Swallowing disorders (dysphagia) and associated risks have increased in young children. Videofluoroscopic swallowing studies (VFSS), the primary method used to evaluate dysphagia, are increasingly performed in bottle-fed children. However, there are no standardized approaches to characterize the type and severity of the swallowing impairment. The goal of this project is to develop and test a standardized measurement tool and scoring schema for the quantification of swallowing impairment in bottle-fed children.
In Aim 1, we will empirically reduce components for the tool into a reliable, parsimonious, and clinically relevant set based on measures of rater reliability and factor analysis from the scoring of 300 VFSS exams by trained speech-language pathologists (SLPs) at two clinical sites. We hypothesize at least 80% reliability within and between SLPs and the final set of components will be distributed into five functional domains.
In Aim 2, we will establish the construct validity of the components within each domain by characterizing the relationship between component scores on the tool and external indicators of health, development, and well-being. We hypothesize that higher scores on the tool (poorer swallowing function), will be associated with poorer indicators of health, development, and well-being.
In Aim 3, we will measure changes in physiologic swallowing impairment scores when different liquid consistencies are introduced during the VFSS. We hypothesize impairment scores will differ between consistencies. These studies will help develop a clinically practical, reliable, and valid standardized tool for assessing, measuring, and reporting physiologic swallowing impairment in bottle-fed children, ultimately resulting in improved diagnosis and management of children with this condition. PUBLIC HEALTH AND SAFETY
Swallowing dysfunction is increasingly common in young children and associated with significant consequences. This study will help to improve the diagnosis, care, and outcomes of affected children by: (1) providing a basis for characterizing and tracking the natural history of swallowing impairments, (2) providing outcome measures for interventions for dysphagia, and (3) serving as biomarkers for clinical trials with children diagnosed with specific diagnostic conditions associated with dysphagia. The standardized, reliable, and validated tool will be available for immediate dissemination through web-based training modules.
Motion x-ray swallow studies are increasingly performed in bottle-fed children to diagnose and treat swallowing problems that impact health and quality of life. Despite the common use of these x-ray studies and the critical decisions made based on findings, there are no standardized objective tools to interpret the information. This project will test a new standardize method of translating the x-ray findings into meaningful clinical information that improves the accuracy of swallowing diagnosis and guides swallowing treatment.
|Tran, Thi Tu Anh; Harris, Bonnie Martin; Pearson Jr, William G (2018) Improvements resulting from respiratory-swallow phase training visualized in patient-specific computational analysis of swallowing mechanics. Comput Methods Biomech Biomed Eng Imaging Vis 6:532-538|
|Lefton-Greif, Maureen A; McGrattan, Katlyn Elizabeth; Carson, Kathryn A et al. (2018) First Steps Towards Development of an Instrument for the Reproducible Quantification of Oropharyngeal Swallow Physiology in Bottle-Fed Children. Dysphagia 33:76-82|
|McGrattan, Katlyn E; McFarland, David H; Dean, Jesse C et al. (2017) Effect of Single-Use, Laser-Cut, Slow-Flow Nipples on Respiration and Milk Ingestion in Preterm Infants. Am J Speech Lang Pathol 26:832-839|
|Wilmskoetter, Janina; Bonilha, Heather; Hong, Ickpyo et al. (2017) Construct validity of the Eating Assessment Tool (EAT-10). Disabil Rehabil :1-11|
|Bonilha, Heather Shaw; Wilmskoetter, Janina; Tipnis, Sameer V et al. (2017) EFFECTIVE DOSE PER UNIT KERMA-AREA PRODUCT CONVERSION FACTORS IN ADULTS UNDERGOING MODIFIED BARIUM SWALLOW STUDIES. Radiat Prot Dosimetry 176:269-277|
|O'Rourke, A; Humphries, K; Lazar, A et al. (2017) The pharyngeal contractile integral is a useful indicator of pharyngeal swallowing impairment. Neurogastroenterol Motil 29:|
|McGrattan, Katlyn Elizabeth; McGhee, Heather; DeToma, Allan et al. (2017) Dysphagia in infants with single ventricle anatomy following stage 1 palliation: Physiologic correlates and response to treatment. Congenit Heart Dis 12:382-388|
|Hazelwood, R Jordan; Armeson, Kent E; Hill, Elizabeth G et al. (2017) Identification of Swallowing Tasks From a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment. J Speech Lang Hear Res 60:1855-1863|
|Martin-Harris, Bonnie; Garand, Kendrea L Focht; McFarland, David (2017) Optimizing Respiratory-Swallowing Coordination in Patients With Oropharyngeal Head and Neck Cancer. Perspect ASHA Spec Interest Groups 2:103-110|
|Pearson Jr, William G; Taylor, Brandon K; Blair, Julie et al. (2016) Computational analysis of swallowing mechanics underlying impaired epiglottic inversion. Laryngoscope 126:1854-8|
Showing the most recent 10 out of 15 publications