A validation study of the Facial-Oral Tract Therapy Swallowing Assessment of Saliva

Abstract

Objective:

To investigate the validity and reliability of the Swallowing Assessment of Saliva in detection of aspiration risk.

Design:

Validation study.

Setting:

Inpatient neurorehabilitation centre.

Subjects:

Adult patients with acquired brain injury. A total of 43 patients for concurrent validity and 33 other patients for inter-rater reliability.

Interventions:

Concurrent validity was established with blinded Swallowing Assessment of Saliva and endoscopic evaluation within a 24-hour time interval. Inter-rater reliability was established with two blinded Swallowing Assessments of Saliva within a one-hour time interval.

Main measures:

The Swallowing Assessment of Saliva is a seven-item scale with a combination of swallowing and non-swallowing items. It is based on the Facial-Oral Tract Therapy approach.

Results:

The Swallowing Assessment of Saliva had a sensitivity of 91%, 95% confidence interval (CI) (59; 100), a specificity of 88% %, 95% CI (71; 97) and a kappa coefficient of 0.87 ±0.17 in detection of aspiration risk. Furthermore, analyses showed that experienced and inexperienced occupational therapists performed equally in detection of aspiration risk.

Conclusion:

The Swallowing Assessment of Saliva is a simple, sensitive and reliable assessment for detecting aspiration risk in patients with acquired brain injury.

Keywords

Dysphagia brain injury assessment validity Facial-Oral Tract Therapy

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