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Frakking TT, Chang AB, Carty C, Newing J, Weir KA, Schwerin B, So S. Using an Automated Speech Recognition Approach to Differentiate Between Normal and Aspirating Swallowing Sounds Recorded from Digital Cervical Auscultation in Children. Dysphagia 2022; 37:1482-1492. [PMID: 35092488 PMCID: PMC9643257 DOI: 10.1007/s00455-022-10410-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
Abstract
Use of machine learning to accurately detect aspirating swallowing sounds in children is an evolving field. Previously reported classifiers for the detection of aspirating swallowing sounds in children have reported sensitivities between 79 and 89%. This study aimed to investigate the accuracy of using an automatic speaker recognition approach to differentiate between normal and aspirating swallowing sounds recorded from digital cervical auscultation in children. We analysed 106 normal swallows from 23 healthy children (median 13 months; 52.1% male) and 18 aspirating swallows from 18 children (median 10.5 months; 61.1% male) who underwent concurrent videofluoroscopic swallow studies with digital cervical auscultation. All swallowing sounds were on thin fluids. A support vector machine classifier with a polynomial kernel was trained on feature vectors that comprised the mean and standard deviation of spectral subband centroids extracted from each swallowing sound in the training set. The trained support vector machine was then used to classify swallowing sounds in the test set. We found high accuracy in the differentiation of aspirating and normal swallowing sounds with 98% overall accuracy. Sensitivity for the detection of aspiration and normal swallowing sounds were 89% and 100%, respectively. There were consistent differences in time, power spectral density and spectral subband centroid features between aspirating and normal swallowing sounds in children. This study provides preliminary research evidence that aspirating and normal swallowing sounds in children can be differentiated accurately using machine learning techniques.
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Affiliation(s)
- Thuy T. Frakking
- Research Development Unit, Caboolture Hospital, Metro North Hospital & Health Service, McKean St, Caboolture, QLD 4510 Australia ,Centre for Clinical Research, School of Medicine, The University of Queensland, Herston, QLD 4029 Australia ,Speech Pathology Department, Gold Coast University Hospital, Gold Coast Hospital & Health Service, 1 Hospital Boulevard, Southport, QLD 4215 Australia
| | - Anne B. Chang
- Department of Respiratory Medicine, Queensland Children’s Hospital, 501 Stanley St, South Brisbane, QLD 4101 Australia ,Child Health Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT 0811 Australia ,Australian Centre for Health Services Innovation, Queensland University of Technology, Level 7, 62 Graham St, South Brisbane, QLD 4101 Australia
| | - Christopher Carty
- Research Development Unit, Caboolture Hospital, Metro North Hospital & Health Service, McKean St, Caboolture, QLD 4510 Australia ,Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222 Australia
| | - Jade Newing
- School of Engineering and Built Environment, Griffith University, Parklands Dr, Southport, QLD 4215 Australia
| | - Kelly A. Weir
- Menzies Health Institute QLD & School of Health Sciences & Social Work, Griffith University, Gold Coast Campus, 1 Parklands Avenue, Southport, QLD 4222 Australia ,Allied Health Research, Gold Coast University Hospital, Gold Coast Hospital & Health Service, 1 Hospital Boulevard, Southport, QLD 4215 Australia
| | - Belinda Schwerin
- School of Engineering and Built Environment, Griffith University, Parklands Dr, Southport, QLD 4215 Australia
| | - Stephen So
- School of Engineering and Built Environment, Griffith University, Parklands Dr, Southport, QLD 4215 Australia
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Radford C, Marshall J, Herbert A, Irving H, Weir K. Risk Feeding: An Australian Pediatric Palliative Care Perspective. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-19-00032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
This article explores the challenges of risk feeding from an Australian Paediatric Palliative Care perspective. There is currently limited evidence to guide risk feeding in pediatric clinical practice. Therefore, this article uses evidence from the adult palliative and end-of-life care context (extrapolating to pediatric application), in addition to the authors' clinical experience in supporting children and their families with risk feeding. Recommendations for the clinical management of pediatric risk feeding are discussed, including the suggested focus for families and the interprofessional team along the different phases of the palliative care continuum.
Conclusion
There is currently limited information to guide decision making regarding risk feeding in pediatrics. Overall, in the absence of evidence-based practice guidelines, it is the authors' recommendation that a risk feeding plan is developed in consultation and collaboration with the family, treating physician, and interprofessional team. Further research is required to support guidance for clinicians working in this area.
