title: Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy.
abstract: OBJECTIVE
  To determine the prevalence of oropharyngeal dysphagia (OPD) and its subtypes (oral phase, pharyngeal phase, saliva control), and their relationship to gross motor functional skills in preschool children with cerebral palsy (CP). It was hypothesized that OPD would be present across all gross motor severity levels, and children with more severe gross motor function would have increased prevalence and severity of OPD.
  
  
  METHODS
  Children with a confirmed diagnosis of CP, 18 to 36 months corrected age, born in Queensland between 2006 and 2009, participated. Children with neurodegenerative conditions were excluded. This was a cross-sectional population-based study. Children were assessed by using 2 direct OPD measures (Schedule for Oral Motor Assessment; Dysphagia Disorders Survey), and observations of signs suggestive of pharyngeal phase impairment and impaired saliva control. Gross motor skills were described by using the Gross Motor Function Measure, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type/ distribution.
  
  
  RESULTS
  OPD was prevalent in 85% of children with CP, and there was a stepwise relationship between OPD and GMFCS level. There was a significant increase in odds of having OPD, or a subtype, for children who were nonambulant (GMFCS V) compared with those who were ambulant (GMFCS I) (odds ratio = 17.9, P = .036).
  
  
  CONCLUSIONS
  OPD was present across all levels of gross motor severity using direct assessments. This highlights the need for proactive screening of all young children with CP, even those with mild impairments, to improve growth and nutritional outcomes and respiratory health.
authors.affiliation: Department of Paediatrics and Child Health, Queensland Cerebral Palsy and Rehabilitation Research Centre, Royal Brisbane & Women's Hospital, Herston Queensland, Australia. katherine.benfer@uqconnect.edu.au
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Benfer
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Weir
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Bell
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.forename: Peter S W
authors.initials: PS
authors.lastname: Davies
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D017677:Age Distribution; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009069:Movement Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015999:Multivariate Analysis; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
keywords: cerebral palsy; deglutition disorders; dysphagia; feeding; prevalence