framework of this dissertation is built on a rejection of the categories of identity as arbitrary and as part of a discourse used to divide, rank and degrade people. The framework is propped up with constructs adapted from the work of Butler, Bakhtin and Foucault's interpretations of power and specifically the idea that labels are the work of power used to police exclude and prohibit. From Foucault I adopted the notion that power does not emanate from a single sovereign source, and is instead disseminated through various actors across multiple relationship networks. From Bakhtin I adopted the metaphor of centripetal or unifying discourses vs. centrifugal or diversifying discourses, which provided clarifying imagery regarding the ways in which power moves inside language, more often than not fixing meanings to objects in limiting and tyrannical ways. Finally, from Butler I adopted the idea of performativity, which defines identities as daily repeated communicative, linguistic and corporeal enactments and explains how discourse is manifested through our bodies such that we might accomplish things with words when we perform with and through powerful discourses. The dissertation concludes that bodies (race) and categories (culture) are not fixed entities but rather engaged in a dialogic process with what has been and could be. Our enactment and engagement of categories give durability and credibility to those discourses and performances in large part through the naturalization created by daily repetition. Furthermore, we can self-reflect on our bodies and performances, the discourses that we have helped sustain, and the possibilities that open up once we understand that there is power in our repeated performances and possibilities in the spaces that open once we halt the repetition.

Published
2014
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31. A 31-Year Evolution in Understanding Poor Growth and Failure to Thrive: From Mother Blame to Appetite Regulation.

Author

Ramsay, Maria

Subjects
*INGESTION disorders in children, *HOSPITALS, *PEDIATRICIANS
Abstract

The author reflects on establishment of the first Failure to Thrive and Feeding Disorders Clinic at the Montreal Children's Hospital (MCH) with a pediatrician in 1988 and the Pediatric Feeding Program (PFP) in 2008 and the poor growth and failure to thrive in appetite regulation in the state.

Published
2016

32. The Thai version of the Montreal Children's Hospital Feeding Scale (MCH-FS): psychometric properties.

Author

Benjasuwantep B, Rattanamongkolgul S, and Ramsay M

Subjects
Caregivers, Child, Preschool, Factor Analysis, Statistical, Feeding and Eating Disorders of Childhood ethnology, Female, Hospitals, Pediatric, Humans, Infant, Male, Psychometrics, ROC Curve, Reproducibility of Results, Thailand, Asian People, Feeding Behavior, Feeding and Eating Disorders of Childhood diagnosis, Surveys and Questionnaires
Abstract

Objective: To standardize and evaluate the psychometric properties of the Thai version of the Montreal Children's Hospital Feeding Scale (MCH-FS)., Material and Method: The MCH-FS was translated and the cultural effects of the Thai version (Thai.MCH-FS) were reviewed. Caregivers of 200 children between the age of12 and 48 months were interviewed and completed the Thai.MCH-FS. In addition to demographic information, each child had a physical exam and anthropometric measures were taken. Each child was classified with or without feeding problems by at least two of three pediatricians who were blind to the results of the feeding scale., Results: Internal consistency for reliability was high (Cronbach's alpha at 0.835). The area under the ROC curve was 0.864. With a discrimination score of 40, both sensitivity (72%) and specificity (80.67%) were at acceptable levels. Factor analysis resulted in three factors accounting for 52.3%. Of the 200 children, 150 children were classified with nofeedingproblems and 50 with feeding problems. There were no significant differences in the characteristics of the two groups; however the Thai.MCH-FS scores were significantly different for the two groups., Conclusion: The Thai version of the MCH-FS has been shown to be a valid and reliable short scale for detecting feeding problems in a pediatric care setting.

Published
2015

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