Psychometric evaluation of the culturally adapted interprofessional socialisation and valuing scale (ISVS)-19 for health practitioners and students in Indonesia.

We aimed to develop a culturally appropriate psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. Our study was organized in three phases (a) translation, (b) cross-cultural validation by evaluating the content validity and internal structure of the translated instrument (i.e. structural validity, internal consistency reliability, and measurement invariances), and (c) hypotheses testing for construct validity. A total of 266 health practitioners and 206 students from various professional backgrounds participated. The Indonesian ISVS-19 was confirmed unidimensional. Content validity evaluation confirmed the inclusion of relevant, understandable items and was comprehensive. Factor analysis supported removal of two items. Configural, metric, and scalar tests confirmed the invariance of the 1-Factor 19-Items model in practitioner and student cohorts. Age was a differentiating factor in both cohorts; length of work was only significant for practitioners, and educational background was significant for students (80% of assumptions were accepted, fulfilling COSMIN requirement for construct validity). The Indonesian ISVS-19 has good psychometric properties regarding content validity, internal structure, and construct validity and, therefore, is a psychometrically robust measure for assessing interprofessional socialization for health practitioners and students in Indonesia.

Seeking consensus on a play-based intervention framework for promoting play of children with HIV/Aids in a low-resourced setting: A Delphi study.

INTRODUCTION: Implementing occupation-based practice in low-resourced settings can be challenging especially when working with children with HIV/Aids whose daily occupation of play is often affected by their health condition and other contextual factors such as poverty or stigma. AIM: The aim of this paper is to obtain consensus from experts on the content and application of a play-based intervention for children with HIV/Aids living in a low-resourced setting. METHODS: A Delphi study involving two rounds using an online survey format was conducted with experts from the field of child development, play and/or HIV/Aids. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5-point Likert scale. CONSUMER AND COMMUNITY INVOLVEMENT: This paper is part of a multi-stage study that involved input and feedback from families of children who were born HIV/Aids, occupational therapists working with families of children with HIV/Aids, and input from local and international experts working with people with HIV/Aids. RESULTS: Thirty-seven experts completed the first round, and 35 completed the second round of the study. Consensus was achieved on the application of the Cooper's Model of Children's Play, techniques to be used and the structure of the intervention. Experts also agreed on the inclusion of a pre-intervention workshop as part of the play-based intervention. DISCUSSION AND CONCLUSION: The consensus on the content and application of a play-based intervention framework through a process of gaining expert perspectives provides confidence that the intervention planned to promote play for children with HIV/Aids living in low-resourced settings is likely to be effective.

Proxy-reported sensory measures for children and adolescents with neurodevelopmental disorders: A systematic review.

AIM: To determine the quality and utility of proxy-reported sensory measures for children and adolescents with neurodevelopmental disorders (such as autism spectrum disorder, attention-deficit/hyperactivity disorder, movement disorders, and intellectual disability). METHOD: We systematically searched 11 databases. We applied the updated Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist and criteria for good measurement properties to evaluate instrument development and psychometric properties. Findings were summarized using a COSMIN adaptation of Grading of Recommendations, Assessment, Development and Evaluations. RESULTS: From 11 databases, 6748 articles were screened. Ninety-one full-length articles were reviewed after removing excluded studies and manual searches conducted by two reviewers. Data were extracted for 12 measures from 20 articles. Of the 12 measures, only three provided sufficient data to evaluate content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home (PSEQ-H) was the only measure that satisfied moderate content validity and moderate-to-high quality for measurement properties. These properties included: structural validity, hypothesis testing for construct validity, internal consistency, reliability, and measurement error. INTERPRETATION: One measure, the PSEQ-H, met eight criteria for good measurement properties. To facilitate evidence-informed clinical decision-making, all psychometric properties of all 12 sensory-based, proxy-reported measures were presented. The importance of consumer engagement in measure development and the need for ongoing evaluation of measures against contemporaneous standards is recommended. WHAT THIS PAPER ADDS: Three measures provided studies on content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire-Home had moderate quality for content validity studies and high-to-moderate quality evidence for psychometric properties. The Participation and Sensory Environment Questionnaire was the only measure that included consumer involvement through qualitative interviews and pilot testing. Consumer involvement in measure development is important for content validity. Ongoing evaluation of measures against contemporaneous standards is recommended.

