Item-Level Psychometrics of the Neonatal Eating Outcome Assessment in Orally Feeding Infants

Abstract

Background: The Neonatal Eating Outcome Assessment determines feeding performance based on the infant’s postmenstrual age (PMA). Objective: To examine item-level measurement properties of this assessment’s rating scale. Methodology: In this retrospective study, Rasch analysis was completed on clinical data from the Neonatal Eating Outcome Assessment for 100 infants (52 preterm and 48 full-term) using Winsteps version 3.93.1. Instead of PMA-based scores, ordered letters converted to numerical scores were analyzed. Results: Analysis demonstrated that Section I (Pre-Feeding Skills) represents a separate construct from Sections II and III (Oral Feeding and End of Feeding, respectively). Sections II and III were adequately unidimensional to complete Rasch analysis. These sections fit the Rasch model overall, but rating scale category underuse was common, which may be attributed to sample characteristics. Implications: This analysis supports using validated ordered letter scoring of Sections II and III to measure oral feeding performance in preterm and full-term newborns.