Objective To verify the effectiveness of a screening tool for feeding/swallowing difficulties and malnutrition in children with cerebral palsy (hereafter referred to as the screening tool) in clinical application. Methods A total of 94 children with cerebral palsy, who were hospitalized in the Department of Rehabilitation Medicine of Anhui Provincial Children's Hospital from January to October 2021, were enrolled in this study. The screening tool, Z-scores, Subjective Global Nutrition Assessment (SGNA), and Eating and Drinking Ability Classification System (EDACS) were used for evaluation. The cut-off value of the screening tool was re-determined, then the consistency and validity indicators were calculated. Results The cut-off value of evaluating malnutrition and feeding/swallowing difficulties was 2 and 3, respectively. The Kappa coefficients of the screening tool with traditional Z-scores classification, Z-scores classification in the 2014 American Society for Enteral and Parenteral Nutrition (ASPEN) consensus statement, SGNA, and EDACS were 0.349 (95%CI:0.177 - 0.521), 0.466 (95%CI:0.288 - 0.644), 0.574 (95%CI:0.409 - 0.739) and 0.747 (95%CI:0.582 - 0.912), respectively. When taking traditional Z-scores classification as reference, the sensitivity and specificity of the screening tool were 80.0% and 63.8%, respectively. When taking ASPEN Z-scores as reference, the sensitivity and specificity of the screening tool were 73.8% and 73.1%, respectively. When taking SGNA as reference, the sensitivity and specificity of the screening tool were 76.6% and 80.9%, respectively. When taking EDACS as reference, the sensitivity and specificity of the screening tool were 72.7% and 97.2%, respectively. The detection rate of severe malnutrition and severe eating disorders screened by ≥3 was 100%. Conclusion The screening tool for feeding/swallowing difficulties and malnutrition can be used to identify nutritional and swallowing problems in children with cerebral palsy, which is helpful for avoiding missed diagnosis of severe malnutrition and severe eating disorders.
Key words
cerebral palsy /
feeding difficulties /
swallowing disorders /
malnutrition /
screening tool
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