This questionnaire helps identify whether your child's eating habits may indicate ARFID
Personal Information
Assessment Questions
For each question, select the response that is most applicable to your child. This questionnaire is designed to help identify whether your child's eating habits are a flag for the possibility that they are experiencing avoidant/restrictive food intake disorder (ARFID).
Please answer all questions before calculating results.
Q1. Does your child have difficulties with eating – involving avoidance or restriction of certain foods or of overall amount eaten – that are NOT explained by a diagnosed medical condition?
Q2. Are your child's eating habits related to them thinking that they are too big or too heavy?
Q3. Over the past 3 months, has your child's eating led to difficulty maintaining a healthy weight, OR if they are still growing, difficulty gaining enough weight to grow as expected?
Q4. Does your child have any nutritional deficiencies or inadequacies as a result of limited eating (e.g. low iron, low vitamin B12, low vitamin C, etc.)?
Q5. Does your child depend on tube feeding or nutritional supplements to maintain their nutrition, weight or growth (i.e. without these they would have nutritional deficiencies or lose weight)?
Q6. Does your child's eating have a negative effect on their day to day life or their ability to participate in a full range of age-appropriate activities?
Q7. Does your child's eating have a negative effect on your family relationships or other aspects of your family life (e.g. going out together, on holiday, etc.)?
SAS-P Assessment Results
ARFID screening analysis based on validated criteria
0
Total Score
(0-14)
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Screen Result
ARFID Assessment
Scoring Details
Positive Screen Criteria:
• Q1 = "Yes, definitely" (2 points) AND Q2 = "No, not at all" (0 points)
• AND at least one of Q3, Q4, Q5, Q6, or Q7 = "Yes, definitely" (2 points)
• Minimum total score of 4 required
Score Visualization
0
Total Score
Clinical Interpretation
Recommendations:
Important Clinical Information
Screening Tool: The SAS-P is a screening instrument designed to identify patterns that may indicate ARFID. It is not a diagnostic tool.
Professional Evaluation: Positive screens or concerning patterns should be followed up with comprehensive clinical assessment by qualified healthcare professionals.
Research Basis: Based on clinical research by Rachel Bryant-Waugh (2019) and validated assessment criteria for ARFID.
Age Range: This tool is designed for children and adolescents. Clinical interpretation should consider developmental factors.
Copyright: Adapted from "Short ARFID Screen – parent/carer (SAS-P)", by R. Bryant-Waugh, 2019. Copyright 2019 by Rachel Bryant-Waugh. Adapted with permission.