Preliminary psychometric performance of the Neonatal Feeding Assessment Scale

Abstract

ObjectiveThe objective was to determine the preliminary psychometric performance of a new clinical feeding scale to diagnose oropharyngeal dysphagia (OPD) in neonates.MethodsTwenty neonates with a median gestational age of 35 weeks were evaluated using the Neonatal Feeding Assessment Scale (NFAS) and modified barium swallow studies (MBSS). The results were compared.ResultsNine of the 20 participants presented with OPD on the NFAS. Comparison of the scale’s results with instrumental MBSS indicated that all participants without OPD were correctly excluded (100% sensitivity). The specificity was 78.6%, indicating that three participants were falsely identified with OPD on the scale. Inter-rater reliability was determined on 50% (n = 10) of the sample. Substantial agreement (80%) was obtained between two raters in five of the six sections of the scale and on the diagnostic outcome.ConclusionThe preliminary performance of the scale appears to be promising. A further validation study will take place.

Reliability and validity of the neonatal feeding assessment scale (NFAS) for the early identification of dysphagia in moderate to late preterm neonates

“…Medical records and parental interviews were used to obtain additional information. The NFAS 16 and a MBSS checklist was developed for use in this study. 19 The philosophy underlying the NFAS and a detailed description of the instrument is available in previously published articles.…”

“…A valid instrument to address early identification of OPD remains unavailable for the neonatal population. 3 Development of the Neonatal Feeding Assessment Scale (NFAS) 16 began in response to the need for an efficient, objective, and clinically valid means, to reliably identify OPD in high-risk neonates. Consequently, the research question for the current study was: 'Is the NFAS a valid and reliable assessment instrument for the early identification of OPD in premature neonates?…”

Feeding difficulties in infants with unrepaired cleft lip and palate and HIV-exposure

“…Symptoms of OPD may include uncoordinated tongue movements during NNS and NS, poor/weak sucking response, and coughing or gurgling during/after swallowing23. Criterion validity and inter-rater reliability of the NFAS was established with very young LBW/PTB infants24. The NFAS was supplemented with an objective measure.…”

“…Some participant's feeds were shorter than five minutes which meant that the combined proficiency could not be measured to determine the level of OFS as intended. The combined proficiency of feeding is the volume of milk taken during the first five minutes divided by the total volume of milk prescribed in millilitres and the rate of milk transfer per minute24. The aim of this measurement was therefore to compare the effectiveness of OFS between the RG and CG as described in the results.…”

Prevalence and associated prenatal and perinatal risk factors for oropharyngeal dysphagia in high-risk neonates in a South African hospital

“…Most studies are conducted in high-income countries, where findings may not be generalisable to LMICs (McKinney et al, 2016). Neonatal OPD may be transient and vary in degree, where mild conditions are not reported, contributing to the challenge of identifying OPD (Viviers, Kritzinger, Vinck, & Graham, 2017). Thus, there is a need for better population-based data to gain an improved understanding of OPD in high-risk infants in neonatal care in LMICs (Jahan et al, 2018).…”