Standardized Measures Used Regularly by Speech-Language Pathologists when Assessing the Language Abilities of School-Aged Children: A Survey.

INTRODUCTION: This study examined speech-language pathologist (SLP)'s use of standardized language measures when assessing school-aged children. METHOD: A total of 335 SLPs provided information in a web-based survey regarding the standardized language measures they use for school-aged children. SLPs were asked to identify the domains targeted, purposes of use, and reasons for which regularly used standardized measures were chosen for use. RESULTS: Findings indicated that SLPs collectively use many standardized measures, although only a small number are used regularly. SLPs reported using standardized measures to assess domains that measures are not ideally designed for and for purposes that the measures are not ideally suited to assessing. SLPs reported selecting diagnostic measures based on psychometric properties but not for screening measures. Reasons for choice varied depending on the particular measure. CONCLUSION: Overall, findings indicated that SLPs need to place greater focus on evidence-based practice recommendations when selecting standardized measures for use with school-aged children. Implications for clinical practice and future directions are discussed.

Using Classical Test Theory to Determine the Psychometric Properties of the Deglutition Handicap Index.

The Deglutition Handicap Index (DHI) is a self-report measure for patients at risk of oropharyngeal dysphagia on deglutition-related aspects of functional health status (FHS) and health-related quality of life (HR-QoL). The DHI consists of 30 items which are subsumed within the Symptom, Functional and Emotional subscales. The purpose of this study was to evaluate the psychometric properties of the DHI using Classic Test Theory according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. A total of 453 patients with dysphagia with different aetiologies were recruited concurrently at two academic hospitals. Dysphagia was confirmed by fiberoptic endoscopic and/or videofluoroscopic evaluation of swallowing. In addition, a healthy control group of 132 participants were recruited. Structural validity was determined using exploratory and confirmatory factor analyses and internal consistency by calculating Cronbach's alpha coefficients. Hypothesis testing was evaluated using Mann-Whitney U-tests, linear regression analysis and correlations analysis. Diagnostic performance and receiver operating characteristic curves analysis were calculated. Factor analyses indicated that the DHI is a unidimensional measure. The DHI has good internal consistency with some indication of item redundancy, weak to moderate structural validity and strong hypothesis testing for construct validity. The DHI shows high diagnostic performance as part of criterion validity. These findings support that the DHI is an appropriate choice as a patient self-report measure to evaluate FHS and HR-QoL in dysphagia. Ongoing validation to assess the measure for possible item redundancy and to examine the dimensionality of the DHI using item response theory is recommended.

White Paper by the European Society for Swallowing Disorders: Screening and Non-instrumental Assessment for Dysphagia in Adults.

This White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia.

Health promotion challenges for young adults living with intellectual disability and type 1 diabetes.

BACKGROUND: Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion. METHODS: Five male participants with intellectual disability, aged 17-26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed. FINDINGS: Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support). CONCLUSIONS: Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.

Visuoperceptual Analysis of the Videofluoroscopic Study of Swallowing: An International Delphi Study.

