Assessing children’s swallowing: parent and professional perceptions

Abstract

This is the accepted version of the paper.This version of the publication may differ from the final published version. Contact author: C.Harding C.Harding@city.ac.uk Permanent repository link Conflicts of Interest and Source of FundingThere are no conflicts of interest to declare.This was a pilot project which received no funding. Acknowledgements:The authors wish to thank the parents and referrers for participating and Candice Margolis for collecting the data. Thanks also to the paediatric speech and language therapy team at The Evelina Hospital and A. Hollings, Dr.N.Botting and Dr.K.Hilari. Abstract:Purpose: For infants and children who have difficulties with eating, drinking and swallowing, (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the 2 instrumental method of assessment used to exclude or confirm aspiration. This exploratory review investigated parental and referrer expectations of videofluoroscopy.Design/methodology/approach: Data were gathered through the use of structured telephone interviews before and after videofluoroscopy.Findings: Four key themes emerged: 1) The importance of identifying specifically the problems with swallowing; 2) understanding the rationale for videofluoroscopy; 3) preparing a child for videofluoroscopy, and 4) using videofluoroscopy to inform management. Referrers used videofluoroscopy to confirm their concerns about a child's ability to swallow safely. Practical implications:Parents understood that the videofluoroscopy was to identify specific swallowing difficulties. They reported anxieties with managing the child's positioning during the procedure and if the child would eat. They also had concerns about outcomes from the study. Some of these issues raise questions about the true value and benefits of videofluoroscopy.Originality /value: This is the first study that considers parent views of an instrumental assessment. For some parents of children with learning disabilities, mealtimes are an important social occasion. Further studies that focus on decision making about children with learning disabilities who find feeding difficult are warranted as parents feel loss and disempowerment when decisions are made about non -oral feeding.