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Feeding development in healthy infants: A comparative framework for children with Spinal Muscular Atrophy - The
Charlotte Dumitrascu1, Christina Pflug1, Jun Oh2
1Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Germany.
Insights
This study established normative data for the Dysphagia in Spinal Muscular Atrophy (DySMA) tool in healthy infants. The DySMA effectively tracks feeding development, aiding in the assessment of children with Spinal Muscular Atrophy (SMA).
Area of Science:
- Pediatric Swallowing and Feeding
- Neuromuscular Disorders
- Clinical Diagnostics
Background:
- Limited normative data exists for swallowing parameters in healthy children, crucial for diagnosing conditions like Spinal Muscular Atrophy (SMA).
- Early detection of swallowing dysfunction in SMA is vital, even with disease-modifying therapies, necessitating reliable assessment tools.
Purpose of the Study:
- To generate normative data for the Dysphagia in Spinal Muscular Atrophy (DySMA) tool in a healthy infant population.
- To establish a benchmark for comparing swallowing and feeding abilities in infants with and without SMA.
Main Methods:
- Recruitment of healthy infants and toddlers aged 0-24 months, stratified into seven age groups.
- Assessment using the DySMA protocol by two certified speech-language pathologists.
- Descriptive statistical analysis and inter-rater reliability testing (ICC).
Main Results:
- 92 healthy children were analyzed, with DySMA scores ranging from 21 to 35.
- Excellent inter-rater reliability (ICC = .936) was demonstrated for the DySMA tool.
- Physiological development categories showed significant age-dependent changes, unlike pathology categories.
Conclusions:
- The DySMA tool accurately reflects physiological feeding development in infants and toddlers.
- Higher DySMA scores correlate with broader skill sets, while lower scores indicate limitations.
- This normative data enables the identification of deviations from typical development in children with SMA.
Objectives:
Normative data for swallowing parameters in non-dysphagic, healthy children for instrumental and clinical diagnostics are limited. In children with SMA, where due to the degenerative nature a deterioration in swallowing function in the first months of life is possible despite disease-modifying therapy, regular monitoring is required. The DySMA (Dysphagia in Spinal Muscular Atrophy) is a tool available to assess both physiological feeding development and specific abnormalities in children with SMA. We aimed to generate normative data for the DySMA in a sample of healthy infants to facilitate comparisons with children with SMA.
Methods:
Healthy infants and toddlers aged zero to 24 months were recruited and divided into seven age groups. Two speech-language pathologists assessed the children according to the DySMA study protocol. The data were evaluated descriptively and the inter-rater reliability was calculated.
Results:
A total of 92 healthy children were included. The DySMA total score ranged from 21 to 35 and showed excellent inter-rater reliability (ICC = .936; 95 % CI .752 to .984). The maximum score of 35 was first reached from 16 months onwards. Categories representing physiological development showed the most significant age-dependent changes, while no age-related development was observed in categories expressing pathology.
Conclusion:
The DySMA effectively captures physiological feeding development. A higher total score reflects more comprehensive skills in children, while a lower score indicates a reduced range of abilities. By analyzing the normative sample, this tool makes it possible to represent a deviation from the norm for children with SMA.
