Reliability and validity of the Karaduman Chewing Performance Scale in paediatric neuromuscular diseases: A system for classification of chewing disorders

Abstract

Chewing disorders can be seen in children with neuromuscular diseases (NMDs), which may cause swallowing difficulties such as choking, retching and food stuck feeling in the throat. Due to these effects, it is important to determine chewing disorders early with appropriate assessment methods to plan appropriate therapies in NMDs. The aim of this study was to investigate reliability and validity of the Karaduman Chewing Performance Scale (KCPS) in children with NMDs. Age, sex and diagnosis were recorded. Children were asked to chew a standardised biscuit while video-recording. Two physical therapists scored each video according to the KCPS. The correlation between the KCPS scores of 2 therapists was analysed for interobserver reliability. One therapist rescored the recordings after an interval of 2 weeks for intra-observer reliability. The Pediatric Version of the Eating Assessment Tool (PEDI-EAT-10) was used for criterion-based validity. Sixty-eight children with a mean age of 8.34 ± 3.73 (min = 2.5, max = 14.5) years were included, of which 94.1% were male. Karaduman Chewing Performance Scale scores were found to be level 0 in 20 cases, level 1 in 35 cases, level 2 in 12 cases and level 3 in 1 case. A positive, very strong correlation was detected between 2 therapists (r = .93, P < .001) and between 2 examinations of 1 therapist (r = .83, P < .001). A good correlation between the KCPS and PEDI-EAT-10 was detected (r = .62, P < .001). Chewing function, especially food processing phase, deteriorated in children with NMDs. The KCPS could be used as a reliable and valid instrument in determining chewing performance level for children with NMDs.

Evaluation of the Effectiveness of Functional Chewing Training Compared with Standard Treatment in a Population of Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials

“…Each item is rated on a 5-point Likert scale based on the frequency with which particular behaviors occur [ 40 ]. The Karaduman Chewing Performance Scale (KCPS) is a valid, reliable, quick, and clinically easy-to-use instrument to determine the level of chewing function in children [ 41 ]. The Tongue Thrust Rating Scale (TTRS) is the first and only scale that is valid, reliable, quick, and clinically easy-to-use to define tongue thrust severity in children [ 42 ].…”

“…The Karaduman Chewing Performance Scale (KCPS) is a valid, reliable, quick, and clinically easy-to-use instrument to determine the level of chewing function in children [ 41 ].…”

Orofacial functions and oral health: An analysis on children aged 5–8 years old

“…It may be possible to ensure early detection of any problem in the stomatognathic system and needed consultation, by using a reliable and valid screening of the orofacial function in children (Marquezin et al, 2014). Most of the studies on this topic had been reported on a sample of the children with neurological or anatomical problems (Bergendal et al, 2014; Serel Arslan, Aydın, Alemdaroğlu, Tunca Yılmaz, & Karaduman, 2018; Serel Arslan, Kılınç, Yaşaroğlu, Demir, & Karaduman, 2018). Therefore, this study was conducted to show the OFD status and oral health status among healthy children.…”

“…Normal oral functions also contribute to maintaining oral health (Furuta & Yamashita, 2013). Valid, reliable, and clinically easy‐to‐use KCPS is an instrument that shows the chewing performance levels based on the order of functional movements during chewing (Serel Arslan, Aydın, et al, 2018). Chewing disorders and problems generally are characterized by long meal times, increased number of meals, late teething experience, fewer teeth existence, more problematic feeding behavior, and lack of oral motor functions (Gisel & Alphonce, 1995; Serel Arslan et al, 2016).…”

Assessment of Chewing in Children With Down Syndrome

“…In recent years, a team of physiotherapists developed The Karaduman Chewing Performance Scale (KCPS) to determine via observation the overall level of chewing function in children with neuromuscular diseases ( Serel Arslan et al, 2016 ). The authors operationally defined chewing as a predictable sequence of movements from the first step of accepting food within the mouth to the final step of grinding and softening the food via a series of MC ( Serel Arslan et al, 2018 ). The scale was found to be a reliable and valid functional instrument to measure chewing ( Serel Arslan et al, 2018 ).…”