Paediatric dysphagia assessments used by speech and language therapists in Low and Middle-Income countries: A Scoping Review

Abstract

Introduction: Paediatric dysphagia is highly prevalent in low and middle-income countries (LMICs), where healthcare facilities have limited resources. The awareness of available resources for Speech and Language Therapists (SLTs) to assess paediatric dysphagia is useful to ensure early diagnosis and intervention. Objectives: To describe different types of paediatric dysphagia assessments used by SLTs in LMICs, characteristics of identified assessments and gaps in current evidence. Methods: This systematic scoping review was conducted using a modified version of Arksey and O’Malley’s framework. Keywords comprised ‘paediatric’, ‘dysphagia’. Two electronic databases were searched for relevant articles published from January 2005 to December 2020, and reference list of included studies were reviewed for missed articles. Two independent reviewers reviewed the articles and one reviewer extracted data on sample descriptors, paediatric dysphagia assessment types and characteristics of paediatric dysphagia assessments used by SLTs in LMICs. The same reviewer collected the results and resolved discrepancies with the support of the supervisor. Results: Six articles were included in this review (two from Brazil, two from Turkey and two from India). Samples and methods of identified articles were heterogeneous. There were 12 different paediatric dysphagia assessments used by three LMICs covering two main paediatric dysphagia assessments types; instrumental or non- instrumental. The non¬instrumental assessments were the most prominent assessment type among SLTs and the Video- fluoroscopic swallow study was the only assessment repeated in two countries: Brazil and India. Assessment’s characteristics were identified. Less information was available on results, interpretation and assessing time duration. Conclusions: Both instrumental and non-instrumental assessments for paediatric dysphagia are common among SLTs in LMICs.