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Reliability of the hazelbaker assessment tool for lingual frenulum function
Lisa H Amir1, Jennifer P James, Susan M Donath
1Key Centre for Women's Health in Society, University of Melbourne, Australia. lamir@unimelb.edu.au.
International Breastfeeding Journal
|May 26, 2006
Summary
The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) shows high reliability for assessing infant tongue-tie. Simplified scoring of the HATLFF is recommended for consistent frenotomy recommendations.
Area of Science:
- Pediatric medicine
- Lactation consulting
- Speech-language pathology
Background:
- Tongue-tie (ankyloglossia) affects approximately 3% of infants, potentially causing breastfeeding difficulties like poor latch and weight gain.
- The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) provides a quantitative method for evaluating tongue-tie severity and guiding frenotomy decisions.
Purpose of the Study:
- To evaluate the inter-rater reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF).
Main Methods:
- Two clinicians independently assessed 58 infants with suspected tongue-tie and 25 control infants using the HATLFF.
- Inter-rater reliability was calculated using kappa statistics for different HATLFF components.
Main Results:
- Appearance items showed moderate reliability (kappa 0.4-0.6).
- The first three Function items (lateralization, lift, extension) demonstrated substantial agreement (kappa >0.65).
- Sucking-related Function items had low reliability; however, frenotomy recommendations showed excellent agreement (kappa 0.92, 96%).
Conclusions:
- The HATLFF demonstrates high overall reliability for assessing tongue-tie in infants.
- A simplified Function Score, excluding sucking items, is proposed for consistent frenotomy recommendations.
