Validity and reliability of the Mastication Observation and Evaluation (MOE) instrument (original) (raw)
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The aim of this study was to develop the Mastication Observation and Evaluation instrument for observing and assessing the chewing ability of children eating solid and lumpy foods. This study describes the process of item definition and item selection and reports the content validity, reproducibility and consistency of the instrument. In the developmental phase, 15 experienced speech therapists assessed item relevance and descriptions over three Delphi rounds. Potential items were selected based on the results from a literature review. At the initial Delphi round, 17 potential items were included. After three Delphi rounds, 14 items that regarded as providing distinctive value in assessment of mastication (consensus >75%) were included in the Mastication Observation and Evaluation instrument. To test item reproducibility and consistency, two experts and five students evaluated video recordings of 20 children (10 children with cerebral palsy aged 29-65 months and 10 healthy children aged 11-42 months) eating bread and a biscuit. Reproducibility was estimated by means of the intraclass correlation coefficient (ICC). With the exception of one item concerning chewing duration, all items showed good to excellent intraobserver agreement (ICC students: 0Á73-1Á0). With the exception of chewing duration and number of swallows, inter-observer agreement was fair to excellent for all items (ICC experts: 0Á68-1Á0 and ICC students: 0Á42-1Á0). Results indicate that this tool is a feasible instrument and could be used in clinical practice after further research is completed on the reliability of the tool.
Dysphagia, 2019
The Mastication Observation and Evaluation (MOE) instrument is an objective assessment of the chewing process in children. This study aimed to translate the MOE into Turkish and to test its reliability and validity in children with cerebral palsy (CP). A total of 53 children with CP and 27 typical children were included in the study. The MOE was translated from Dutch into Turkish by using the forward, backward, forward translation method. The internal consistency, intra-and inter-observer reliability, criterion, and discriminant validity of the Turkish version of the MOE (T-MOE) were investigated. Internal consistency was excellent with a Cronbach's alpha value of 0.98. The Intraclass correlation coefficient ranged from 0.89 to 0.97 for intra-rater reliability and from 0.86 to 0.94 for inter-rater reliability. The median score from Karaduman Chewing Performance Scale (KCPS) was 7 (min = 1, max = 8). All of the items in the T-MOE and the total T-MOE score had a negative and strong correlation with the KCPS score. Typical children without chewing disorders had greater T-MOE scores than the children with CP suffering from chewing disorders (p < 0.01). The T-MOE is a reliable and valid instrument for evaluating the observed oral motor behaviors of chewing function in children. It can be used in clinical practice and research. Clinical trial number: NCT03811353.
Development of a new instrument for determining the level of chewing function in children
Journal of Oral Rehabilitation, 2016
This study aimed to develop a chewing performance scale that classifies chewing from normal to severely impaired and to investigate its validity and reliability. The study included the developmental phase and reported the content, structural, criterion validity, interobserver and intra-observer reliability of the chewing performance scale, which was called the Karaduman Chewing Performance Scale (KCPS). A dysphagia literature review, other questionnaires and clinical experiences were used in the developmental phase. Seven experts assessed the steps for content validity over two Delphi rounds. To test structural, criterion validity, interobserver and intra-observer reliability, two swallowing therapists evaluated chewing videos of 144 children (Group I: 61 healthy children without chewing disorders, mean age of 42Á38 AE 9Á36 months; Group II: 83 children with cerebral palsy who have chewing disorders, mean age of 39Á09 AE 22Á95 months) using KCPS. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used for criterion validity. The KCPS steps arranged between 0-4 were found to be necessary. The content validity index was 0Á885. The KCPS levels were found to be different between groups I and II (v 2 = 123Á286, P < 0Á001). A moderately strong positive correlation was found between the KCPS and the subscales of the BPFAS (r = 0Á444-0Á773, P < 0Á001). An excellent positive correlation was detected between two swallowing therapists and between two examinations of one swallowing therapist (r = 0Á962, P < 0Á001; r = 0Á990, P < 0Á001, respectively). The KCPS is a valid, reliable, quick and clinically easy-to-use functional instrument for determining the level of chewing function in children.
A clinical protocol to increase chewing and assess mastication in children with feeding disorders
Behavior modification, 2014
Children with feeding disorders often cannot or do not chew when presented with table food. Children with chewing deficits also often swallow the bite before masticating it appropriately, which we will refer to as early swallowing. In the current study, we evaluated a clinical protocol to increase chews per bite, assess mastication, and eliminate early swallowing with three children with feeding disorders. The current study adds to a small body of literature on chewing and mastication of children with feeding disorders. Suggestions for future research are also discussed.
Journal of Texture Studies, 2020
This study investigated, for the first time, the masticatory capability of preschool children using natural foods, and the impact of an early oral health alteration (early childhood caries: ECC) on the granulometry of ready‐to‐swallow food boluses. Thirteen children with ECC were compared to 13 preschool children with a healthy oral condition. Oral health criteria and NOT‐S scores (Nordic Orofacial dysfunction Test‐Screening) were recorded. For each child, number of masticatory cycles (Nc), chewing time (Ti), and frequency (Fq = Nc/Ti) were recorded during mastication of raw carrot (CAR), cheese (CHS) and breakfast cereals (CER) samples. Food boluses were collected by stopping children at their food‐dependent individual swallowing threshold (Nc), and the median food bolus particle size value (D50) was calculated. Correlations were sought between oral health and masticatory criteria. In the ECC group, mean Fq values were significantly decreased for all three foods (p ≤ .001) and mean...
