Novel mealtime duration measures (Mishra et al., 2017)

<div><b>Purpose: </b>The purpose of this study is to examine (a) the reliability of newly developed measures of mealtime duration and (b) their relationship to clinical feeding/swallowing performance in children with spastic cerebral palsy (SCP).</div><div><b>Method: </b>Seventeen self-feeding children (9 boys, 8 girls) with SCP (age range = 5;1 [years;months] to 17;6, Gross Motor Function Classification System range = I–IV) were assessed during mealtimes using the Dysphagia Disorder Survey (DDS; Sheppard, Hochman, & Baer, 2014). Children were divided into 2 groups, children with primarily unilateral or bilateral brain involvement. Duration measures included mealtime duration and total sip/bite duration for each bolus type (liquid and solid).</div><div><b>Results:</b> Excellent intra- and inter-rater reliability for all duration measures was observed (intraclass correlation coefficient [ICC] = 1.00 and 0.955, respectively, for mealtime duration; ICC = 1.00 and 0.963, respectively, for solid/bite duration; ICC = 1.00 and 0.957, respectively, for liquid/sip duration). Positive correlations were found between total mealtime duration and DDS Part 1, <i>r<sub>s</sub></i> = .514 [.045–.797], <i>p</i> = .035; Part 2, <i>r<sub>s</sub></i> = .528 [.064–.804], <i>p</i> = .029; and total scores, <i>r<sub>s</sub></i> = .665 [.271–.868], <i>p</i> = .004, and between total solid/bite duration and DDS Part 1, <i>r<sub>s</sub></i> = .579 [.137–.828], <i>p</i> = .015; Part 2, <i>r<sub>s</sub></i> = .620 [.199–.847], <i>p</i> = .007; and total scores, <i>r<sub>s</sub></i> = .762 [.444–.909], <i>p</i> < .001. Children with unilateral brain involvement exhibited significantly lower DDS total (<i>p</i> = .049) and Part 2 scores (<i>p</i> = .026), indicating better feeding/swallowing performance/skills. They also had shorter mealtime duration (<i>p</i> = .019) and solid/bite duration (<i>p</i> = .025) compared with children with bilateral involvement.</div><div><b>Conclusions:</b> Our new mealtime duration measures are reliable and correlate with feeding/swallowing performance in a sample of self-feeding children with SCP. Therefore, they may be useful supplements to feeding/swallowing assessments for this population.</div><div><br></div><div><b>Supplemental Material S1.</b> Foods/liquids consumed by each child.</div><div><br></div><div>Mishra, A., Sheppard, J. J., Kantarcigil, C., Gordon, A. M., & Malandraki, G. A. (2017). Novel mealtime duration measures: Reliability and preliminary associations with clinical feeding and swallowing performance in self-feeding children with cerebral palsy. <i>American Journal of Speech-Language Pathology</i>. Advance online publication.</div>