Predictors and outcomes of the Neonatal Oral Motor Assessment Scale (NOMAS) performance: a systematic review

Abstract

The present review highlights benefits and limitations of the NOMAS. Future research is needed to develop observational and clinically-relevant tools to better identify newborns which are at lower- and higher-risk of developing less-than-optimal feeding behaviors and to guide with greater precision the diagnostic and therapeutic journey of these newborns. What is Known: • The assessment of oral-motor skills in newborns and infants is critical for early intervention • The NOMAS is the most adopted tool to assess oral-motor skills in newborns and infants What is New: • The ability of the NOMAS to target newborn at risk for feeding disorders is confirmed • Nonetheless, the capacity to predict long-term developmental outcomes is limited.

Functional Evaluation of Eating Difficulties Scale to predict oral motor skills in infants with neurodevelopmental disorders: a longitudinal study

“…As for false‐negative cases, it is notable that over 80% of infants identified as low risk during hospitalization based on FEEDS score were actually able to feed autonomously 24 months after discharge. Previous systematic reviews have highlighted that the major limitations of available tools for oral motor assessment in newborn infants are a lack of reliability and/or predictive validity . As such, taken together with previous appreciation of the interrater reliability of the FEEDS, the present findings suggest that this instrument might be a well‐validated, non‐invasive, and non‐time‐consuming approach to support clinical evaluations and decision‐making in clinical practice.…”

“…The early detection and evaluation of oral motor abilities allows clinicians to identify, monitor, and manage feeding problems. Available assessment tools often did not present adequate reliability and validity and their psychometric properties are not systematically available . Additionally, there is no general consensus on which instruments work best to assess feeding modalities in at‐risk infants diagnosed with neurodevelopmental disabilities .…”

“…Available assessment tools often did not present adequate reliability and validity and their psychometric properties are not systematically available . Additionally, there is no general consensus on which instruments work best to assess feeding modalities in at‐risk infants diagnosed with neurodevelopmental disabilities . Finally, no assessment tool has been specifically developed for infants with neurodevelopmental disabilities or has demonstrated adequate interrater reliability and robust predictive validity .…”

“…Additionally, there is no general consensus on which instruments work best to assess feeding modalities in at‐risk infants diagnosed with neurodevelopmental disabilities . Finally, no assessment tool has been specifically developed for infants with neurodevelopmental disabilities or has demonstrated adequate interrater reliability and robust predictive validity . As such, in these infants, the early assessment of oral motor impairments and the clinical evaluation of potential eating difficulties is largely based on qualitative and subjective clinical observations during meal times and it is limited to the assessment of safety and competent oral motor skills.…”

Impact of a pre-feeding oral stimulation program on first feed attempt in preterm infants: Double-blind controlled clinical trial

“…The strength of our study is that, differently of NOMAS [18], which assesses oral-motor skills, we have had an approach to aptitude of first oral feed, as well as to sucking, swallowing, and breathing coordination, involving cognitive aspects.…”