(395) Predictive Value of Feeding/Swallowing Impact Survey on Pediatric Diet Modification

Introduction: Instrumental swallowing assessments are considered the gold standard for diagnosis of pediatric dysphagia, but they expose children to radiation (Video Fluoroscopic Swallowing Study (VFSS)) or significant discomfort (Flexible Endoscopic Evaluation of Swallowing (FEES)). The goal of this study is to determine whether the validated Feeding/Swallowing Impact Survey (FS-IS) can be used as a baseline screening tool to predict instrumental swallowing assessment outcomes in children using Functional Oral Intake Scale (FOIS) as an endpoint.

Methods: A prospective cohort study was conducted at a single institution, March-June 2021. Caregivers of children undergoing initial VFSS were identified and administered the FS-IS within three weeks prior to VFSS. Non-parametric Spearman correlation coefficients were used to compare the strength of association between the caregiver FS-IS and FOIS scores, based on VFSS recommendations. Multivariable linear regression was performed to determine other caregiver characteristics that may contribute to FS-IS scores.

Results: Of the 84 caregivers and children enrolled, 74 completed both the FS-IS and VFSS. No correlation was noted between overall FS-IS score and FOIS score, but a weak correlation was noted between the Worry Subscale and the FOIS (rho=0.36). On multivariable linear regression, there were no caregiver characteristics that were associated with a greater FS-IS score.

Conclusions: FS-IS does not appear to be a good screening tool for dysphagia on VFSS, though higher scores on the Worry Subscale may suggest a greater restriction of diet indicated by FOIS. Further research is needed to develop a screening tool to decrease negative effects of instrumental assessments.