Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.
BACKGROUND
Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows.


OBJECTIVE
To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types.


METHODS
Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows.


RESULTS
The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude.


CONCLUSIONS
Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required.
Centre for Children's Health Research, The University of Queensland, South Brisbane, Queensland, Australia t.frakking@uq.edu.au.|Speech Pathology Department, Caboolture Hospital, Caboolture, Queensland, Australia.
Thuy
T
Frakking
Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia.|Child Health Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Australia.|Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Queensland, Australia.
Anne
A
Chang
Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Queensland, Australia.
Kerry
K
O'Grady
School of Public Health, The University of Queensland, Herston, Queensland, Australia.
Michael
M
David
Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Kelly
K
Weir
D000162:Acoustics; D001314:Auscultation / Q000379:methods*; D001466:Barium Sulfate; D002675:Child, Preschool; D003287:Contrast Media; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D009333:Neck; D010865:Pilot Projects; D012372:ROC Curve; D053120:Respiratory Aspiration / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000209:etiology; D012680:Sensitivity and Specificity; D014741:Video Recording
D003287:Contrast Media; D001466:Barium Sulfate
aspiration; cervical auscultation; deglutition; deglutition disorders; swallowing sounds