Clinical Usefulness of Schedule for Oral-Motor Assessment (SOMA) in Children with Dysphagia

Abstract

ObjectiveTo investigate the clinical usefulness of the Schedule for Oral-Motor Assessment (SOMA) in children with dysphagia by comparing findings of SOMA with those of the videofluoroscopic swallowing study (VFSS).MethodBoth SOMA and VFSS were performed in 33 children with dysphagia (21 boys and 12 girls; mean age 17.3±12.1 months) who were referred for oropharyngeal evaluation. Ratings of oral-motor functions indicated by SOMA were based upon the cutting score of each specific texture of food (puree, semi-solids, solids, cracker, liquid-bottle, and liquid-cup). Abnormalities of either the oral phase, or the pharyngeal phase as indicated by VFSS were assessed by a physician and a speech-language pathologist.ResultsThere was significant consistency between the findings of SOMA and the oral phase evaluation by VFSS (Kappa=0.419, p=0.023). SOMA reached 87.5% sensitivity, 66.6% specificity, and 95.4% positive predictive value when compared with the oral phase of the VFSS. We were able to evaluate oral-motor function by using SOMA in 6 children who were unable to complete the oral phase evaluation by VFSS, due to fear and crying during the study. The findings of SOMA failed to show any consistency with the pharyngeal phase evaluation by VFSS (Kappa=-0.105, p=0.509).ConclusionThese results suggest that SOMA is a reliable method for evaluation of oral-motor function in children with dysphagia. In particular, SOMA is recommended for children that were unable to complete the oral phase evaluation by VFSS due to poor cooperation.

Diagnostic accuracy of the clinical feeding evaluation in detecting aspiration in children: a systematic review

“…10,11,30 They require the cooperation of the child, and their administration can invoke fear and anxiety in the child, thus they may not reflect the child's typical feeding and swallowing ability. 31 In addition, they require specialist healthcare practitioners and specific machines, and can therefore be highly expensive procedures. Moreover, the invasiveness and the risks associated with their administration limit their use in children with critical clinical conditions for safety reasons.…”

“…Furthermore, instrumental assessments are by their nature brief and may not detect all occurrences of OPA episodes . They require the cooperation of the child, and their administration can invoke fear and anxiety in the child, thus they may not reflect the child's typical feeding and swallowing ability . In addition, they require specialist healthcare practitioners and specific machines, and can therefore be highly expensive procedures.…”

Assessment of feeding and swallowing in children: Validity and reliability of the Ability for Basic Feeding and Swallowing Scale for Children (ABFS-C)

“…A number of assessment methods for children have been reported abroad [3,[11][12][13][14][15]. A systematic review of 27 papers published before 2012 [16] cited the Schedule for Oral Motor Assessment (SOMA) [17] as an excellent assessment method with regard to reliability, validity, and clinical usefulness. This method was aimed at assessing oral motor function and distinguishes between normal and abnormal function by determining whether feeding status for each of 5 food forms exceeded the minimum level.…”

Test-Retest and Inter-Rater Reliability Study of the Schedule for Oral-Motor Assessment in Persian Children

“…If the behavior was seen, a "yes" was ticked on the form; otherwise, a "no" was selected. The assessment of five food textures was performed in triplicates [12,18,19].…”