Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing Performance in Self-Feeding Children With Cerebral Palsy Purpose The purpose of this study is to examine (a) the reliability of newly developed measures of mealtime duration and (b) their relationship to clinical feeding/swallowing performance in children with spastic cerebral palsy (SCP). Method Seventeen self-feeding children (9 boys, 8 girls) with SCP (age range = 5;1 ... Research Article
Research Article  |   February 06, 2018
Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing Performance in Self-Feeding Children With Cerebral Palsy
 
Author Affiliations & Notes
  • Avinash Mishra
    Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
  • Justine J. Sheppard
    Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
  • Cagla Kantarcigil
    Department of Speech, Language, & Hearing Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN
  • Andrew M. Gordon
    Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
  • Georgia A. Malandraki
    Department of Speech, Language, & Hearing Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN
  • Disclosure: Justine J. Sheppard discloses that she developed the Dysphagia Disorder Survey (one of the instruments used in this study) and is a member of the Nutritional Management Associates, LLC. The other coauthors have declared that no competing interests existed at the time of publication.
    Disclosure: Justine J. Sheppard discloses that she developed the Dysphagia Disorder Survey (one of the instruments used in this study) and is a member of the Nutritional Management Associates, LLC. The other coauthors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Georgia A. Malandraki: malandraki@purdue.edu
  • Avinash Mishra is now at the Speech-Language Pathology and Audiology, Hunter College, City University of New York, New York, NY.
    Avinash Mishra is now at the Speech-Language Pathology and Audiology, Hunter College, City University of New York, New York, NY.×
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Julie Barkmeier-Kraemer
    Associate Editor: Julie Barkmeier-Kraemer×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Genetic & Congenital Disorders / Research Articles
Research Article   |   February 06, 2018
Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing Performance in Self-Feeding Children With Cerebral Palsy
American Journal of Speech-Language Pathology, February 2018, Vol. 27, 99-107. doi:10.1044/2017_AJSLP-16-0224
History: Received November 14, 2016 , Revised May 10, 2017 , Accepted August 3, 2017
 
American Journal of Speech-Language Pathology, February 2018, Vol. 27, 99-107. doi:10.1044/2017_AJSLP-16-0224
History: Received November 14, 2016; Revised May 10, 2017; Accepted August 3, 2017

Purpose The purpose of this study is to examine (a) the reliability of newly developed measures of mealtime duration and (b) their relationship to clinical feeding/swallowing performance in children with spastic cerebral palsy (SCP).

Method Seventeen self-feeding children (9 boys, 8 girls) with SCP (age range = 5;1 [years;months] to 17;6, Gross Motor Function Classification System range = I–IV) were assessed during mealtimes using the Dysphagia Disorder Survey (DDS; Sheppard, Hochman, & Baer, 2014). Children were divided into 2 groups, children with primarily unilateral or bilateral brain involvement. Duration measures included mealtime duration and total sip/bite duration for each bolus type (liquid and solid).

Results Excellent intra- and inter-rater reliability for all duration measures was observed (intraclass correlation coefficient [ICC] = 1.00 and 0.955, respectively, for mealtime duration; ICC = 1.00 and 0.963, respectively, for solid/bite duration; ICC = 1.00 and 0.957, respectively, for liquid/sip duration). Positive correlations were found between total mealtime duration and DDS Part 1, r s = .514 [.045–.797], p = .035; Part 2, r s = .528 [.064–.804], p = .029; and total scores, r s = .665 [.271–.868], p = .004, and between total solid/bite duration and DDS Part 1, r s = .579 [.137–.828], p = .015; Part 2, r s = .620 [.199–.847], p = .007; and total scores, r s = .762 [.444–.909], p < .001. Children with unilateral brain involvement exhibited significantly lower DDS total (p = .049) and Part 2 scores (p = .026), indicating better feeding/swallowing performance/skills. They also had shorter mealtime duration (p = .019) and solid/bite duration (p = .025) compared with children with bilateral involvement.

Conclusions Our new mealtime duration measures are reliable and correlate with feeding/swallowing performance in a sample of self-feeding children with SCP. Therefore, they may be useful supplements to feeding/swallowing assessments for this population.

Supplemental Material https://doi.org/10.23641/asha.5715076

Acknowledgments
This study was partially supported by internal funds provided to Georgia A. Malandraki by Teachers College, Columbia University, and Purdue University. The authors thank the children and their parents for their participation. We also acknowledge with gratitude the contributions of Erika Levy for her help with subject recruitment; Akila Rajappa, Chad Grossman, Kamila Kaldan, Manushree Karthik, Aditi Valada, and Lucia Mourao for their help with data collection; and Alyssa Jones and Katy Baar for their help with data analysis.
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