Assessing Swallowing and Mastication Using the Swallowing Proficiency for Eating and Drinking Protocol Among Healthy Adults

Abstract

Background: Objective evaluation of swallowing using single bolus consistency are popular among Speech-Language Pathologists (SLPs) but has limited generalization to other bolus consistencies. The Swallowing Proficiency for Eating and Drinking (SPEAD) test assesses the oral and pharyngeal phases of swallowing using three different consistencies.

Objectives: The aim of this study was to establish normative data for the SPEAD test among healthy individuals aged 20-79 years.

Method and materials: One hundred and twelve healthy adults recruited from the community were divided into three age groups (20-39.11, 40-59.11, & 60-79.11 years). Participants swallowing 100 g of water and thickened Electral, and 6.67 g of Parle Monaco was video recorded for data analysis.

Results: Cronbachs Alpha test indicated good to excellent internal consistency and inter-class correlation test revealed a high level of inter-rater reliability for all SPEAD parameters. Older adults exhibited a higher number of bites, chews, and swallows, and required more time to swallow compared to younger and middle adults. Similarly, speed of ingestion and SPEAD rate were lowest in older adults. SPEAD indices also showed significant differences across the three consistencies at p < 0.01.

Conclusion: In summary, the SPEAD test was found to be feasible, reliable, and valid in healthy adults of India between 20 and 79 years of age. The age and sex based normative data established in this study will enable SLPs in assessing the presence and / or absence of swallowing difficulties in the oral and pharyngeal phases across different consistencies using one test.

Keywords: Healthy Adults; Solids; Swallowing Assessment; Thick Liquids; Thin Liquids.

Fig. 1

Feeds used for SPEAD protocol (left to right: level 0, 3, & 7)

Fig. 2

Visual capture of the landmarks

Fig. 3

Mean and standard deviation of speed of ingestion by age groups across consistencies

Fig. 4

Mean and standard deviation of average volume of swallow by age groups across consistencies

Fig. 5

Mean and standard deviation of SPEAD rate across age groups