A/Prof. Kelly Weir1,2, Ms Julie Bettle2, Sree Vidya Metlapalli1, Brittany Ng1, Melody Ou1, Madeline Stockdale1, A/Prof Thuy Frakking1,2
1The University of Melbourne, Melbourne, Australia, 2The Royal Children's Hospital, Parkville, Australia, 3Gold Coast Health, Southport, Australia, 4The University of Queensland, St Lucia, Australia
Biography:
Associate Professor Kelly Weir is a Joint Director of Allied Health Research at The Royal Children’s Hospital and The University of Melbourne. She is a certified practicing speech pathologist with over 35 years clinical and research experience, predominantly in tertiary state-wide paediatric hospitals in Australia. Kelly researches and teaches in the assessment and management of infants and children with paediatric dysphagia and feeding disorders including neonatal intensive care, tertiary paediatric acute/critical care, children with disability and paediatric palliative care. She currently leads the Allied Health Research Capacity and Development Program at The Royal Children’s Hospital, Melbourne.
Abstract:
Background:
Whilst the Videofluoroscopic Swallow Study (VFSS) is a commonly used instrumental assessment for evaluating oropharyngeal dysphagia and aspiration in children, there is currently no standardised protocol for paediatric VFSS, causing variability across practices, reporting, and potentially leading to increased radiation dose. We aimed to understand current practice variation in conducting paediatric VFSS across Australia and New Zealand (ANZ) in order to inform future training.
Method:
We conducted an online survey of ANZ speech pathologists/therapists who conduct paediatric VFSS using the Qualtrics platform, from 29/07/2024–30/09/2024. Participants were asked 71 questions about their demographics and current practices regarding VFSS, including pre-VFSS assessment; field of view and dose reduction measures; contrasts, textures, fluids and utensils; trials of posture and positions; manoeuvres for interventions or compensation; assessment tools; parent feedback; competency training and reports. All data was analysed using descriptive statistics.
Results:
52 valid responses (of 71) included 90% Australian, and 100% female. Pre-VFSS clinical feeding evaluations were required by 88% and had a standard referral form; whilst only 46% had a specific protocol in use. Both barium sulphate and water-soluble contrasts were used (71%). An acquisition rates included 15 frames per second (fps) (79%), and 30 fps (31%) during trials. Whist 79% used a standard VFSS analysis tool to rate studies, including the Penetration-Aspiration Scale (98%), there was minimal use of quantitative measures.
Conclusion:
Practice variation and minimal use of quantitative measures suggests further research and training is required to determine best practice protocols and support implementation into practice.