Validated eating disorder screening tools for paediatric populations: a systematic review

Importance: The COVID-19 pandemic has led to a rise in paediatric eating disorder (ED) cases, highlighting the need for validated screening tools, particularly for pre-adolescent children, to enable early detection. Objective: This review aims to systematically evaluate the validation and psychometric properties of screening tools for assessing EDs in the paediatric population, with a focus on pre-adolescents (under 12 years). Evidence Review: A systematic search of Medline (OVID) and PsycInfo (OVID) databases was conducted following Cochrane Rapid Review Guidelines, registered with PROSPERO (CRD42023465366). Studies were selected based on seven criteria, including ED diagnoses (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, binge eating disorder) in children under 12. A random 20% sample was cross-checked for errors. Data extraction followed a pre-defined template with additional independent checks. The primary outcome was the predictive validity of the screening tools. Results: Of 3,911 citations screened, 28 studies (N=25,444) were included, with six focusing on children under 12 (N=1,430). The methods varied, with 18 studies using clinical interviews and 10 using validated questionnaires. Most tools achieved a Level 3 rating on The Rational Clinical Examination Levels of Evidence, indicating methodological limitations. The child version of the Eating Attitudes Test (ChEAT) had the most evidence, though it has not been validated for DSM-5 criteria. Conclusions and Relevance: There is a significant gap in validated ED screening tools for children under 12. Future research should focus on developing tools for this population to improve early detection and treatment outcomes.