Concurrent Use of Videofluoroscopic and Nutritional Intake Measures in the Assessment of Pediatric Patients With...

The videofluoroscopic swallowing study (VFSS) is a radiographic procedure that assesses swallowing physiology in real time by visualizing bolus flow in coordination with structural movement throughout the upper aerodigestive tract. Nutritional intake measures are intended to identify restrictions placed on a patient's method of nutritional intake. There is a lack of rigorous evidence to inform recommendations about appropriate and adequate means of nutritional intake. The purpose of this scoping review was to explore the type and validity of nutritional intake measures and how they are used with VFSS findings to inform nutritional intake recommendations by speech-language pathologists in children (birth to 17 years of age) with dysphagia.

A comprehensive search of the literature was completed in accordance with the Joanna Briggs Institute methodological recommendations and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews reporting guidelines. Relevant electronic databases and gray literature were searched without any date restrictions. Reviewers were blinded via Rayyan software. Data were extracted using a data extraction tool created by the research team.

Twenty articles met inclusion and exclusion criteria and were included for review. Articles included were from eight different countries, published between the years 2010 and 2024, and included a variety of patient populations and objectives. VFSS administration and nutritional intake measure usage were variable, with fluctuating levels of validity.

At present, there is no one nutritional intake measure that is consistently administered to all pediatric populations jointly with VFSS administration. The current investigation only looked at nutritional intake measures used jointly with VFSS. Other nutritional intake measures exist and are worth exploring as potential assessment options in clinical practice.

There is an evident need for the development of nutritional intake measures with strong validity and reliability that consider physiologic impairments observed during VFSS to inform clinical recommendations.