A Literature Review: Evidence Base in Speech-Language Pathology for the Management of Pediatric Oral Phase Dysphagia

Abstract

Purpose A review was conducted of published literature regarding management of feeding difficulties at the oral phase of feeding in children with autism spectrum disorder and/or developmental disability. The articles selected were open access or free for speech-language pathologist (SLP) members of their professional bodies. The specific research question was: What research and evidence-based practice articles have been published in the SLP literature to assist SLPs in the implementation of evidence-based practice for children with challenges during the oral phase dysphagia? Method Initial inclusion criteria were articles published in English, published in SLP journals, discussed management of behavioral feeding difficulties and oral phase dysphagia, and were published between 2008 and 2018. Exclusion criteria for this review included articles that addressed dysphagia for participants who were medically fragile, used pharmacological intervention, or studies that included adults. A comprehensive search was conducted of ASHAWire, the Speech-Language and Audiology Canada website, the Royal College of Speech and Language Therapy of the United Kingdom and the website Speech Pathology Australia. Articles were analyzed using Preferred Reporting Items for Systematic Review and using a modified feasibility, appropriateness, meaningfulness, effectiveness framework for qualitative case studies. Interrater reliability was calculated using intraclass correlation coefficient across four raters. Results All but one of the articles included for this review were qualitative articles containing descriptions of strategies or case studies (e.g., food chaining), were not peer reviewed, but did constitute evidence-based practice as outlined by American Speech-Language-Hearing Association (i.e., were either Level III or Level IV evidence-based strategies or intervention models). Conclusion The review highlighted the need for additional research in SLP designed to answer questions about the management of functional skills in feeding and eating for the population of children with autism spectrum disorder and developmental disability, patients who are increasingly on caseloads of SLPs.