Evidence- and consensus-based guidelines for the management of communication and swallowing disorders following pediatric traumatic brain injury

Abstract

Objective: Evidence-based management guidelines for communication and swallowing disorders following pediatric traumatic brain injury (TBI) are scarcely available, potentially resulting in suboptimal outcomes. To improve clinical care of this population, a multidisciplinary guideline development committee was formed to develop evidence-based recommendation (EBR) and consensus-based recommendation (CBR) for the management of speech, language, and swallowing disorders during the first year of recovery. Methods: A 3-round Delphi survey was completed by the committee to reach agreement (80% consensus) for the CBRs. Systematic review evidence guided development of EBRs, devised using the National Health and Medical Research Council statement form. Results: Altogether, 30 recommendations (5 EBRs and 25 CBRs) were developed to guide management of speech, language, and swallowing disorders, including prediction of these disorders; health team required, optimal timing of assessment; assessment tools; intervention strategies and commencement of treatment; and key information to support parents. Conclusion: The developed recommendations provide a basis for the systematic management of communication and swallowing disorders to be refined as new evidence emerges. Key recommendations include screening of children with moderate/severe TBI for these disorders acutely using specified measures. Patients with severe TBI and prolonged ventilation are a particular at-risk group and should be considered for early referral to speech–language pathology to support timely diagnosis and management. No evidence was identified to support an EBR for treatment, highlighting a key area for research. (PsycINFO Database Record (c) 2019 APA, all rights reserved)Murdoch Children’s Research Institute, Melbourne, VIC, Australia. Institutional Authors: TBI Guideline Development Group. Release Date: 20191230. Publication Type: Journal (0100), Peer Reviewed Journal (0110). Format Covered: Electronic. Document Type: Journal Article. Language: EnglishGrant Information: Morgan, Angela T. Major Descriptor: Traumatic Brain Injury. Minor Descriptor: Language; Oral Communication; Swallowing. Classification: Neurological Disorders & Brain Damage (3297). Population: Human (10); Male (30); Female (40). Location: Australia; New Zealand; England. Age Group: Childhood (birth-12 yrs) (100); Infancy (2-23 mo) (140); Preschool Age (2-5 yrs) (160); School Age (6-12 yrs) (180); Adolescence (13-17 yrs) (200); Adulthood (18 yrs & older) (300). Methodology: Empirical Study; Quantitative Study. Page Count: 16. Issue Publication Date: Sep-Oct, 2018. Copyright Statement: All rights reserved. Wolters Kluwer Health, Inc. 2018.Sponsor: National Health and Medical Research Council, Centre of Research Excellence in Brain Recovery. Grant: 1023043; 1105008. Other Details: Practitioner Fellowship. Recipients: Morgan, Angela T. <br />