INTRODUCTION: The Videofluoroscopic Swallow Study (VFSS) is a commonly used dysphagia assessment that is routinely analysed visuoperceptually. However, no consensus exists regarding which visuoperceptual measures should be used to analyse VFSSs. Current visuoperceptual measures for VFSSs are limited by poor quality and incomplete or indeterminate psychometric properties. OBJECTIVE: This study aimed to establish the content validity for a new visuoperceptual VFSS measure for oropharyngeal dysphagia in adults, by identifying relevant domains of the construct and generating items and corresponding response scales. METHODS: Consensus among experts in dysphagia and VFSS from over 20 countries was achieved across three rounds of anonymous online surveys, using the Delphi technique. Participants judged relevance and comprehensiveness of definitions of visuoperceptual domains of VFSS and the relevance of various domains to the overall construct. After reaching consensus on definitions of relevant domains, consensus on items were established using the same process. RESULTS: Participants achieved consensus on definitions of 32 domains recommended for analysis, and at least one item per domain (range 1-4). Domains selected by participants included both those which occur in existing measures and domains which have not been included in any measures to date. This study will form the basis for content validity of a new measure for VFSS. CONCLUSIONS: This first phase of developing a visuoperceptual measure of VFSS resulted in the identification of 32 domains and 60 items for oropharyngeal dysphagia. Developers can now advance to the next phase of measure construction; prototype development and psychometric testing.

European white paper: oropharyngeal dysphagia in head and neck cancer.

PURPOSE: To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. METHODS: Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. RESULTS: Twenty-four sections on HNC-specific OD topics. CONCLUSION: This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.

Play profiles of children with HIV/Aids: A comparative study.

INTRODUCTION: Despite play being widely used in occupational therapy practice as a means and ends in intervention, no research has explored how the play of children with HIV/AIDS is affected. Therefore, the specific processes through which play can be used in therapy with children with HIV/AIDS remains underexplored, especially in low resourced settings. This study aims to compare the level of playfulness of children with HIV/AIDS to that of age and gender matched typically developing children living in the same low resourced community. METHODS: The Test of Playfulness (ToP) was used to examine the differences and similarities of play between children aged 4-7 years who are typically developing children (n = 52) and children with HIV/AIDS who receive antiretroviral treatment (n = 44). Each child was video recorded playing with a familiar playmate both indoors and outdoors. The videos were scored by two independent raters who were blinded to all aspects of the study. Scores were subjected to Rasch analysis to calculate interval level measure scores. Independent t-tests were used to compare differences between the means of the groups. RESULTS: Typically developing children scored significantly higher when playing outdoors, as compared to children with HIV [t (94) = 3.57, p = .001]. There was no significant difference between mean measure scores for indoor play when comparing typically developing children and children with HIV. Children who are HIV positive scored significantly lower than typically developing children on items related to the ability to suspend reality and framing in both indoor and outdoor environments. CONCLUSIONS: Children with HIV/AIDS exhibited lower levels of playfulness when compared to typically developing children. This study provides insight on the play profiles of children with HIV/AIDS, highlighting play deficits and differences between indoor and outdoor play. Occupational therapy can play a significant role in promoting playfulness in children with HIV/AIDS.

A systematic review of video-modelling interventions for children and adolescents with attention-deficit hyperactivity disorder.

OBJECTIVE: To identify, appraise, and synthesise the evidence for video-modelling interventions for individuals with attention-deficit hyperactivity disorder (ADHD). METHOD: We searched four electronic databases. Two independent researchers screened abstracts and methodologically assessed data using the Kmet appraisal checklist. RESULTS: A total of 15 studies met the inclusion criteria (11 original studies and four follow-up studies). Of the 11 original studies, one was a randomised controlled trial, one was a controlled between-group comparative design, two were one group pre-test post-test studies, one was an experimental 2 × 2 factorial design, and six were single-case experimental design studies. Studies included 1-35 participants with ADHD aged 5-16 years. Three studies targeted behaviour, three targeted social play skills, two targeted social behaviour, one targeted social skills, one targeted goal orientation and friendship quality, targeted and one attention/comprehension of social behaviour. In four studies video-modelling was the whole intervention, with no other intervention components reported. Nine studies reported positive outcomes immediately after intervention, two studies reported mixed findings. All studies were found to have good or strong methodological quality. CONCLUSION: There is preliminary evidence to suggest video-modelling may be a promising intervention approach for targeting the social skills and behaviours of individuals with ADHD when used in conjunction with other intervention components. Future studies need to lower the risk of bias and use larger sample sizes before the efficacy of video-modelling interventions can be fully investigated.

Research protocol of a multifaceted prospective mixed-method longitudinal study: Navigating Through Life - Western Australian study of transitions from out-of-home care.

