Weight Estimation in Children and Adolescents with Autism Spectrum Disorder (ASD) And/Or Attention Deficit Hyperactive Disorder (ADHD): A Comparison Between Mercy and Cattermole Methods

Abstract

Abstract Weight is an essential parameter in identifying nutritional status in children with special healthcare needs including children with autism spectrum disorder (ASD) and Attention Deficit Hyperactive Disorder (ADHD). However, weight measurement using a standard scale is challenging especially for children who are nervous and uncooperative. Therefore, this study aims to determine the accuracy of the weight estimation methods between Mercy and Cattermole in estimating weight in children with ASD and/or ADHD at selected community-based rehabilitation (CBR) centers located in Selangor, Kuala Lumpur, and Negeri Sembilan. A total of 198 children with ASD and/or ADHD aged 2-18 years participated in the cross-sectional study through a convenience sampling technique. Anthropometric measurements included weight, humeral length, and mid-upper arm circumference (MUAC) were measured and applied to two distinct methods for estimating weight, Cattermole and Mercy. Mean error (ME), mean percentage error (MPE), root mean square error (RMSE), limits of agreement (LoA), and intra-class correlation coefficient (ICC) were used to determine the validity, reliability, and agreement between estimated weight and actual weight. The mean age of children was 8.07 years (SD: 3.72). The Mercy method demonstrated the smallest degree of bias including absolute MPE (-1.9 ± 11.1% vs. 12.0 ± 21.5%), and RMSE (3.36 kg vs. 6.19 kg). Mercy had the highest ICC value (0.988 vs. 0.954) and the estimated weight was within 20% of the actual weight in the majority of subjects (93.9% vs. 63.1%) compared to Cattermole method. The Mercy method provides the best option for weight estimation in Malaysian children with ASD and/or ADHD aged between 2 to 18 years old if the standard weight measurement is unavailable.