Thickener viscosity in dysphagia management: variability among speech-language pathologists

Area of Science:

• Speech-language pathology
• Swallowing disorders (Dysphagia)
• Food and liquid rheology

Background:

• Dysphagia management often involves thickening liquids to ensure safe swallowing.
• Current practices rely on speech-language pathologists' (SLPs) subjective perceptions of viscosity.
• Lack of standardized methods may lead to inconsistent liquid consistencies.

Purpose of the Study:

• To assess the reliability of SLPs in creating specific liquid viscosities.
• To determine if SLPs can consistently replicate nectar, honey, and pudding consistencies.
• To evaluate the consistency of thickened liquids used in dysphagia evaluations.

Main Methods:

• Twenty-three experienced SLPs prepared thickened liquid solutions mimicking nectar, honey, and pudding consistencies.
• Viscosity measurements were taken using a viscometer for each prepared solution.
• Replication reliability analysis was performed on the viscosity data.

Main Results:

• SLPs demonstrated significant inconsistency in replicating target liquid viscosities.
• Intrasubject (within-participant) reliability was higher than intersubject (between-participant) reliability.
• The actual viscosities of the prepared solutions varied considerably from intended consistencies.

Conclusions:

• SLPs' perceptions of thickened liquid consistencies are not reliably reproducible.
• A standardized protocol is essential for consistent viscosity in dysphagia management.
• Standardization will improve the safety and efficacy of thickened liquids in clinical practice.