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Affiliation(s)
- Claire Radford
- Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Jeanne Marshall
- Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Anthony Herbert
- Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Helen Irving
- Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Kelly Weir
- Gold Coast Hospital and Health Service, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Heijnen BJ, Böhringer S, Speyer R. Prediction of aspiration in dysphagia using logistic regression: oral intake and self-evaluation. Eur Arch Otorhinolaryngol 2020; 277:197-205. [PMID: 31630245 PMCID: PMC6942603 DOI: 10.1007/s00405-019-05687-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Oropharyngeal dysphagia (OD) has a major influence on health in general and health-related quality of life (HR-QoL) in particular. The gold standard assessments for OD, especially for aspiration in OD, are fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VFSS), but not all patients have access to such procedures. Therefore, the current study built a prediction model to forecast aspiration in patients with OD on the basis of common self-evaluation questionnaires and oral intake status. METHODS A consecutive series of 111 patients with confirmed diagnosis of OD was measured according to a standardised protocol using the following tools: the Swallowing Quality of Life Questionnaire (SWAL-QOL), the Dysphagia Handicap Index (DHI), two self-report visual analogue scales which measure the Severity and the Impairment of the swallowing problem on everyday social life as experienced by the patient, the Eating Assessment Tool 10 (EAT-10), the Functional Oral Intake Scale (FOIS) and subsequently FEES (the gold standard). Penalised logistic regression was carried out to predict aspiration. The performance of the resulting models was evaluated by constructing receiver operating characteristics (ROC) curves and computing areas under the curve (AUC). RESULTS The final model showed an AUC of 0.92, indicating excellent performance. CONCLUSION This study shows that it may be possible to accurately predict aspiration in oropharyngeal dysphagia by a non-invasive and non-instrumental assessment protocol including oral intake status and self-report questionnaires on functional health status and HR-QoL.
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Affiliation(s)
- Bas J Heijnen
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Zone H2-Q, PO Box 9600, 2300, Leiden, RC, The Netherlands.
| | - Stefan Böhringer
- Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Renée Speyer
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Zone H2-Q, PO Box 9600, 2300, Leiden, RC, The Netherlands
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Australia
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Frakking TT, Chang AB, David M, Orbell‐Smith J, Weir KA. Clinical feeding examination with cervical auscultation for detecting oropharyngeal aspiration: A systematic review of the evidence. Clin Otolaryngol 2019; 44:927-934. [DOI: 10.1111/coa.13402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 05/16/2019] [Accepted: 07/07/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Thuy T. Frakking
- Speech Pathology Department & Research Development Unit, Metro North Hospital & Health Service, Queensland Health Caboolture Hospital Caboolture QLD Australia
- School of Health and Rehabilitation Sciences The University of Queensland St Lucia QLD Australia
| | - Anne B. Chang
- Department of Respiratory Medicine Queensland Children's Hospital QLD Australia
- Child Health Division, Menzies School of Health Research Charles Darwin University Casuarina NT Australia
- Centre for Children's Health Research Queensland University of Technology QLD Australia
| | - Michael David
- School of Medicine and Public Health The University of Newcastle Gosford NSW Australia
| | - Jane Orbell‐Smith
- Library Services, Metro North Hospital & Health Service Caboolture Hospital Caboolture QLD Australia
| | - Kelly A. Weir
- School of Allied Health Sciences, Menzies Health Institute Queensland Griffith University Brisbane QLD Australia
- Clinical Governance, Education & Research Gold Coast University Hospital Southport QLD Australia
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Current approaches to instrumental assessment of swallowing in children. Curr Opin Otolaryngol Head Neck Surg 2019; 26:349-355. [PMID: 30325754 DOI: 10.1097/moo.0000000000000492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF THE REVIEW This article reviews recent developments in the instrumental assessment of swallowing in children with a specific focus on research published between January 2017 and June 2018. RECENT FINDINGS Instrumental swallowing assessments reported in the time period included: videofluoroscopic study of swallowing, digital cervical auscultation, dynamic ultrasound, high-resolution impedance manometry, nasal airflow thermistry and respiratory inductance plethysmography. Several studies were found exploring tools to objectively quantify videofluoroscopic study of swallowing data; swallowing from the mouth through to stomach was addressed including approaches to analysing mastication as well as evaluating oesophageal motility disorders. SUMMARY Even though a vast range of instrumentation were studied, lack of clarity on clinical feasibility and objective measures that facilitate medical decision-making in practice mean further research is required to provide guidance on implementation. Promising novel approaches to aid the quantification of swallowing physiology from the mouth, pharynx and through to the oesophagus are emerging.
