Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Gyeonggi-do, Republic of Korea.
J Pediatr Gastroenterol Nutr. 2020 Nov;71(5):686-691. doi: 10.1097/MPG.0000000000002861.
The functional oral intake scale (FOIS), developed for adults based on the categories of consumable food has been adapted for infants. A FOIS for children is necessary as oral motor development continues after 1 year of age. This study proposed a FOIS for children and investigated the reliability and validity of the scale.
We adapted the original FOIS into a scale for children by removing 2 item levels to generate a 5-point scale. This retrospective study included 194 children ages 1 to 7 years. Their nutrition records were evaluated separately by 2 raters using the FOIS for children. Dysphagia and aspiration severity were evaluated based on the findings from a videofluoroscopic swallowing study. For children partially dependent on tube feeding, medical records were investigated to determine whether full oral feeding was accomplished within 1 year.
The inter-rater reliability of FOIS for children had 97.4% agreement (weighted kappa = 0.985, intraclass correlation coefficient = 0.994). Significant associations were identified between the FOIS for children and aspiration severity (P < 0.001, r = 0.315) and dysphagia severity (P < 0.001, r = 0.287). The rate of reaching full oral feeding within 1 year was greater (71.4% vs 30%) in children at the FOIS 3 level (tube and oral feeding in parallel) than for children at FOIS 2 (tube-dependent with minimal oral intake).
The FOIS for children showed adequate reliability and validity and could be appropriate for documenting children's eating abilities and evaluating the effectiveness of interventions.
功能性口腔摄入量表（FOIS）是基于可食用食物的类别为成年人开发的，现已被改编为适用于婴儿的量表。由于口腔运动在 1 岁后仍在继续发展，因此有必要为儿童制定 FOIS。本研究提出了一种适用于儿童的 FOIS，并对该量表的信度和效度进行了研究。
我们通过删除 2 个项目级别将原始 FOIS 改编为儿童量表，生成 5 分制量表。本回顾性研究纳入了 194 名 1 至 7 岁的儿童。由 2 名评估员分别使用儿童 FOIS 对儿童的营养记录进行评估。根据视频透视吞咽研究的结果评估吞咽困难和误吸的严重程度。对于部分依赖管饲喂养的儿童，通过查阅病历来确定是否在 1 年内实现了完全经口喂养。
儿童 FOIS 的组内一致性有 97.4%（加权 κ=0.985，组内相关系数=0.994）。儿童 FOIS 与误吸严重程度（P<0.001，r=0.315）和吞咽困难严重程度（P<0.001，r=0.287）之间存在显著相关性。在 FOIS 3 级（管饲和经口喂养并行）的儿童中，1 年内达到完全经口喂养的比例（71.4%比 30%）高于 FOIS 2 级（仅通过管饲喂养且经口摄入极少的儿童）。
儿童 FOIS 具有足够的信度和效度，可用于记录儿童的进食能力和评估干预措施的效果。
