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Development and validation of a screening tool for feeding/swallowing difficulties and undernutrition in children

Kristie L Bell1,2, Katherine A Benfer3, Robert S Ware4

  • 1Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.

Developmental Medicine and Child Neurology
|April 3, 2019
PubMed

Insights

A new 4-item screening tool effectively identifies feeding/swallowing issues and undernutrition in children with cerebral palsy (CP). This tool aids early detection and management for improved health outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Neurology
  • Clinical Nutrition

Background:

  • Children with cerebral palsy (CP) often experience feeding and swallowing difficulties.
  • Undernutrition is a common comorbidity in children with CP, impacting growth and development.
  • Existing screening methods may not adequately address both feeding/swallowing issues and nutritional status.

Purpose of the Study:

  • To develop and validate a novel screening tool for identifying feeding/swallowing difficulties and/or undernutrition in children with CP.
  • To assess the sensitivity and specificity of the developed screening tool.

Main Methods:

  • A cross-sectional, observational study involving 89 children with CP (excluding those with feeding tubes).
  • Nutritional status assessed using the pediatric Subjective Global Nutrition Assessment.
  • Eating and drinking abilities classified using the Eating and Drinking Ability Classification System (EDACS).
  • Parents/caregivers completed a 33-item questionnaire; a 4-item tool was finalized based on diagnostic ability.

Main Results:

  • Feeding difficulties affected swallow safety in 29% of children; 29% were undernourished.
  • The final 4-item tool demonstrated high sensitivity and specificity for feeding/swallowing difficulties (81%, 79%) and undernutrition (72%, 75%).
  • The tool achieved 100% sensitivity for severe undernutrition and for EDACS levels IV/V.

Conclusions:

  • The developed 4-item screening tool is effective in identifying children with cerebral palsy who have feeding/swallowing difficulties and/or undernutrition.
  • Early identification through this tool can facilitate timely assessment and management, improving patient outcomes.
  • This validated tool offers a practical approach for clinicians to screen vulnerable pediatric populations.
Abstract

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