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Taveira KVM, Santos RS, Leão BLCD, Stechman Neto J, Pernambuco L, Silva LKD, De Luca Canto G, Porporatti AL. Diagnostic validity of methods for assessment of swallowing sounds: a systematic review. Braz J Otorhinolaryngol 2018; 84:638-652. [PMID: 29456200 PMCID: PMC9452251 DOI: 10.1016/j.bjorl.2017.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/07/2017] [Accepted: 12/27/2017] [Indexed: 02/03/2023] Open
Abstract
Introduction Objective Methods Results Conclusion
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Affiliation(s)
| | - Rosane Sampaio Santos
- Universidade Tuiuti do Paraná (UTP), Programa de Pós-graduação em Distúrbios da Comunicação, Curitiba, PR, Brazil
| | | | - José Stechman Neto
- Universidade Tuiuti do Paraná (UTP), Programa de Pós-graduação em Distúrbios da Comunicação, Curitiba, PR, Brazil
| | - Leandro Pernambuco
- Universidade Federal da Paraíba (UFPB), Departamento de Fonoaudiologia, João Pessoa, PB, Brazil
| | - Letícia Korb da Silva
- Instituto de Educação Luterana de Santa Catarina, Departamento de Fonoaudiologia, Joinville, SC, Brazil
| | - Graziela De Luca Canto
- Universidade Federal de Santa Catarina (UFSC), Departamento de Odontologia, Brazilian Centre for Evidence-based Research, Florianópolis, SC, Brazil; University of Alberta, Faculty of Medicine and Dentistry, School of Dentistry, Alberta, Canada
| | - André Luís Porporatti
- Universidade Federal de Santa Catarina (UFSC), Departamento de Odontologia, Brazilian Centre for Evidence-based Research, Florianópolis, SC, Brazil
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Almeida STD, Ferlin EL, Maciel AC, Fagondes SC, Callegari-Jacques SM, Fornari F, Sérgio G. Silva DB, Goldani HAS. Acoustic signal of silent tracheal aspiration in children with oropharyngeal dysphagia. LOGOP PHONIATR VOCO 2018; 43:169-174. [DOI: 10.1080/14015439.2018.1487993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sheila T. de Almeida
- Post-Graduate Program: Science in Gastroenterology and Hepatology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Elton L. Ferlin
- Modelling and Signal Analysis Unit, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | | | | | - Fernando Fornari
- Post-Graduate Program: Science in Gastroenterology and Hepatology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - de Barros Sérgio G. Silva
- Post-Graduate Program: Science in Gastroenterology and Hepatology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Frakking TT, Chang AB, O'Grady KAF, Yang J, David M, Weir KA. Acoustic and Perceptual Profiles of Swallowing Sounds in Children: Normative Data for 4-36 Months from a Cross-Sectional Study Cohort. Dysphagia 2016; 32:261-270. [PMID: 27830392 DOI: 10.1007/s00455-016-9755-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/18/2016] [Indexed: 12/12/2022]
Abstract
Limited data on cervical auscultation (CA) sounds during the transitional feeding period of 4-36 months in healthy children exist. This study examined the acoustic and perceptual parameters of swallowing sounds in children aged 4-36 months over a range of food and fluid consistencies. Using CA, swallowing sounds were recorded from a microphone as children ate or drank. Acoustic parameters of duration, peak frequency and peak intensity were determined. Perceptual parameters of swallowing/breath sounds heard pre-, during and post-swallow were rated ('present', 'absent', 'cannot be determined') for each texture. 74 children (35 males; mean age = 17.1 months [SD 10.0]) demonstrated mean swallow durations of <1 s. Increasing age correlated to reduced peak frequency on puree (r = -0.48, 95 % CI -0.66, -0.24). Age correlated to peak amplitude when swallowing puree (r = 0.27, 95 % CI 0.02, 0.49), chewable solids (r = 0.31, 95 % CI 0.02, 0.56) and thin fluids (r = 0.48, 95 % CI 0.27, 0.64). The bolus transit sound was present in all swallows. A majority of children had normal breathing sounds and coordinated swallows. A swallow duration of <1 s and the presence of a quick bolus transit sound with normal breathing sounds were found in healthy children. The normative data reported in this study provide a platform for future comparison to abnormal swallowing sounds in children.
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Affiliation(s)
- Thuy T Frakking
- Centre for Children's Health Research, The University of Queensland, Level 7, 62 Graham St, South Brisbane, QLD, 4101, Australia. .,Speech Pathology Department, Caboolture Hospital, McKean St, Caboolture, QLD, 4510, Australia.
| | - Anne B Chang
- Queensland Children's Respiratory Centre, Lady Cilento Children's Hospital, 501 Stanley St, South Brisbane, QLD, 4101, Australia.,Child Health Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.,Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Level 7, 62 Graham St, South Brisbane, QLD, 4101, Australia
| | - Kerry-Ann F O'Grady
- Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Level 7, 62 Graham St, South Brisbane, QLD, 4101, Australia
| | - Julie Yang
- Centre for Children's Health Research, The University of Queensland, Level 7, 62 Graham St, South Brisbane, QLD, 4101, Australia
| | - Michael David
- School of Public Health, The University of Queensland, Herston Rd, Herston, QLD, 4029, Australia
| | - Kelly A Weir
- School of Medicine, The University of Queensland, St Lucia, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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