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Evaluating the Use of Telepractice for Bottle-Feeding Assessments
Madeline Raatz1,2, Elizabeth C Ward2,3, Jeanne Marshall1,2
1Speech Pathology Department, Queensland Children's Hospital, Brisbane, QLD 4101, Australia.
Insights
Synchronous telepractice shows high reliability for most bottle-feeding assessments, enhancing accessibility for families. Further research is needed for specific intra-oral components in these remote feeding evaluations.
Area of Science:
- Pediatric feeding and swallowing
- Telehealth and digital health interventions
- Clinical assessment reliability
Background:
- Limited evidence exists for telepractice in pediatric bottle-feeding assessments.
- Telepractice offers potential for increased access to specialized feeding services.
- Assessing inter-rater reliability is crucial for validating remote assessment methods.
Purpose of the Study:
- To determine the inter-rater reliability of synchronous telepractice for bottle-feeding assessments.
- To evaluate parent and clinician satisfaction with telepractice feeding assessments.
- To identify specific components of bottle-feeding assessment suitable for telepractice.
Main Methods:
- Simultaneous remote (telepractice) and in-person assessments of 30 children's bottle-feeding skills.
- Use of a standardized assessment form covering developmental level, oral motor skills, and feeding.
- Comparison of telepractice speech-pathologist (T-SP) and in-person speech-pathologist (IP-SP) ratings using agreement statistics.
Main Results:
- 85% of assessment components met agreement criteria (≥80% exact agreement) between telepractice and in-person assessments.
- High parent and clinician satisfaction reported, with 93% of clinicians willing to offer telepractice again.
- Challenges identified in assessing palate integrity, gagging, and tongue tie components via telepractice.
Conclusions:
- Synchronous telepractice is a reliable method for most bottle-feeding assessment components.
- Telepractice demonstrates high parent and clinician satisfaction, supporting its use in pediatric feeding.
- Further research is necessary to refine telepractice reliability for specific intra-oral feeding assessment elements.
Abstract:
There is currently limited evidence supporting the use of telepractice to conduct bottle-feeding assessments. This study aimed to investigate the inter-rater reliability of bottle-feeding assessments conducted via synchronous telepractice (real-time videoconferencing). Secondary aims were to investigate parent and clinician satisfaction. Bottle-feeding skills of 30 children (aged 1 month-2 years) were simultaneously assessed by a telepractice SP (T-SP) at a remote location and an in-person SP (IP-SP) at the family home. A purpose-designed assessment form was used to evaluate: (1) developmental level (screen only), (2) state, color, and respiration, (3) oral motor skills, (4), infant oral reflexes, (5) tongue tie (screen only), (6) non-nutritive suck, (7) bottle-feeding, (8) overall feeding skills and (9) recommendations. Results of the T-SP and IP-SP assessments were compared using agreement statistics. Parents reported perceptions of telepractice pre and post session, and also rated post-session satisfaction. The telepractice SP completed a satisfaction questionnaire post-appointment. The majority of assessment components (45/53, 85%) met the agreement criteria (≥80% exact agreement). Difficulties were noted for the assessment of palate integrity, gagging during non-nutritive suck assessment, and 6 components of the tongue tie screen. Parent and clinician satisfaction was high; SPs reported that they would offer telepractice services to 93% of families again in the future. Overall, the results demonstrated that most components of a bottle-feeding assessment could be reliably completed via synchronous telepractice in family homes. However, further research is required to improve the reliability of some intra-oral assessment components.
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