BACKGROUND: Developing robust evidence is a challenge for researchers working with disadvantaged or vulnerable populations. For example, research shows that young people who have transitioned from out-of-home care (OOHC) to independent adulthood often experience poor long-term outcomes. However, evidence for the aetiology of those outcomes is weak due to methodological limitations such as small sample sizes and a lack of longitudinal data. This paper details the protocol for Navigating Through Life, a study that utilises novel research methods to better understand the pathways and outcomes of young people as they leave OOHC in Western Australia (WA). METHODS: Navigating Through Life is a longitudinal, mixed methods, population-based study. A prospective longitudinal study of young people aged 15-25 years will follow participants' experiences and outcomes over a two-year period. Quantitative and qualitative data is being collected from participants five times over 2 years, using standardised outcome measures and individual interviews. Outcome measures focus on key dimensions of young people's lives (e.g., social inclusion, well-being, resilience, self-determination). Interviews examine important influences and the variable contexts into which young people have transitioned from care. In addition, retrospective population-level data for young people transitioning from OOHC will be obtained from linked Western Australian government administrative records. Using a multitude of data sources, analysis will map pathways and outcomes of young people with care experience, and comparisons will be made with other population groups within WA. DISCUSSION: Navigating Through Life exemplifies a novel utilisation of multiple data sources to research outcomes for vulnerable and difficult to reach populations, and offers insights for other complex mixed-methods longitudinal studies. Results will provide new and more comprehensive data about specific pathways that may be influential to a range of post-care outcomes. Findings will extend evidence to inform better service-delivery models that improve outcomes and reduce disparities for vulnerable young people.

Older male mentors: Outcomes and perspectives of an intergenerational mentoring program for young adult males with intellectual disability.

ISSUE ADDRESSED: Intergenerational mentoring is emerging as a way to provide meaningful engagement and improve wellbeing for older adults in retirement. However, there is little, if any, Australian research concerning the benefits for older mentors involved in such mentoring. This study aims to investigate the experiences of older male mentors involved in an intergenerational mentoring program with young men with intellectual disability and identify any benefits to physical and mental health and generativity. METHODS: This study used a mixed methods concurrent triangulation design. Quantitative outcomes data were collected pre and postintervention using the SF-36 and Loyola Generativity Scale. Qualitative data were collected using a single-interview approach. Mentors and mentees took part in a 6-month mentoring program based in Australian Men's Sheds. RESULTS: No significant changes were seen in physical health and generativity. Investigation of mental health scores revealed a significant improvement in scores on the mental health subscale. Qualitative analysis revealed the main theme as "Learning together through a relational and practical routine" and four sub-themes. CONCLUSION: Men's Shed intergenerational mentoring programs present an environment for older, retired men to express generativity, improve their mental health and bond with younger generations.So what? The potential wellbeing implications for older men through intergenerational mentoring should form the basis of future research and intervention.

Experience sampling method and the everyday experiences of adults with intellectual disability: A feasibility study.

BACKGROUND: Experiences of people with intellectual disability are often reported by proxy, excluding the person's own perception. To assist people with intellectual disabilities ability to communicate their own experiences, the current study explored the feasibility, reliability and validity of experience sampling methods (ESMs) for people with intellectual disability. METHOD: After a training session, 19 participants carried a mobile device for 7 consecutive days, answering a survey when prompted 7 times daily. Participants were interviewed at the end of data collection. RESULTS: Excluding incomplete entries, the response rate was 33.8%, varying by living arrangement and employment. Split-half reliability and correlations among logically linked internal experiences demonstrated strong reliability and validity. Illustration of the context of responses supported face validity. Technological and content difficulties were discussed in interviews. CONCLUSIONS: Experience sampling methods is feasible for some people with intellectual disability, providing valid and reliable information. Future research is needed to further improve feasibility.

Can I join in? Multiple case study investigation of play performance generalisation for children with autism spectrum disorder from dyad to triad.

