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Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing
Avinash Mishra1, Justine J Sheppard1, Cagla Kantarcigil2
1Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.
Insights
New measures of mealtime duration are reliable for children with spastic cerebral palsy (SCP). These measures correlate with feeding and swallowing abilities, aiding clinical assessments.
Area of Science:
- Pediatric feeding and swallowing disorders
- Neurology and developmental disorders
- Clinical measurement and reliability
Background:
- Children with spastic cerebral palsy (SCP) often experience feeding and swallowing difficulties.
- Accurate assessment of mealtime behaviors is crucial for effective intervention.
- Existing measures may not fully capture the nuances of mealtime performance in this population.
Purpose of the Study:
- To evaluate the reliability of novel mealtime duration measures in children with SCP.
- To determine the correlation between these duration measures and clinical feeding/swallowing performance.
- To assess potential differences in duration and performance based on brain involvement (unilateral vs. bilateral).
Main Methods:
- Seventeen children with SCP (ages 5-17, GMFCS I-IV) participated.
- Mealtime duration and sip/bite durations for liquids and solids were recorded.
- The Dysphagia Disorder Survey (DDS) was used to assess feeding/swallowing performance.
Main Results:
- High intra- and inter-rater reliability was found for all duration measures (ICCs ≥ 0.955).
- Positive correlations were observed between mealtime duration measures and DDS scores.
- Children with unilateral brain involvement showed better feeding/swallowing outcomes and shorter meal durations compared to those with bilateral involvement.
Conclusions:
- Newly developed mealtime duration measures demonstrate excellent reliability for children with SCP.
- These measures show significant correlations with clinical feeding and swallowing performance.
- The duration measures can serve as valuable supplementary tools for assessing feeding and swallowing in children with SCP.
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, rs = .514 [.045-.797], p = .035; Part 2, rs = .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, rs = .620 [.199-.847], p = .007; and total scores, rs = .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.
Supplemental Material:
https://doi.org/10.23641/asha.5715076.
