Exploring the diagnostic accuracy and applicability of the Gugging Swallowing Screen in children with feeding and/or swallowing disorders.

BACKGROUND: The Gugging Swallowing Screen (GUSS) is a bedside dysphagia screening tool that has been designed to determine the risk of aspiration in acute stroke patients. There is no evidence in the literature for the GUSS for the pediatric population. The present study aimed to determine the diagnostic accuracy of GUSS as a screening tool in the Greek language for children with dysphagia. METHODS: Eighty-Greek-Cypriot children aged 3-12 years who had dysphagia participated in this retrospective study. The translated into Greek GUSS was administered twice (pre- and post-therapy) to each patient throughout 24 sessions of dysphagia therapy. KEY RESULTS: The GUSS showed a high internal consistency (Cronbach's α = 0.826), good test-retest reliability (rs = 0.767), convergent validity compared to the Greek Pediatric Eating Assessment tool-10 (PEDI-EAT-10) total score (rs = -0.365), and inter-rater reliability (κ = 0.863). A total cutoff points equal to 13.00 was also calculated. Aspiration was identified by the GUSS with low sensitivity and high specificity (PPV 100%, NPV 57%, LR+ NA, LR- 0.79); dysphagia/penetration was identified with high sensitivity and low specificity (PPV 33%, NPV 100%, LR+ 0.102, LR- NA). CONCLUSIONS & INFERENCES: The pediatric version of GUSS has been found to be a valuable tool in identifying the risk of aspiration as that of adults. It proved to be used as a good screening guide for selecting and confirming the existence of dysphagia from instrumental assessments. This is the first study of the pediatric version of GUSS, and future studies on this topic are needed.

Cross-Cultural Adaptation and Validation of the Greek Cypriot Montreal Children's Hospital Feeding Scale.

INTRODUCTION: Assessing pediatric feeding difficulties (PFD) is essential for a child's development to prevent severe consequences. The assessment procedures for PFD may include parents' questionnaires such as the Montreal Children's Hospital Feeding Scale (MCH-FS). The aim of this study was the cross-cultural adaptation of the MCH-FS to the Greek language. METHODS: 100 parents of Greek Cypriot children with PFD (clinical group) and 100 parents of healthy Greek Cypriot children (control group) aged six months to 16 years old participated in the study and completed the MCH-FS. World Health Organization (WHO) guidelines were implemented for translation and cultural adaptation. RESULTS: The internal consistency was excellent α= 0.85 (ICC: 0.817-0.891). Content validity was significant (S-CVI=1) with an agreement equal to 14. A strong and significant correlation of MCH-FS was computed according to Principal Component Αnalysis (PCA) [14 items ranging between -0.6 and 0.7]. The Kaiser-Meyer-Olkin (KMO) Factor analysis was equal to 0.91 with substantial correlations (Bartlett's test= 0.001654804). The MCH-FS cut-off point between the two groups was 38.00 [AUC 0.901, (95% CI: 0.859-0.942), p<0.001; sensitivity= 0.800 and 1-specificity= 0.630]. A statistically significant difference between the two groups was observed for the MCH-FS total score, with the clinical group scoring higher [U= 992.00, p< 0.001]. Likewise, the same differences were observed among children with different PFD, H (3) = 96.715, p< 0.001. CONCLUSION: The MCH-FS had good psychometric properties in its current form in Greek. It is suggested that the MCH-FS can be used as a valid tool for children with PFD in the Greek Cypriot population.

Validation and cultural adaptation of a Greek Version of Pediatric Eating Assessment Tool 10 (PEDI - EAT - 10) in Greek-Cypriot Parents.

PURPOSE: The Pediatric Eating Assessment Tool (PEDI-EAT-10) is a parents/caregivers screening tool that assesses pediatric patients at risk of penetration and/or aspiration symptoms. The aim of this study was the validation of PEDI-EAT-10 in the Greek language. MATERIALS AND METHODS: This cross-sectional study included 222 parents/caregivers of children with (n = 122) and without (n = 100) feeding and/or swallowing disorders, with age range 3 - 12 years. The children were selected from Cypriot schools and health settings. All parents filled out the PEDI-EAΤ-10 questionnaire and after its initial completion, it was re-administered after 2 weeks. RESULTS: A statistically significant difference was observed in the PEDI-EAT-10 total mean scores between the study's two groups [t (220) = 9.886, p < 0.001]. Internal consistency was high (Cronbach's alpha= 0.801) with very good split-half reliability equal to 0.789. A significant and strong test-retest reliability was computed (r = 0.998, p < 0.001). The PEDI-EAT-10 cutoff point was 11.00 (AUC: 0.869, p < 0.001) for children with feeding and/or swallowing disorders in accordance with the PAS scale. CONCLUSIONS: In conclusion, the Greek version of PEDI-EAT-10 is shown to be a valid and reliable screening tool for the assessment of the pediatric population with a risk of dysphagia.

The Pediatric Eating Assessment Tool (PEDI - EAT - 10) is a clinical screening tool to assess pediatric patients at risk of penetration and/or aspiration reported by parents or caregivers.This study is a cross cultural translation of PEDI - EAT - 10 in Greek language and it is proven to have excellent internal consistency, reliability, and validity.The use of PEDI ­ EAT ­ 10 will be a very useful utility for health professionals in rehabilitation settings.