Validation of the Teddy the Bear hunger and satiety rating scale in 3-5-year-old children

Using validated measures to assess children's hunger and satiety is important for eating behaviour research. Pictorial rating scales, such as the Teddy the Bear hunger and satiety rating scale (Bennett & Blissett, 2014), provide a child-friendly approach to assess hunger and satiety. The Teddy the Bear scale has been validated for use with primary school aged children (5-9 years); however, the scale has not been validated for use with preschoolers (3-5 years). Children's hunger ratings may also differ depending on individual characteristics, for example, their eating profile, but this remains to be examined. Hence, this validation study included preschool children aged 3-5-years-old (N = 115, 45 male, 70 female) who had been identified as having either typical (n = 76) or avid (n = 39) eating behaviour profiles. Children consumed a standardised meal and rated their pre- and post-meal hunger using the Teddy the Bear scale. Differences in pre- and post-meal ratings between children with typical and avid eating profiles, and differences in ratings of boys and girls were also examined. Findings showed that children reported lower hunger ratings after a standardised meal, compared to before a standardised meal. There was no difference in hunger ratings between children's eating profiles. However, exploratory analyses demonstrated that greater probability of having an avid eating profile was associated with greater change in ratings, and that greater energy intake was significantly associated with greater change in ratings. Overall, the Teddy the Bear scale may be a valid measure for assessing preschool children's hunger and satiety which is sufficiently sensitive to capture changes resulting from ingesting a meal. However, the scale may be less suitable for use with children aged 3 years.