4.2 Article

Best practice recommendations for speech-language pathology in children with neuromuscular disorders: A Delphi-based consensus study

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Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/17549507.2023.2181224

Keywords

Dysphagia; dysarthria; saliva control; oral hygiene; neuromuscular disorders; best practice recommendations

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This study aimed to achieve consensus and present best practice recommendations on speech-language pathology intervention in paediatric neuromuscular disorders. The results led to six core intervention components that cover various symptoms and provide guidance for speech-language pathologists working in this field.
Purpose: Speech-language pathology (SLP) is considered an essential intervention due to the high prevalence of dysphagia and dysarthria in paediatric neuromuscular disorders (pNMD). Evidence-based guidelines for SLP in pNMD are missing and children could be deprived the best of care. This study aimed to achieve consensus and present best practice recommendations on SLP intervention in pNMD.Method: A modified Delphi technique was used with a panel of experienced Dutch speech-language pathologists. In two online survey rounds and a face-to-face consensus meeting, the SLP experts proposed intervention items for cases of four types of pNMD (congenital myopathy, Duchenne muscular dystrophy, myotonic dystrophy type 1, and spinal muscular atrophy type 2), covering symptoms of dysphagia, dysarthria, drooling, and oral hygiene problems. They rated the level of agreement.Result: Intervention items that achieved consensus were incorporated into best practice recommendations. These recommendations cover six core intervention components (wait and see, explanation and advice, training and treatment, aids and adjustments, referral to other disciplines, and monitoring) suitable for the described symptoms.Conclusion: Insight into treatment options is essential to facilitate speech-language pathologists in clinical decision-making. The current study led to best practice recommendations for speech-language pathologists working within the field of pNMD.

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