30th Anniversary Academic Sessions, Faculty of Medicine-2021

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Paediatric dysphagia assessments used by speech and language therapists in Low and Middle-Income countries: A Scoping Review
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Sumanasiri, D.
Introduction: Paediatric dysphagia is highly prevalent in low and middle-income countries (LMICs), where healthcare facilities have limited resources. The awareness of available resources for Speech and Language Therapists (SLTs) to assess paediatric dysphagia is useful to ensure early diagnosis and intervention. Objectives: To describe different types of paediatric dysphagia assessments used by SLTs in LMICs, characteristics of identified assessments and gaps in current evidence. Methods: This systematic scoping review was conducted using a modified version of Arksey and O’Malley’s framework. Keywords comprised ‘paediatric’, ‘dysphagia’. Two electronic databases were searched for relevant articles published from January 2005 to December 2020, and reference list of included studies were reviewed for missed articles. Two independent reviewers reviewed the articles and one reviewer extracted data on sample descriptors, paediatric dysphagia assessment types and characteristics of paediatric dysphagia assessments used by SLTs in LMICs. The same reviewer collected the results and resolved discrepancies with the support of the supervisor. Results: Six articles were included in this review (two from Brazil, two from Turkey and two from India). Samples and methods of identified articles were heterogeneous. There were 12 different paediatric dysphagia assessments used by three LMICs covering two main paediatric dysphagia assessments types; instrumental or non- instrumental. The non¬instrumental assessments were the most prominent assessment type among SLTs and the Video- fluoroscopic swallow study was the only assessment repeated in two countries: Brazil and India. Assessment’s characteristics were identified. Less information was available on results, interpretation and assessing time duration. Conclusions: Both instrumental and non-instrumental assessments for paediatric dysphagia are common among SLTs in LMICs.
Administering Sinhala Pedi-EAT to detect feeding difficulties in children with disabilities: Evidence from a university clinic in Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Priyadarshana, S.
Introduction: Dysphagia in children with disabilities leads to aspiration and has a long¬term impact on a child’s development. The Sinhala Paediatric Eating Assessment Tool (Pedi-EAT) is a parent-report instrument developed to assess symptoms of feeding problems in children aged 6 months to 7 years. Objectives: To determine feeding related concerns of paediatric cohort with disabilities and the association between Sinhala Pedi-EAT scores and parental feeding experience of children with disabilities. Methods: A descriptive cross-sectional survey was conducted at the MDT clinic for children with disabilities and their families at a university clinic. The study population included parents of children between 6 months-7 years attending the MDT clinic from November to December 2019. The Sinhala Pedi-Eat was administered to 410parents of children with disabilities. Results: The most prevalent feeding concerns under the physiologic symptoms was cough during or after mealtime (71%, n=291). Under the problematic mealtime behaviours, rejection of the foods (54%, n=221) was the commonest. Mealtime was longer than 45 minutes for majority of the children (61%, n=149). They were red flagged for a diagnosis of dysphagia. Children who were diagnosed with developmental disorders (72%, n=296) presented higher risk for having dysphagia. Conclusions: Highest scored feeding difficulties were under the problematic mealtime behaviours of Pedi-EAT questionnaire. Educating parents/ caregivers regarding helpful and unhelpful behaviours on child’s feeding will aid in managing problematic feeding behaviours in children. Pedi-EAT can be reliably used to screen feeding difficulties in children in Sri Lankan clinical context.
Anxiety and Depression among the patients with Dysphagia following Oral Maxillofacial and Neck surgeries in four selected hospitals in Western Province, Sri Lanka.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Fernando, K.; Fernando, R.; de Silva, D.
Introduction: Undiagnosed anxiety and depression are obstacles to effective management of post-operative dysphagia. In Sri Lanka, the prevalence of anxiety and depression among patients with postoperative dysphagia is not known. Objectives: This study aimed at determining the severity and the stage of dysphagia, presence of anxiety and depression, and to identify the association between the severity and the stage of dysphagia with anxiety and depression following Neck, Oral & Maxillo-Facial (OMF) Surgeries. Methods: A cross-sectional study was conducted among 97 participants, with post¬operative dysphagia following OMF and Neck surgeries at four selected hospitals. Oral-motor and cranial nerve examination, the 3 ml water test, Cervical auscultation, Dysphagia Severity Rating Scale and Hospital Anxiety and Depression Scale were used for data collection. Results: Among the participants 51% presented with pharyngeal phase dysphagia and severe dysphagia. Prevalence of depression was 51% and anxiety was 38%, while 35% and 45% were at the borderline range respectively. With the increasement of dysphagia severity, high levels of anxiety and depression were noted. There was a statistically significant association between the severity of anxiety with severity of dysphagia (p< 0.05). Conclusion: Psychological burden is high among the participants with dysphagia following OMF and neck surgeries. Holistic management of dysphagia following OMF and neck surgeries, should include an assessment of the mental state of these patients and the treatment of anxiety and depression if required.

30th Anniversary Academic Sessions, Faculty of Medicine-2021

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