International standardisation of the test of masticating and swallowing solids in children
Journal of Oral Rehabilitation, 2018
The Test of Masticating and Swallowing Solids (TOMASS) is a validated assessment tool measuring the efficiency of solid bolus intake by four quantitative parameters: discrete bites, masticatory cycles, swallows, and time to ingest a single cracker. A normative data base for adults (20-80+ years) has previously been established. The objective of this study was to investigate the applicability and reliability of the TOMASS in children and adolescents (TOMASS-C) and to establish the normative data base for this younger population. We collected data from 638 participants (male: 311, female: 327) in five age groups (4-18 years) with five different but very similar test crackers in four countries. Significant effects of bolus type (cracker), age group and gender on the TOMASS parameters were identified, requiring stratification of the TOMASS-C database by these variables. Intra-rater reliability was excellent (ICC> .94) for all parameters, inter-rater reliability was moderate for 'number of swallows' (ICC= .54), good for 'bites' (ICC= .78) and 'time' (ICC= .82), and excellent for 'masticatory cycles' (ICC= .96). The 'Test of Masticating and Swallowing Solids in Children (TOMASS-C)' was identified to be a reliable diagnostic tool for the comprehensive measurement of discrete oral stage components of solid bolus ingestion, standardized by a large normative data base that covers age groups from preschoolers to young adults. While differences between gender groups were less pronounced than in the adult population, previous results relating to changes in masticatory and swallowing as a function of age are confirmed by our data.
The objective rating of oral-motor functions during feeding
Dysphagia, 1995
The Schedule for Oral Motor Assessment (SOMA) was developed to record oral-motor skills objectively in infants between ages 8 and 24 months postnatal. Its aim is to identify areas of dysfunction that could contribute to feeding difficulties. The procedure takes approximately 20 min to administer, and is intended to be rated largely from a videorecording of a structured feeding session. A series of foodstuffs of varying textures, including liquids, is presented to the child in a standardized manner. Oral-motor skills are evaluated in terms of discrete oral-motor movements. The schedule distinguishes these from skills at more aggregated levels of functioning such as jaw, lip, and tongue control. A total of 127 children have been studied with the instrument, including normal healthy infants and samples with nonorganic failure to thrive, and cerebral palsy. Interrater and test-retest reliabilities were determined on a subset of 10 infants who each took part in three trials rated by 2 therapists. Excellent levels of interrater reliability (kappa >0.75) were obtained for the presence/absence of 69% of discrete oral-motor behaviors. Test-retest reliability was similarly excellent for 85% of ratable behaviors. For the first time an assessment of oral-motor functioning has been shown to have adequate reliability for children aged 8–24 months. The validation of the SOMA on a large sample of normally developing infants and its application to clinical groups is presented in an accompanying paper [1].
Masticatory behavior for different solid foods in preschool children according to their oral state
Journal of Texture Studies, 2019
Gradual introduction of solid foods in early childhood takes part in the maturation of mastication. The impact of any oral state alteration on food oral processing development is poorly documented for this age group. This study investigated the masticatory behavior in 3 to 6 year‐old children with or without early childhood caries (ECC) for three solid foods of different textures. Twenty‐one children with healthy oral state and 23 children with severe ECC were observed during complete mastication of calibrated samples of raw carrot, cheese and breakfast cereals. Food refusals and kinematic parameters (Ti: chewing time, Nc: number of cycles and Fq: chewing frequency) were used to assess children masticatory behavior. Oral Health‐related Quality of Life and orofacial dysfunctions were evaluated using, respectively the early childhood oral health impact scale (ECOHIS) and the Nordic orofacial dysfunction test screening (NOT‐S). Children suffering from ECC exhibited significantly higher...
Lado De Preferencia Masticatoria en Niños Con Fisura Palatina: Concordancia De Tres Métodos
Revista Facultad De Odontologia Universidad De Antioquia, 2014
Introduction: the objective was to measure the concordance of three methods to determine chewing side preference in children with cleft palate. Materials and methods: The sample included 47 children with cleft palate and similar age and socioeconomic level. Methods: the test of Christensen & Radue (1985), the test of Paphangkorakit et al (2006) and surface electromyography (sEMG) were used. Comparisons among groups were made by non-parametric methods. Results: the method of Paphangkorakit et al (2006) did not show concordance with the preference measured by the Christensen & Radue method (1985) (Pearson's χ2 = 0.96, p = 0,619; Kappa =-0.08, p = 0,475). The results showed that cleft type is not associated to chewing side preference measured by the method of
A Pilot Study to Increase Chewing in Children With Feeding Disorders
Behavior Modification, 2013
Children with feeding disorders often display chewing deficits. Unfortunately, there is a paucity of research examining procedures to increase or teach chewing to children with feeding disorders. The few studies on this topic have utilized multicomponent treatments typically involving a shaping procedure. In addition, to our knowledge, studies on chewing have not yet incorporated a product measure of chewing (whether the food is broken down enough to swallow after chewing), which we have termed mastication. In the current investigation, we evaluated relatively simple treatments to increase chewing with two children with a feeding disorder who were not chewing at clinically acceptable levels after treatment with nonremoval of the spoon. We also developed a product measure of chewing. In Study 1, we used a least-to-most prompting plus praise procedure to increase chews per bite in a typically developing child with a feeding disorder. We then used the results of Study 1 to refine treat...