INTRODUCTION: Children with autism spectrum disorder (ASD) have difficulties with play, social interaction with peers and generalisation of intervention outcomes. The Ultimate Guide to Play, Language and Friendship (PLF) has demonstrated effectiveness in improving play performance of children with ASD and their typically developing (TD) peers. The aim of this investigation was to examine the changes in play performance when an additional TD child is added to an existing dyad of a child with ASD and a TD playmate to inform future delivery and adaptations of the intervention. METHODS: Participants in this multiple case study design were five children with ASD and their TD peer who completed a dyad intervention as part of a randomised control trial investigation of the PLF and an additional TD peer who joined the play dyad. A trained occupational therapist delivered an adapted version of the PLF to the triad over four clinic sessions. An independent rater scored each child (N = 15) on The Test of Playfulness at pre- and post-triad intervention. Line graphs were used to examine case data and compare to dyad play performance and patterns of interaction. RESULTS: Four of the five children with ASD generalised their play performance from the dyad to the triad social environment. However, the triad intervention did not demonstrate improvements in play performance. The play performance scores for the children with ASD and their TD peers were variable and demonstrated changes in their play pattern from the dyad to the triad. CONCLUSION: This investigation delivered preliminary evidence of play performance generalisation from a dyad to a triad with TD peers for children with ASD. Careful consideration of characteristics of all playmates is recommended for delivering the intervention to support play performance of children with ASD.

"Just one of the guys" An application of the Occupational Wellbeing framework to graduates of a Men's Shed Program for young unemployed adult males with intellectual disability.

INTRODUCTION: Conceptualisation of occupation requires understanding of subjective wellbeing and experiences of occupation. Opportunities for participation in productivity activities, such as employment, may be limited for people with intellectual disability (ID). An occupational wellbeing framework was recently re-imagined to focus on the subjective meaning of a person's occupational life rather than occupational performance. This study analysed experiences and possible benefits to occupational wellbeing of young adult men with ID in an intergenerational mentoring program based on Australian Men's Sheds using this revised occupational wellbeing framework. METHODS: A qualitative approach was used to gather individual semi-structured interviews at the end of an intergenerational mentoring program to explore occupational wellbeing experiences. Eight individual mentees and five parents of mentees (n = 13) from the different Men's Sheds sites agreed to participate in an individual interview about their experiences of the program. All mentees were male aged between 17 and 24 years. Family members included four female mothers and one male father. Data were highlighted, selected and deductively coded using content analysis according to the five occupational wellbeing domains of the framework. RESULTS: Mentees reflected upon their experience with their mentor, the program, activities and environment of the Men's Shed. Findings were organised in relation to each of the five domains of occupational wellbeing, including contentment, competence, belonging, identity and autonomy. Experiences of mentees and their family members reflected the positive impact of participation on each domain and occupational wellbeing, including opportunities for socialisation outside of the program, mastery of skills and knowledge and validation of belief in self. CONCLUSION: Mentees involved in an intergenerational mentoring program in Australian Men's Sheds report benefits of participation in activities that foster and increase occupational wellbeing experiences. The experience of such domains should be considered when attempting to understand the quality of life and function for people with disabilities.

Comparison of psychometric properties between recall methods of interview-based physical activity questionnaires: a systematic review.

BACKGROUND: This systematic review examined the methodological quality of studies and assessed the psychometric qualities of interview-administered Past-week and Usual-week Physical Activity Questionnaires (PAQs). Pubmed and Embase were used to retrieve data sources. METHODS: The studies were selected using the following eligibility criteria: 1) psychometric properties of PAQs were assessed in adults; 2) the PAQs either consisted of recall periods of usual 7-days (Usual-week PAQs) within the past 12 months or during the past 7-days (Past-week PAQs); and 3) PAQs were interview-administered. The COSMIN taxonomy was utilised to critically appraise study quality and a previously established psychometric criteria employed to evaluate the overall psychometric qualities. RESULTS: Following screening, 42 studies were examined to determine the psychometric properties of 20 PAQs, with the majority of studies demonstrating good to excellent ratings for methodological quality. For convergent validity (i.e., the relationship between PAQs and other measures), similar overall associations were found between Past-week PAQs and Usual-week PAQs. However, PAQs were more strongly associated with direct measures of physical activity (e.g., accelerometer) than indirect measures of physical activity (i.e., physical fitness), irrespective of recall methods. Very few psychometric properties were examined for each PAQ, with the majority exhibiting poor ratings in psychometric quality. Only a few interview-administered PAQs exhibited positive ratings for a single psychometric property, although the other properties were either rated as poor or questionable, demonstrating the limitations of current PAQs. CONCLUSION: Accordingly, further research is necessary to explore a greater number of psychometric properties, or to develop new PAQs by addressing the psychometric limitations identified in the current review.

