Assessment Across the Life Span: The Clinical Swallow Evaluation

Garand, Kendrea L Focht; McCullough, Gary H.; Crary, Michael A.; Arvedson, Joan C.; Dodrill, Pamela

doi:10.1044/2020_ajslp-19-00063

Cited by 38 publications

(31 citation statements)

References 80 publications

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“…A purpose-designed assessment form (attached in Supplemental Material S1) was developed by the authors as no available fit-for-purpose standardized protocol encompassing all required elements was available (Benfer et al, 2012;Garand et al, 2020;Heckathorn et al, 2016). The form was developed incorporating various assessment parameters/measures based on multiple reference sources (American Speech-Language-Hearing Association, n.d.; Arvedson et al, 2020;Brodsky, 1989;Dodrill, 2016a;Morris & Klein, 2000;Redstone & West, 2004;Sellers et al, 2014;Skuse et al, 1995;Thomas-Stonell & Greenberg, 1988).…”

Section: The Feeding Assessment Formmentioning

confidence: 99%

Evaluating the Use of Telepractice to Deliver Pediatric Feeding Assessments

Raatz

Ward

Marshall

et al. 2021

Am J Speech Lang Pathol

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Purpose This study aimed to investigate the interrater reliability of pediatric feeding assessments conducted via synchronous (real-time) telepractice. Secondary aims were to investigate parent and clinician satisfaction. Method The eating and/or cup drinking skills of 40 children (aged 4 months to 7 years) were simultaneously assessed by one speech-language pathologist (SLP) leading the appointment via telepractice and a second SLP present in the family home. A purpose-designed assessment form was used to assess (a) positioning, (b) development, (c) oral sensorimotor function, (d) prefeeding respiratory status, (e) observation of eating and drinking, (f) parent–child interaction, (g) overall feeding skills, and (h) feeding recommendations. The telepractice SLP completed a postappointment satisfaction questionnaire, and parents completed five questionnaires specifically investigating perceptions of and satisfaction with the telepractice feeding appointment. Results Agreement for all assessment components except intraoral examination (palate integrity and tonsils) was > 85%. All appointments were able to be conducted via telepractice, and for 90% of these ( n = 36), clinicians agreed that telepractice was an effective service delivery method. Parents reported high levels of satisfaction with telepractice, with 76% reporting that the telepractice appointment was similar to a traditional in-person appointment. Conclusion Study results demonstrated that synchronous pediatric feeding assessments conducted in family homes via telepractice were feasible, reliable, and acceptable to both clinicians and parents. Supplemental Material https://doi.org/10.23641/asha.14700228

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Section: The Feeding Assessment Formmentioning

confidence: 99%

Evaluating the Use of Telepractice to Deliver Pediatric Feeding Assessments

Raatz

Ward

Marshall

et al. 2021

Am J Speech Lang Pathol

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“…Only 18.7% of aspirations were silent. This is a moderate rate compared to other studies [20]. It is worth noting that the diagnosis of no dysphagia was referred to as absence of pharyngeal swallowing pathologies in FEES.…”

Section: Clinical Observationsmentioning

confidence: 70%

“…Similar inaccuracies are also apparent in other studies. As recently reported by Garand et al [20], there is a great need for specific guidelines even in CSE.…”

Section: Challenges and Future Perspectivesmentioning

confidence: 92%

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Pediatric Flexible Endoscopic Evaluation of Swallowing: Critical Analysis of Implementation and Future Perspectives

et al. 2021

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This study aimed to critically review pediatric swallowing assessment data to determine the future need for standardized procedures. A retrospective analysis of 152 swallowing examinations in 128 children aged 21 days to 18 years was performed. The children were presented at a university dysphagia center between January 2015 and June 2020 for flexible-endoscopic evaluation of swallowing (FEES). Descriptive analysis was conducted for the sample, swallowing pathologies, diagnosis, and missing values. Using binary logistic regression, the relationship between dysphagia and underlying diseases was investigated. The largest group with a common diagnosis in the cohort were children with genetic syndromes (n = 43). Sixty-nine children were diagnosed with dysphagia and 59 without dysphagia. The non-dysphagic group included 15 patients with a behavioral feeding disorder. The presence of an underlying disease significantly increased the chance of a swallowing problem (OR 13.08, 95% CI 3.66 to 46.65, p = .00). In particular, the categories genetic syndrome (OR 2.60, 95% CI 1.15 to 5.88) and neurologic disorder (OR 4.23, 95% CI 1.31 to 13.69) were associated with higher odds for dysphagia. All pediatric FEES were performed without complications, with a completion rate of 96.7%, and with a broad variability of implementation. Several charts lacked information concerning swallowing pathologies, though. Generally, a more standardized protocol and documentation for pediatric FEES is needed to enable better comparability of studies on epidemiology, assessment, and treatment outcomes in future.

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“…Swallowing function is typically first evaluated at bedside, either by a dysphagia screen or by thorough evaluation of orofacial structure and function by a speech-language pathologist. Although it is an integral part of swallowing evaluation, there is consensus among the dysphagia community that instrumented approaches are instead the only ways to assess certain aspects of swallowing physiology, such as airway protection, bolus propulsion, and pharyngeal residue, to name a few [ 5 ].…”

Section: What Does Post-stroke Dysphagia Look Like?mentioning

confidence: 99%

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

Jones¹,

Colletti

Ding

2020

Curr Neurol Neurosci Rep

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Purpose of Review We explored themes in recent post-stroke dysphagia literature, focusing on the following questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia? Recent Findings There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Summary Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.

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Assessment Across the Life Span: The Clinical Swallow Evaluation

Cited by 38 publications

References 80 publications

Evaluating the Use of Telepractice to Deliver Pediatric Feeding Assessments

Evaluating the Use of Telepractice to Deliver Pediatric Feeding Assessments

Pediatric Flexible Endoscopic Evaluation of Swallowing: Critical Analysis of Implementation and Future Perspectives

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

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