Validation of the Choking Risk Assessment and Pneumonia Risk Assessment for adults with Intellectual and Developmental Disability (IDD). (October 2017)

• Record Type: Journal Article
• Authors: Sheppard, Justine Joan; Malandraki, Georgia A.; Pifer, Paula; Cuff, Jill; Troche, Michelle; Hemsley, Bronwyn; Balandin, Susan; Mishra, Avinash; Hochman, Roberta
• Is Part Of: Research in developmental disabilities. Volume 69(2017:Oct.)
• Page Start: 61
• Page End: 76
• Publication Date: 2017-10
• Subjects: Intellectual disability -- Adults -- Risk assessment -- Dysphagia -- Choking -- Pneumonia; Developmental disabilities -- Periodicals; Developmentally disabled -- Research -- United States -- Periodicals; Developmentally disabled children -- Education -- Research -- United States -- Periodicals; Developmental Disabilities -- Periodicals; Disabled -- Periodicals; Mental Retardation -- rehabilitation -- Periodicals; Personnes atteintes de troubles du développement -- Recherche -- États-Unis -- Périodiques; Enfants atteints de troubles du développement -- Éducation -- Recherche -- États-Unis -- Périodiques; Développement, Troubles du -- Recherche -- États-Unis -- Périodiques; 616.858800
• DOI: 10.1016/j.ridd.2017.07.016
• Languages: English
• ISSNs: 0891-4222

Abstract

Highlights: Choking and Pneumonia Risk Assessments (CRA/PRA) were developed for adults with IDD. The CRA and PRA are valid and reliable in identifying high and low risk individuals. Choking and pneumonia were associated with clinical diagnosis of dysphagia. The CRA and PRA will facilitate timely introduction of strategies to mitigate risk. Abstract: Background: Risk assessments are needed to identify adults with intellectual and developmental disability (IDD) at high risk of choking and pneumonia. Aim: To describe the development and validation of the Choking Risk Assessment (CRA) and the Pneumonia Risk Assessment (PRA) for adults with IDD. Methods: Test items were identified through literature review and focus groups. Five-year retrospective chart reviews identified a positive choking group (PCG), a negative choking group (NCG), a positive pneumonia group (PPG), and a negative pneumonia group (NPG). Participants were tested with the CRA and PRA by clinicians blind to these testing conditions. Results: The CRA and PRA differentiated the PCG (n = 93) from the NCG (n = 526) and the PPG (n = 63) from the NPG (n = 209) with high specificity (0.91 and 0.92 respectively) and moderate to average sensitivity (0.53 and 0.62 respectively). Further analyses revealed associations between clinical diagnoses of dysphagia and choking (p = 0.043), and pneumonia (p < 0.001). Conclusions: The CRA and PRA are reliable, valid risk indicators for choking and pneumonia in adults with IDD. Precautions for mitigating choking and pneumonia risks can be applied selectively thus avoiding undue impacts on quality of life and unnecessary interventions for low risk individuals.