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta-analyses.

AIM: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. METHOD: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. RESULTS: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6-52.7) for drooling, 50.4% (95% CI 36.0-64.8) for swallowing problems, and 53.5% (95% CI 40.7-65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. INTERPRETATION: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. WHAT THIS PAPER ADDS: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP.

PREVALENCIA DE PROBLEMAS DE SIALORREA, DEGLUCIÓN Y ALIMENTACIÓN EN PARÁLISIS CEREBRAL A LO LARGO DE LA VIDA: UNA REVISIÓN SISTEMÁTICA Y METAANÁLISIS: OBJETIVO: Determinar la prevalencia de problemas de sialorrea/babeo, deglución y alimentación en personas con parálisis cerebral (PC) a lo largo de la vida MÉTODO: Se llevó a cabo una revisión sistemática utilizando cinco bases de datos diferentes (AMED, CINAHL, Embase, MEDLINE y PubMed). El proceso de selección fue completado por dos investigadores independientes y la calidad metodológica de los estudios incluidos se evaluó utilizando las directrices STROBE y AXIS. Se realizó un metaanálisis para determinar las estimaciones de prevalencia agrupadas en problemas de babeo, deglución y alimentación con análisis de grupos estratificados por tipo de evaluación y nivel del Sistema de Clasificación de la Función Motora Gruesa. RESULTADOS: Se incluyeron un total de 42 estudios. Se observaron variaciones sustanciales en las medidas y variables de resultados seleccionadas, y los datos sobre adultos fueron limitados. Las estimaciones de prevalencia agrupadas determinadas por metaanálisis fueron tan altas como 44,0% (intervalo de confianza [IC] del 95% 35,6-52,7) para babeo, 50,4% (IC 95% 36,0-64,8) para problemas de deglución y 53,5 % (IC 95% 40,7-65,9) para problemas de alimentación. Los análisis de grupo para el tipo de evaluaciones no fueron significativos; sin embargo, el funcionamiento más severo en PC se asoció con problemas concomitantes de aumento de sialorrea, deglución y de la alimentación. INTERPRETACIÓN: Problemas relacionados con sialorrea, tragar, y de alimentación son muy comunes en personas con PC. En consecuencia, ellos experimentan mayores riesgos de desnutrición y deshidratación, neumonía por aspiración y mala calidad de vida.

