Guidelines for speech, language and swallowing management following paediatric TBI

Abstract

Background and aims: Evidence-based guidelines aim to enhance patient outcomes and consistency of care.Yet they are rarely used for the management of communication and swallowing disorders following paediatric TBI. We aimed to improve clinical care of this population by developing evidenceand consensus-based recommendations for the management of speech, language and swallowing disorders during the first year of rehabilitation. Method: A multidisciplinary committee consisting of expert health professionals and consumers was convened to develop recommendations. Systematic review evidence was appraised for the formulation of evidence-based recommendations, created using the National Health and Medical Research Council statement form. Consensus-based recommendations were devised using a three-round Delphi survey completed by the committee. The criterion for agreement was 80%. Results: Consensus-based and, where sufficient research was available, evidence-based recommendations were formed to guide management of speech, language and swallowing disorders, including: prediction of these disorders, health professional team required, optimal timing of assessment, assessment tools, intervention strategies, commencement of treatment, and key information to support parents. Conclusions: Key recommendations include screening of children with moderate and severe TBI for these disorders acutely using appropriate informal and formal measures to guide intervention. In particular, patients with severe TBI and prolonged ventilation are an at risk group, and should be considered for early referral to speech pathology to support timely diagnosis and management. The developed recommendations provide a basis for the systematic management of communication and swallowing disorders that can be refined as new high-quality evidence emerges.L6265167362019-03-01 <br />