R Samuels1, D D Chadwick. 1. Department of Psychology and Speech Pathology, Manchester Metropolitan University, Manchester, UK.
Abstract
BACKGROUND: Adults with learning disabilities referred for assessment of their eating and drinking are frequently reported to cough and choke when eating and drinking. The research literature investigating dysphagia has often overlooked asphyxiation risk, highlighting coughing and choking as indicators of aspiration only. This is a notable oversight due to the prevalence of asphyxia as a cause of mortality in this population. AIM: This study aims to identify the physiological and environmental factors that predict asphyxiation risk in adults with intellectual disabilities and dysphagia. METHOD: Data were collected from dysphagia-trained speech and language therapists (SLTs) working with the participant adults with intellectual disabilities and dysphagia. The SLTs used case notes, clinical assessment and videofluoroscopic assessment reports to gather the data. RESULTS: Speed of eating, cramming food and premature loss of the bolus into the pharynx were identified as significant predictors of asphyxiation risk in this population. CONCLUSIONS: The findings highlight the importance of maladaptive eating strategies in exacerbating the risk of asphyxiation and choking. These factors should be considered in the assessment of asphyxiation and choking risk and management. Finally, the need for joint assessment and management with other members of the multidisciplinary team is advocated.
BACKGROUND: Adults with learning disabilities referred for assessment of their eating and drinking are frequently reported to cough and choke when eating and drinking. The research literature investigating dysphagia has often overlooked asphyxiation risk, highlighting coughing and choking as indicators of aspiration only. This is a notable oversight due to the prevalence of asphyxia as a cause of mortality in this population. AIM: This study aims to identify the physiological and environmental factors that predict asphyxiation risk in adults with intellectual disabilities and dysphagia. METHOD: Data were collected from dysphagia-trained speech and language therapists (SLTs) working with the participant adults with intellectual disabilities and dysphagia. The SLTs used case notes, clinical assessment and videofluoroscopic assessment reports to gather the data. RESULTS: Speed of eating, cramming food and premature loss of the bolus into the pharynx were identified as significant predictors of asphyxiation risk in this population. CONCLUSIONS: The findings highlight the importance of maladaptive eating strategies in exacerbating the risk of asphyxiation and choking. These factors should be considered in the assessment of asphyxiation and choking risk and management. Finally, the need for joint assessment and management with other members of the multidisciplinary team is advocated.
Authors: Julie A Y Cichero; Catriona Steele; Janice Duivestein; Pere Clavé; Jianshe Chen; Jun Kayashita; Roberto Dantas; Caroline Lecko; Renee Speyer; Peter Lam; Joseph Murray Journal: Curr Phys Med Rehabil Rep Date: 2013-08-24
Authors: Catriona M Steele; Woroud Abdulrahman Alsanei; Sona Ayanikalath; Carly E A Barbon; Jianshe Chen; Julie A Y Cichero; Kim Coutts; Roberto O Dantas; Janice Duivestein; Lidia Giosa; Ben Hanson; Peter Lam; Caroline Lecko; Chelsea Leigh; Ahmed Nagy; Ashwini M Namasivayam; Weslania V Nascimento; Inge Odendaal; Christina H Smith; Helen Wang Journal: Dysphagia Date: 2014-10-25 Impact factor: 3.438
Authors: Julie A Y Cichero; Peter Lam; Catriona M Steele; Ben Hanson; Jianshe Chen; Roberto O Dantas; Janice Duivestein; Jun Kayashita; Caroline Lecko; Joseph Murray; Mershen Pillay; Luis Riquelme; Soenke Stanschus Journal: Dysphagia Date: 2016-12-02 Impact factor: 3.438