Mok Xue Ting Joelle
Speech Language Therapy Service, Rehabilitation Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore, 229899.
Dysphagia. 2024 Oct;39(5):825-836. doi: 10.1007/s00455-023-10664-0. Epub 2024 Feb 6.
Dysphagia screening tests are useful in identifying possible dysphagia for further evaluation and in supporting feeding recommendations. This study aimed to investigate swallowing parameters in children, while widening the pool of data available, using the '100 ml-Timed Water Swallow Test' (100 ml-TWST). Sixty Singaporean children aged 4 to 18 years old completed the 100 ml-TWST via a cup and a straw. Task completion, presence of cough, choke or throat clear, post-swallow voice quality, total time taken and number of swallows were observed. Subsequently, analysis of time per swallow (T/S), volume per swallow (V/S) and volume per time or swallowing capacity (V/T) were performed. Higher tendencies for coughing and task incompletion were observed in younger participants. A shorter time taken, fewer number of swallows, greater V/S and greater swallowing capacity were observed for adolescent or male participants, or via the mode of cup drinking. These could be due to oropharyngeal structural changes and swallow maturation with age, an increased capacity of oropharyngeal structures for swallowing in adolescent males, and more controlled or paced drinking from a straw. A plateau in time taken, number of swallows and swallowing capacity in adolescence were also observed, possibly indicating an emerging maturation of swallow functions during that period. Interestingly, speed of bolus movement was largely unaffected by age, gender and mode of drinking. Pilot data for children with no dysphagia have been established, while gaining insight into the swallowing parameters and maturation process in the paediatric population.
吞咽困难筛查测试有助于识别可能存在的吞咽困难,以便进一步评估,并为喂养建议提供支持。本研究旨在通过“100毫升定时水吞咽测试”(100 ml - TWST)来调查儿童的吞咽参数,同时扩大可用数据集。60名年龄在4至18岁的新加坡儿童通过杯子和吸管完成了100 ml - TWST。观察任务完成情况、是否出现咳嗽、呛噎或清嗓、吞咽后嗓音质量、总用时以及吞咽次数。随后,对每次吞咽时间(T/S)、每次吞咽量(V/S)以及单位时间吞咽量或吞咽能力(V/T)进行了分析。较年轻的参与者咳嗽和任务未完成的倾向更高。青少年或男性参与者、通过杯子饮用方式完成测试的参与者,表现出用时更短、吞咽次数更少、每次吞咽量更大以及吞咽能力更强。这可能是由于口咽结构变化和随着年龄增长吞咽功能成熟,青少年男性口咽结构吞咽能力增强,以及从吸管饮水时控制或节奏更好。在青少年时期,还观察到吞咽用时、吞咽次数和吞咽能力出现平稳状态,这可能表明在此期间吞咽功能正在逐渐成熟。有趣的是,食团移动速度在很大程度上不受年龄、性别和饮用方式的影响。已建立了无吞咽困难儿童的初步数据,同时深入了解了儿科人群的吞咽参数和成熟过程。