The 3-ounce (90-cc) water swallow challenge: a screening test for children with suspected oropharyngeal dysphagia.
OBJECTIVE
To investigate the clinical utility of the 3-ounce (90-cc) water swallow challenge alone to determine both aspiration status and oral feeding recommendations in children.


METHODS
Cross-sectional evaluation of a diagnostic test with a consecutive, referral-based sample.


METHODS
Urban, tertiary care, teaching hospital.


METHODS
Fifty-six children (age range 2-18 years; mean 13 years) referred for swallowing evaluations.


METHODS
Aspiration status during fiberoptic endoscopic evaluation of swallowing (FEES) was the objective criterion standard with which results from the 3-ounce water swallow challenge were compared.


RESULTS
Twenty-two (39.3%) participants passed and 34 (60.7%) failed the 3-ounce challenge. Sensitivity for predicting aspiration status during FEES = 100.0 percent, specificity = 51.2 percent, and false-positive rate = 48.4 percent. Sensitivity for identifying individuals who were deemed safe for oral intake based on FEES results = 100.0 percent, specificity = 44.0 percent, and false-positive rate = 56.0 percent.


CONCLUSIONS
If the 3-ounce water swallow challenge is passed, not only thin liquids but diet recommendations with puree and solid food consistencies can be made without the need for further instrumental dysphagia assessment.


CONCLUSIONS
The 3-ounce water swallow challenge has been shown to be a clinically useful screening test for oropharyngeal dysphagia in children.
Suiter
Debra M
DM
School of Audiology and Speech-Language Pathology, the University of Memphis, Memphis, TN, USA. dsuiter@memphis.edu
Leder
Steven B
SB
Karas
David E
DE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000209:etiology*; D018570:Risk Assessment; D014867:Water
D014867:Water