QUESTION: What swallow screen are your hospitals using, (specifically for the RNs to use either on admission or with change of status). We are an adult hospital with a large Women’s and Children’s center with a recently upgraded Trauma status. We have a dedicated Peds ED and we want to do better at capturing all the patients who need swallow evaluations by SLP. We get a great variety of orders on a consult basis, but physicians don’t always catch every risk factor of course or know how a patient does in every skill. Our adult side uses the Yale Swallow Screen but we know that is not standardized for Pediatric patients.
CATHERINE’S ANSWER:
The Pediatric Screening-Priority Evaluation Dysphagia (PS-PED). It gives a pilot of potential considerations for screening protocol and YES/NO prompts that may help identify higher risk populations based on clinical history, health status and feeding conditions.
Cerchiari, A., Tofani, M., Giordani, C., Franceschetti, S., Capuano, E., Pizza, F., … & Biondo, G. (2023). Development and Pilot Study of a Pediatric Screening for Feeding and Swallowing Disorders in Infants and Children: The Pediatric Screening–Priority Evaluation Dysphagia (PS–PED). Children, 10(4), 638.
I like the PS–PED for both ED and acute care pediatric patients. It looks at predictive markers related to high risk co-morbidities (neuro, cardiac, GI, respiratory), current health status (ETT, alertness, growth/malnutrition, recurrent RTIs, need for suction, GERD, constipation, NG/GT) and feeding conditions (parenteral /enteral nutrition, atypical diet for age, prolonged mealtimes). 14 yes/no items. Can be administered in less than 10 min and does not require any specific education in swallowing disorders. Pediatric nurses report it is easy to use. Does not involve administering any food to the patient. And what I really like too is data was collected for 4 month old through 17 y/os and that the psychometric properties strongly highlight solid reliability and support the screening tool’s usability.
It should work well in your Peds ED. Could also be used as a tool to enhance appropriate referrals in PICU – current research shows that “SLP involvement is infrequent in US PICUs. PICU teams should be educated about the scope of SLP practice, to support communication and oral feeding needs during early recovery from critical illness.”
Santiago, R., et al (2024). Speech-language pathologist involvement in the pediatric intensive care unit. International journal of speech-language pathology, 26(5), 674-681.
I suspect the PS-PED could be easily integrated into the electronic medical record for ease of use across multiple disciplines