Predictors of asphyxiation risk in adults with intellectual disabilities and dysphagia.
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.


OBJECTIVE
This study aims to identify the physiological and environmental factors that predict asphyxiation risk in adults with intellectual disabilities and dysphagia.


METHODS
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.
Samuels
R
R
Department of Psychology and Speech Pathology, Manchester Metropolitan University, Manchester, UK.
Chadwick
D D
DD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001237:Asphyxia / Q000209:etiology* / Q000517:prevention & control; D001519:Behavior; D003680:Deglutition Disorders / Q000150:complications*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors