Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing Performance in Self-Feeding Children With Cerebral Palsy

作者：Mishra, Avinash; Sheppard, Justine J.; Kantarcigil, Cagla; Gordon, Andrew M.; Malandraki, Georgia A.^*

来源：American Journal of Speech-Language Pathology, 2018, 27(1): 99-107.

DOI：10.1044/2017_AJSLP-16-0224

• GROSS MOTOR FUNCTION
• OROPHARYNGEAL DYSPHAGIA
• PEDIATRIC DYSPHAGIA
• PRESCHOOL-CHILDREN
• CLASSIFICATION
• DEGLUTITION
• IMPAIRMENTS
• DYSFUNCTION
• DIFFICULTIES
• PREVALENCE

Purpose: The purpose of this study is to examine (a) the reliability of newly developed measures of mealtime duration and (b) their relationship to clinical feeding/swallowing performance in children with spastic cerebral palsy (SCP).
Method: Seventeen self-feeding children (9 boys, 8 girls) with SCP (age range = 5; 1 [years; months] to 17; 6, Gross Motor Function Classification System range = I-IV) were assessed during mealtimes using the Dysphagia Disorder Survey (DDS; Sheppard, Hochman, & Baer, 2014). Children were divided into 2 groups, children with primarily unilateral or bilateral brain involvement. Duration measures included mealtime duration and total sip/bite duration for each bolus type (liquid and solid).
Results: Excellent intra-and inter-rater reliability for all duration measures was observed (intraclass correlation coefficient [ICC] = 1.00 and 0.955, respectively, for mealtime duration; ICC = 1.00 and 0.963, respectively, for solid/bite duration; ICC = 1.00 and 0.957, respectively, for liquid/sip duration). Positive correlations were found between total mealtime duration and DDS Part 1, r(s) =.514 [. 045-. 797], p =.035; Part 2, r(s) =.528 [. 064-. 804], p =.029; and total scores, rs =.665 [. 271-. 868], p =.004, and between total solid/bite duration and DDS Part 1, rs =.579 [. 137-. 828], p =.015; Part 2, r(s) =.620 [. 199-. 847], p =.007; and total scores, r(s) =.762 [. 444-. 909], p <.001. Children with unilateral brain involvement exhibited significantly lower DDS total (p =.049) and Part 2 scores (p =.026), indicating better feeding/swallowing performance/skills. They also had shorter mealtime duration (p =.019) and solid/bite duration (p =.025) compared with children with bilateral involvement.
Conclusions: Our new mealtime duration measures are reliable and correlate with feeding/swallowing performance in a sample of self-feeding children with SCP. Therefore, they may be useful supplements to feeding/swallowing assessments for this population.

• 出版日期2018-2
• 单位南宁师范大学