Related Experiment Video
Updated: Mar 15, 2026
Assessment of Spatial Lingual Tactile Sensitivity using a Gratings Orientation Test
Published on: September 17, 2021
Intra- and Inter-Rater Reliability of Tongue Physical Function Assessments in Children
Pierre Cnockaert1,2, Apolline Fondeur2, Elsa Gabillet2
1Pole of Pulmonology, ENT and Dermatology (LUNS), Institute of Experimental and Clinical Research (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgium.
Insights
This study validates a new method for measuring tongue protrusion in children, finding it reliable for clinical use. These tongue function assessments are crucial for feeding, sleep, and airway patency.
Area of Science:
- Pediatric medicine
- Speech-language pathology
- Biomechanics
Background:
- Tongue function is vital for feeding, sleep, and airway patency.
- Standardized methods for assessing tongue protrusion in children are lacking.
- Reliability of existing tongue function assessments in pediatric populations is underexplored.
Purpose of the Study:
- To evaluate the reliability of a novel 3D-printed stand method for measuring tongue protrusion.
- To assess the intra- and inter-rater reliability of established tongue function measurements in children.
Main Methods:
- Fifty-six children (4-17 years) participated in reliability testing over three visits.
- Tongue protrusion and elevation strength/endurance, swallowing pressure (IOPI), mobility (MBLF-t), and frenulum restriction (TRMR) were measured.
- Intraclass correlation coefficients (ICCs) were used to analyze reliability.
Main Results:
- The novel tongue protrusion method demonstrated good to excellent intra- and inter-rater reliability.
- Most tested tongue functions showed good reliability, with slight variations in specific measures like protrusion strength.
- The Iowa Oral Performance Instrument (IOPI) based protrusion measurement showed good reliability.
Conclusions:
- Tongue function assessments, including the new IOPI-based protrusion method, are reliable for pediatric populations.
- These validated methods can be confidently used in future research and clinical settings.
- Reliable tongue function measurement supports better diagnosis and management of related conditions.
Background:
Tongue function is critical for essential activities such as feeding and sleep. In particular, tongue protrusion plays a key role in maintaining airway patency during sleep. However, standardised protocols for measuring tongue protrusion are lacking, and the reliability of tongue function assessments in children remains underexplored.
Objectives:
To assess the intra- and inter-rater reliability of a novel tongue protrusion measurement method using a 3D-printed stand, alongside established tongue measurements.
Methods:
Fifty-six children aged 4 to 17 years underwent two successive visits with the same rater and a third visit with a different rater, each spaced 1-4 weeks apart. Tongue protrusion strength (pProt) and endurance (eProt), elevation strength (pElev) and endurance (eElev), and tongue pressure during swallowing (pSwal) were assessed using the Iowa Oral Performance Instrument (IOPI). An adjustable 3D-printed stand was developed and used to standardise the protrusion task. Tongue mobility was assessed using the Motricité Bucco-Linguo-Faciale tongue subscore (MBLF-t), and mobility restriction due to the frenulum was measured with the Tongue Range of Motion Ratio (TRMR). Reliability was analysed using intraclass correlation coefficients (ICCs).
Results:
pProt showed good intra-rater reliability and moderate inter-rater reliability, while eProt demonstrated excellent intra-rater and good inter-rater reliability. All other outcomes exhibited at least good intra- and inter-rater reliability, except for pElev, which showed slightly lower inter-rater reliability (ICC = 0.73).
Conclusion:
This study highlights the reliability of tongue function assessments, including a novel IOPI-based protrusion measurement method, supporting their use in future research and clinical practice.
Trial Registration:
ClinicalTrials.gov ID: NCT06166680.
Related Concept Videos
01:26Assessment of the Mouth
Mouth Inspection
The inspection begins with visually examining the mouth for symmetry, color, and size.
01:01Tongue
Anatomical Position in the Oral Cavity
The tongue is located within the oral cavity, also known as the mouth. It is attached to the floor of the mouth by a fold of mucous membrane called the...
01:24Physical Assessment of the Respiratory Tract II: Palpation
Thoracic Palpation
Thoracic palpation detects tenderness, masses, lesions, respiratory excursions, and vocal fremitus. The nurse assesses...