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AJSLP-16-0224malandraki_SuppS1.pdf (85.41 kB)

Novel mealtime duration measures (Mishra et al., 2017)

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journal contribution
posted on 2017-12-22, 19:36 authored by Avinash Mishra, Justine J. Sheppard, Cagla Kantarcigil, Andrew M. Gordon, Georgia A. Malandraki
Purpose: The purpose of this study is to examine (a) the reliability of newly developed measures of mealtime duration and (b) their relationship to clinical feeding/swallowing performance in children with spastic cerebral palsy (SCP).
Method: Seventeen self-feeding children (9 boys, 8 girls) with SCP (age range = 5;1 [years;months] to 17;6, Gross Motor Function Classification System range = I–IV) were assessed during mealtimes using the Dysphagia Disorder Survey (DDS; Sheppard, Hochman, & Baer, 2014). Children were divided into 2 groups, children with primarily unilateral or bilateral brain involvement. Duration measures included mealtime duration and total sip/bite duration for each bolus type (liquid and solid).
Results: Excellent intra- and inter-rater reliability for all duration measures was observed (intraclass correlation coefficient [ICC] = 1.00 and 0.955, respectively, for mealtime duration; ICC = 1.00 and 0.963, respectively, for solid/bite duration; ICC = 1.00 and 0.957, respectively, for liquid/sip duration). Positive correlations were found between total mealtime duration and DDS Part 1, rs = .514 [.045–.797], p = .035; Part 2, rs = .528 [.064–.804], p = .029; and total scores, rs = .665 [.271–.868], p = .004, and between total solid/bite duration and DDS Part 1, rs = .579 [.137–.828], p = .015; Part 2, rs = .620 [.199–.847], p = .007; and total scores, rs = .762 [.444–.909], p < .001. Children with unilateral brain involvement exhibited significantly lower DDS total (p = .049) and Part 2 scores (p = .026), indicating better feeding/swallowing performance/skills. They also had shorter mealtime duration (p = .019) and solid/bite duration (p = .025) compared with children with bilateral involvement.
Conclusions: Our new mealtime duration measures are reliable and correlate with feeding/swallowing performance in a sample of self-feeding children with SCP. Therefore, they may be useful supplements to feeding/swallowing assessments for this population.

Supplemental Material S1. Foods/liquids consumed by each child.

Mishra, A., Sheppard, J. J., Kantarcigil, C., Gordon, A. M., & Malandraki, G. A. (2017). Novel mealtime duration measures: Reliability and preliminary associations with clinical feeding and swallowing performance in self-feeding children with cerebral palsy. American Journal of Speech-Language Pathology, 27, 99–107.


This study was partially supported by internal funds provided to Georgia A. Malandraki by Teachers College, Columbia University, and Purdue University.