The convergent validity of a Dutch Screening tool for Dysphagia (Signaleringslijst Verslikken) for people with severe or profound intellectual and multiple disabilities

Abstract

Background Dysphagia is potentially life‐threatening and highly prevalent in people with severe/profound intellectual and multiple disabilities (SPIMD). The “Signaleringslijst Verslikken” (SV) is a frequently used Dutch screening tool to detect dysphagia. The aim was to examine the convergent validity of the SV for people with SPIMD. Method Direct support staff completed the SV, with speech and language therapists scoring a validated tool, the Dysphagia Disorders Survey (DDS), for 41 persons with SPIMD, aged ≥50 years. The results were compared for agreement using the McNemar's Test. Results The proportion of agreement was 0.59 (95% CI 0.43–0.72). The SV did not detect dysphagia in 17 participants (44%) who were assessed as having dysphagia according to the DDS. The difference in proportion of detection of dysphagia between the two methods was significant (p < 0.0001). Conclusions The results suggest that the convergent validity of the SV is insufficient: the SV is not sensitive for detecting dysphagia in people with SPIMD.

A scoping review of the evidence for the use of screening tools in people with intellectual disabilities with dysphagia

“…A cross‐sectional study was undertaken by Hedworth et al (2019) to assess the nature/extent of swallowing difficulties in people with intellectual disabilities. A cross‐sectional study was also undertaken by van Timmeren et al (2019) to assess the validity of a screening tool for dysphagia among individuals with intellectual disabilities. Calis et al (2008) conducted a longitudinal study focussed on clinical indicators and dysphagia severity in a sample of children (aged 2–19 years) with severe intellectual disabilities.…”

“…Three studies focussed on all ages (Hedworth et al, 2019; Ottenbacher et al, 1985; Sheppard et al, 2014). Two studies focussed on adults only (Sheppard et al, 2017; van Timmeren et al, 2019) and two on children and young adults aged up to 21.5 years (Calis et al, 2008; Matson & Kuhn, 2001).…”

“…The 15 item DDS was the most frequently used tool. It was used in three studies (Calis et al, 2008, Sheppard et al, 2014, van Timmeren et al, 2019) to assess signs and risks of dysphagia among individuals with intellectual disabilities. This tool included two subscales: (1) The eight‐item ‘Related Factors’ (RF) subscale focussed on risk factors for swallowing difficulty or choking such as age, body mass index, diet consistency, feeding techniques, history of coughing at meals, ability to use utensils, medications, seating support and posture and, (2) The seven‐item ‘Feeding and Swallowing Competency’ (FSC) subscale related to signs of dysphagia/swallowing difficulty/choking such as coughing, gurgling, oral transport and chewing.…”

“…Studies were also rated as ‘yes' on queries related to reliability, if they demonstrated a good level of internal reliability between items on their scale (e.g., Calis et al's, 2008; Sheppard et al, 2014). van Timmeren et al's (2019) study was rated as ‘yes” for demonstrating a high proportion of agreement between items on the DDS and SV scales. Studies were assigned ‘unsure” on queries related to reliability if they demonstrated a moderate level of internal reliability on their scales (Ottenbacher et al, 1985; Sheppard et al, 2017) or if they did not report confidence intervals (Hedworth et al, 2019).…”

“…All studies included participants with some level of intellectual disability but the conditions, comorbidities and health status present in the samples were different across all seven studies. Conditions included cerebral palsy (Calis et al, 2008) and visual impairments (van Timmeren et al, 2019). Some studies noted that participants were on multiple medications (Hedworth et al, 2019).…”