Reliability and Validity of the Mastication Observation and Evaluation Tool for Chewing Assessment in Children and Adolescents with Autism

Objective: The aim of this study was to evaluate the reliability and convergent validity of the Mastication Observation and Evaluation (MOE) tool in assessing chewing function in children and adolescents with autism (CAwA). Method: All participants were video-recorded while chewing a standardized biscuit. The videos were independently scored by two experienced physical therapists using the MOE tool. One of the physical therapists also rescored the videos after an interval of one week. Intra-rater reliability and inter-rater reliability were analyzed using the intraclass correlation coefficient (ICC). The Karaduman Chewing Performance Scale (KCPS) was used to evaluate the chewing performance levels of participants. The convergent validity of the MOE was examined by assessing its association with the KCPS. Results: This study was completed with 41 participants, with a mean age of 11.42 ± 3.82 years, of whom 85.4% were male. Average-measures intra-rater reliability ICC values for the MOE sub-items ranged from 0.75 to 0.97, and the total=score ICC was found to be 0.96. Average-measures inter-rater reliability ICC values ranged from 0.60 to 0.89 for the sub-items, and the total score ICC was found to be 0.79. A strong and negative correlation was found between the MOE total score and the KCPS score (r= −0.766; p < 0.001), supporting the convergent validity of MOE. Conclusions: This study demonstrates that the MOE has excellent intra-rater reliability and good overall inter-rater reliability for averaged ratings. The association with the KCPS provides evidence supporting its convergent validity for assessing chewing function in CAwA. Due to its multidimensional observational approach, the MOE may contribute to clinical assessment by providing information not only on overall chewing performance but also on affected components of chewing function.