4.2.1. Nine-Item Avoidant/Restrictive Food Intake Disorder (ARFID) Screen (NIAS)

At the time this study was conducted, there was no validated measure for assessing symptoms of ARFID in children, so the NIAS (21) was adapted in the surveys to collect responses for parents as well as probands. The 9 items in this measure assess three categories of eating disturbance that can lead to ARFID symptoms, as described in the DSM-5: avoidance of many foods based on sensory properties, low appetite or limited interest in eating, and fear of negative consequences (i.e., choking, vomiting) from eating. The scale demonstrated high internal consistency (alpha ranging from 0.79 in an undergraduate sample to 0.90 in a sample with familial eating problem behaviors). One item in this measure simply asks respondents to self-identify picky eating behavior, which has been shown to distinguish picky from non-picky eaters in and of itself (31–34).