A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy

Cagla Kantarcigil; Justine Joan Sheppard; Andrew M. Gordon; Kathleen M. Friel; Georgia A. Malandraki

doi:10.1016/j.ridd.2016.04.008

A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy

Cagla Kantarcigil, Justine Joan Sheppard, Andrew M. Gordon, Kathleen M. Friel, Georgia A. Malandraki^*

^*Corresponding author for this work

Communication Sciences and Disorders

Research output: Contribution to journal › Article › peer-review

48 Scopus citations

Abstract

Background: Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. Aim: To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Methods and procedures: Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Outcomes and results: Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, K_W = 0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, K_W = 0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, K_W = 1); interrater agreement was substantial (85%; K_W = 0.76). Conclusions and implications: Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care.

Original language	English (US)
Pages (from-to)	207-217
Number of pages	11
Journal	Research in Developmental Disabilities
Volume	55
DOIs	https://doi.org/10.1016/j.ridd.2016.04.008
State	Published - Aug 1 2016

Funding

The authors wish to thank the children and their families for participating. In addition, the authors would like to thank Akila Rajappa, Avinash Mishra, Chad Grossman, Aditi Valada, and Manu Ramani for their help with data collection and Zeynep Gunbay for her help with figures. We also acknowledge with appreciation the suggestions of Professor Laurence B. Leonard during manuscript preparation. This project was partially supported by the Patricia Boscamp Cluss Donation Fund awarded to the PI (last author) and the Indiana Lions McKinney Outreach Program’s Research Award awarded to the first author.

Keywords

Asynchronous evaluations
Cerebral palsy
Developmental disability
Pediatric dysphagia
Telehealth

ASJC Scopus subject areas

Developmental and Educational Psychology
Clinical Psychology

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10.1016/j.ridd.2016.04.008

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@article{1301c4ed53664e018641c4685373cfe1,

title = "A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy",

abstract = "Background: Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. Aim: To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Methods and procedures: Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Outcomes and results: Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW = 0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW = 0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW = 1); interrater agreement was substantial (85%; KW = 0.76). Conclusions and implications: Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care.",

keywords = "Asynchronous evaluations, Cerebral palsy, Developmental disability, Pediatric dysphagia, Telehealth",

author = "Cagla Kantarcigil and Sheppard, {Justine Joan} and Gordon, {Andrew M.} and Friel, {Kathleen M.} and Malandraki, {Georgia A.}",

note = "Funding Information: The authors wish to thank the children and their families for participating. In addition, the authors would like to thank Akila Rajappa, Avinash Mishra, Chad Grossman, Aditi Valada, and Manu Ramani for their help with data collection and Zeynep Gunbay for her help with figures. We also acknowledge with appreciation the suggestions of Professor Laurence B. Leonard during manuscript preparation. This project was partially supported by the Patricia Boscamp Cluss Donation Fund awarded to the PI (last author) and the Indiana Lions McKinney Outreach Program{\textquoteright}s Research Award awarded to the first author. Publisher Copyright: {\textcopyright} 2016 Elsevier Ltd.",

year = "2016",

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doi = "10.1016/j.ridd.2016.04.008",

language = "English (US)",

volume = "55",

pages = "207--217",

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AU - Sheppard, Justine Joan

AU - Gordon, Andrew M.

AU - Friel, Kathleen M.

AU - Malandraki, Georgia A.

N1 - Funding Information: The authors wish to thank the children and their families for participating. In addition, the authors would like to thank Akila Rajappa, Avinash Mishra, Chad Grossman, Aditi Valada, and Manu Ramani for their help with data collection and Zeynep Gunbay for her help with figures. We also acknowledge with appreciation the suggestions of Professor Laurence B. Leonard during manuscript preparation. This project was partially supported by the Patricia Boscamp Cluss Donation Fund awarded to the PI (last author) and the Indiana Lions McKinney Outreach Program’s Research Award awarded to the first author. Publisher Copyright: © 2016 Elsevier Ltd.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background: Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. Aim: To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Methods and procedures: Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Outcomes and results: Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW = 0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW = 0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW = 1); interrater agreement was substantial (85%; KW = 0.76). Conclusions and implications: Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care.

AB - Background: Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. Aim: To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Methods and procedures: Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Outcomes and results: Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW = 0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW = 0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW = 1); interrater agreement was substantial (85%; KW = 0.76). Conclusions and implications: Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care.

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KW - Developmental disability

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A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy

Abstract

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Keywords

ASJC Scopus subject areas

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