Clinical swallowing evaluation scale in children with cerebral palsy

To develop and validate a clinical rating scale of swallowing in children with cerebral palsy. The proposed scale was developed based on the evaluation protocol used by a group specialized in the care of children with cerebral palsy. Ten expert judges analyzed the scale for relevance. The clinical swallow evaluation was initially performed by a specialized speech-language pathologist in seventy children with cerebral palsy. Swallowing was classified as normal, functional, mild, moderate or severe dysphagia. The proposed scale was applied by two other speech-language pathology experts. After two weeks, the entire evaluation process was carried out again. The scale presented with efficient internal consistency and reproducibility values. Cutoff value scores were established for the swallowing classifications. Sensitivity showed good results for the classification of normal/functional swallowing, which demonstrated a tendency towards good results for rating moderate and severe dysphagia, and poor results for mild dysphagia. The proposed scale presented high internal consistency and reproducibility values, with a satisfactory degree of reproducibility. It proved to be an effective tool in differentiating cerebral palsy children with or without dysphagia. It was effectively able to establish the classification of moderate and severe dysphagia, but less effectively able to differentiate mild dysphagia.