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Oropharyngeal Dysphagia and Cerebral Palsy

Katherine A Benfer1, Kelly A Weir2,3, Kristie L Bell4,5

  • 1Queensland Cerebral Palsy and Rehabilitation Research Centre and katherine.benfer@uqconnect.edu.au.

Pediatrics
|November 24, 2017
PubMed

Insights

Oropharyngeal dysphagia (OPD) in children with cerebral palsy (CP) significantly decreased from 79.7% at 18-24 months to 43.5% by 60 months. Improvement was most noted in those with better gross motor function (GMFCS I-II).

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Speech-Language Pathology

Background:

  • Oropharyngeal dysphagia (OPD) is a common complication in children with cerebral palsy (CP).
  • Gross Motor Function Classification System (GMFCS) is a key indicator of functional ability in children with CP.
  • Understanding the progression of OPD in relation to motor function is crucial for timely intervention.

Purpose of the Study:

  • To investigate the longitudinal progression of oropharyngeal dysphagia (OPD) in preschool-aged children with cerebral palsy (CP).
  • To examine the relationship between OPD progression and gross motor function, as classified by the Gross Motor Function Classification System (GMFCS).

Main Methods:

  • A longitudinal, population-based cohort study included 179 children with CP (aged 18-60 months at entry).
  • Oropharyngeal dysphagia (OPD) was assessed using the Dysphagia Disorders Survey (DDS) and rated from video by certified speech pathologists.
  • Children were classified into GMFCS levels (I-V) to categorize their gross motor function.

Main Results:

  • OPD prevalence decreased from 79.7% at 18-24 months to 43.5% at 60 months.
  • Decreasing odds of OPD were associated with increasing age (OR=0.92) and increasing odds with poorer gross motor function (OR=6.2).
  • Significant OPD reduction was observed in ambulatory children (GMFCS I-II), but not in those with more severe motor impairment (GMFCS III-V).

Conclusions:

  • Approximately half of preschool children with CP experienced resolution of OPD by 60 months, particularly those with better motor function (GMFCS I-II).
  • The findings suggest that OPD progression is influenced by gross motor function.
  • A more conservative DDS cut-off (6/22) between 18-48 months is recommended for better identification of children with persistent OPD at 60 months.
Abstract

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