PREVALÊNCIA DE PROBLEMAS COM SIALORRÉIA, DEGLUTIÇÃO E ALIMENTAÇÃO EM PARALISIA CEREBRAL AO LONGO DA VIDA: UMA REVISÃO SISTEMÁTICA E METANÁLISE: OBJETIVO: Determinar a prevalência de problemas com sialorréia, deglutição e alimentação em pessoas com paralisia cerebral (PC) ao longo da vida. MÉTODO: Uma revisão sistemática foi realizada utilizando cinco bases de dados diferentes (AMED, CINAHL, Embase, MEDLINE, e PubMed). O processo de seleção foi realizado por dois pesquisadores independentes e a qualidade metodológica dos estudos incluídos foi avaliada usando as diretrizes STROBE e AXIS. Metanálises foram realizadas para determinar as estimativas de prevalência agrupada de problemas de sialorréia, deglutição e alimentação, com análises estratificadas por tipo de avaliação e nível do Sistema de Classificação da Função Motora Grossa. RESULTADOS: Um total de 42 estudos foram incluídos. Variações substanciais nas medidas de resultado e variáveis selecionadas foram observadas, e dados em adultos são limitados. As estimativas de prevalência agrupada determiadas pela metanálise chegaram a 44,0% (intervalo de confiança [IC] 95% 35,6-52,7) para sialorréia, 50,4% (IC 95% 36,0-64,8) para problemas com deglutição, e 53,5% (IC 95% 40,7-65,9) para problemas de alimentação. Análises agrupadas por tipo de avaliação não foram significativas; no entanto, comprometimento funcional mais severo em PC foi associado com mais problemas concomitantes de salivação deglutição e alimentação. INTERPRETAÇÃO: Problemas de sialorréia, deglutição e alimentação são muito comuns em pessoas com PC. Consequentemente, elas apresentam risco aumentado de malnutrição e desidratação, pneumonia por aspiração e pior qualidade de vida.

Measurement properties of self-report questionnaires on health-related quality of life and functional health status in dysphonia: a systematic review using the COSMIN taxonomy.

PURPOSE: The current review was conducted to identify all self-report questionnaires on functional health status (FHS) and/or health-related quality-of-life (HR-QoL) in adult populations with dysphonia (voice problems), and to evaluate the psychometric properties of the retrieved questionnaires. METHODS: A systematic review was performed in the electronic literature databases PubMed and Embase. The psychometric properties of the questionnaires were determined using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) taxonomy and checklist. Responsiveness was outside the scope of this review and as no agreed 'gold standard' measures are available in the field of FHS and HR-QoL in dysphonia, criterion validity was not assessed. Only questionnaires developed and published in English were included. RESULTS: Forty-eight studies reported on the psychometric properties of 15 identified questionnaires. As many psychometric data were missing or resulted from biased study designs or statistical analyses, only preliminary conclusions can be drawn. Based on the current available psychometric evidence in the literature, the Voice Handicap Index seems to be the most promising questionnaire, followed by the Vocal Performance Questionnaire. CONCLUSIONS: More research is needed to complete missing data on psychometric properties of existing questionnaires in FHS and/or HR-QoL. Further, when developing new questionnaires, the use of item response theory is preferred above classical testing theory, as well as international consensus-based psychometric definitions and criteria to avoid bias in outcome data on measurement properties.

Psychometric Properties of Visuoperceptual Measures of Videofluoroscopic and Fibre-Endoscopic Evaluations of Swallowing: A Systematic Review.

Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopic Swallow Studies (VFSS) are instrumental assessments of dysphagia which provide videos of the internal structures of swallowing. They are commonly regarded as 'gold-standard' assessments; however, there is no consensus regarding a gold-standard measure to analyse the video recordings that they produce. Measures require sound psychometric properties to be suitable for clinical or research purposes. To date, no review of psychometric properties of FEES and VFSS measures has been undertaken or formally reported. This review assessed the quality of the psychometric properties of visuoperceptual measures of FEES and VFSS. Electronic databases were searched for studies reporting on psychometric qualities of visuoperceptual measures which are used to analyse recordings from FEES and VFSS. All dates until February 2017 were included. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to evaluate the methodical quality of studies. The measures' overall quality was then assessed by combining COSMIN ratings with quality criteria. Forty-five studies, reporting on 39 measures, met the inclusion criteria for this review. Data about the measures' psychometric properties were very limited. Twenty-one measures had information available about reliability only, while 18 had information on up to five of the possible nine psychometric properties categorised within the COSMIN framework. The majority of the FEES and VFSS measures' psychometric properties were rated as 'indeterminate' overall, due to the small number of studies, issues with design, statistical analyses, and reporting practices of extant studies. There is insufficient evidence to recommend any individual measure included in this review as valid and reliable to interpret VFSS and FEES recordings. Further research, which utilises robust methodological design and reporting, is needed to examine the psychometric properties of measures for FEES and VFSS.