A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy.
Recorded meals let remote clinicians spot dysphagia as well as in-person experts.
01Research in Context
What this study did
Kantarcigil et al. (2016) asked if a clinician can spot swallowing problems from a video. They filmed kids with cerebral palsy eating and drinking. A remote expert later scored the same meals from the clips.
The team compared the remote scores to scores made during live meals. Strong match would mean telehealth swallowing exams are safe and practical.
What they found
Agreement between video and live ratings was substantial to excellent. The remote clinician caught the same signs of dysphagia without being in the room.
This shows recorded meals can travel to experts, letting families skip long trips to hospital swallow labs.
How this fits with other research
Nicola et al. (2018) found the same pattern with the MABC-2 motor test. Remote and in-person scores matched within the smallest detectable change. Together these papers build a rule: if you can film it clearly, you can score it remotely.
Schieltz et al. (2020) pull many small studies into one narrative. Their review says telehealth can deliver both assessment and treatment. Cagla’s work is one brick in that wall.
Foti et al. (2015) give the how-to guide. Their parent-coaching tips for functional analysis apply here too. Good lighting, steady camera, and a backup plan keep the video useful.
Why it matters
You can now add swallowing safety to your telehealth toolkit. Ask caregivers to record five minutes of lunch using a phone stand. Send the clip to a speech-language pathologist for scoring. This one step can cut wait times and travel costs for rural families while keeping clinical accuracy.
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02At a glance
03Original 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.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.04.008