PT  - JOURNAL ARTICLE
AU  - K. Weir
AU  - S. McMahon
AU  - L. Barry
AU  - I. B. Masters
AU  - A. B. Chang
TI  - Clinical signs and symptoms of oropharyngeal aspiration and dysphagia in children
AID  - 10.1183/09031936.00090308
DP  - 2009 Mar 01
TA  - European Respiratory Journal
PG  - 604--611
VI  - 33
IP  - 3
4099  - http://erj.ersjournals.com/content/33/3/604.short
4100  - http://erj.ersjournals.com/content/33/3/604.full
SO  - Eur Respir J2009 Mar 01; 33
AB  - The diagnostic value of various signs and symptoms (clinical markers) in predicting oropharyngeal aspiration (OPA) or swallowing dysfunction has not been established in children. The present retrospective study was undertaken to: 1) identify specific clinical markers associated with radiographic evidence of OPA, isolated laryngeal penetration (ILP) and post-swallow residue (PSR); 2) determine the sensitivity and specificity of clinical markers associated with OPA; and 3) determine the influence of age and neurological impairment on clinical markers of OPA. In total, 11 clinical markers of dysphagia were compared with the videofluoroscopic swallow study (VFSS) results (OPA, ILP and PSR) in 150 children on diets of thin fluid and purée consistencies. Chi-squared and logistic regression were used to analyse the association between clinical markers and VFSS-identified swallowing dysfunction. In children with OPA, wet voice (odds ratio (OR) 8.90, 95% confidence interval (CI) 2.87–27.62), wet breathing (OR 3.35, 95% CI 1.09–10.28) and cough (OR 3.30, 95% CI 1.17–9.27) were significantly associated with thin fluid OPA. Predictive values included: wet voice (sensitivity 0.67; specificity 0.92); wet breathing (sensitivity 0.33; specificity 0.83); and cough (sensitivity 0.67; specificity 0.53). No clinical markers were significantly associated with OPA, ILP or PSR on the purée consistency. Cough was significantly associated with PSR on thin fluids (OR 3.59, 95% CI 1.22–10.55). Differences were found for age. Wet voice, wet breathing and cough were good clinical markers for children with oropharyngeal aspiration on thin fluid but not on purée. Age and neurological status influenced the significance of these clinical markers.