Systematic Review: Non-Instrumental Swallowing and Feeding Assessments in Pediatrics.

There is a high incidence of parental reporting of abnormal swallowing and feeding function and the negative impacts thereof on children. As such there is a need for well validated assessments in the area of pediatric swallowing and feeding. While instrumental assessments are well validated, there is limited information available to guide the selection and use of non-instrumental assessments for swallowing and feeding function. The aim of this study was to identify and report on non-instrumental assessments available to clinicians for pediatric swallowing and/or feeding function in order to support clinical decision making. A systematic literature search was performed by two independent reviewers using Medline and Embase databases, to find non-instrumental assessments for pediatric swallowing and feeding function. Published assessments were also included in the study by searching well-known publishers and relevant feeding and swallowing textbooks. Assessments were summarized and evaluated according to respondent type, target populations, assessment design, domains of assessment and scoring. Thirty assessments were included in the final review. All assessments had either caregiver or clinician respondents. There was high variability in target populations, assessment designs and areas of assessment. Twenty-four of the 30 assessments did not provide instruction for scoring or interpreting scores. There is high variability among the many assessments available to clinicians in the area of feeding and swallowing function in pediatrics. There appears to be limited information available on the validity and reliability of these assessments. Thus, most assessments need to be used with caution. Further research is needed to evaluate the psychometric properties of the assessments.