Clinical progression and outcome of dysphagia following paediatric traumatic brain injury: a prospective study.
OBJECTIVE
To provide a preliminary clinical profile of the resolution and outcomes of oral-motor impairment and swallowing function in a group of paediatric dysphagia patients post-traumatic brain injury (TBI). To document the level of cognitive impairment parallel to the return to oral intake, and to investigate the correlation between the resolution of impaired swallow function versus the resolution of oral-motor impairment and cognitive impairment.


METHODS
Thirteen children admitted to an acute care setting for TBI.


METHODS
A series of oral-motor (Verbal Motor Production Assessment for Children, Frenchay Dysarthria Assessment, Schedule for Oral Motor Assessment) and swallowing (Paramatta Hospital's Assessment for Dysphagia) assessments, an outcome measure for swallowing (Royal Brisbane Hospital's Outcome Measure for Swallowing), and a cognitive rating scale (Rancho Level of Cognitive Functioning Scale).


RESULTS
Across the patient group, oral-motor deficits resolved to normal status between 3 and 11 weeks post-referral (and at an average of 12 weeks post-injury) and swallowing function and resolution to normal diet status were achieved by 3-11 weeks post-referral (and at an average of 12 weeks post-injury). The resolution of dysphagia and the resolution of oral-motor impairment and cognitive impairment were all highly correlated.


CONCLUSIONS
The provision of a preliminary profile of oral-motor functioning and dysphagia resolution, and data on the linear relationship between swallowing impairment and cognition, will provide baseline information on the course of rehabilitation of dysphagia in the paediatric population post-TBI. Such data will contribute to more informed service provision and rehabilitation planning for paediatric patients post-TBI.
Morgan
Angela
A
Department of Speech Pathology adn Audiology, University of Queensland, Brisbane, Queensland, Australia.
Ward
Elizabeth
E
Murdoch
Bruce
B
D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation; D018450:Disease Progression; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009048:Motor Skills; D011379:Prognosis; D011446:Prospective Studies; D011597:Psychomotor Performance; D012720:Severity of Illness Index; D016896:Treatment Outcome