22cb1afe652b7420acec27dc6f5311b1 pmc_34371923.pdf 652c52462d4fba78c2c1f4fd6deb470114a2660b pmc_34371923.pdf 3c2c2f4db0f9058046b67a1a86593b24cace9cc23b70bc42bed1500a5340d766 pmc_34371923.pdf Title: Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy Subject: Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II–III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions. Keywords: neurological disability; cerebral palsy; dysphagia; malnutrition; dehydration; dietary intakes; swallowing disorders; feeding difficulties; oral health Author: Alicia Costa, Alberto Martin, Viridiana Arreola, Stephanie A. 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1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Patients and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Inclusion Criteria Destination: subsection.2.2 Item: Title: Demographics, Health Status, Comorbidities, Medication, and GMFCS Destination: subsection.2.3 Item: Title: Oral-Motor Evaluation, Masticatory Capacity, and Swallowing Function Destination: subsection.2.4 Children: Item: Title: Oral-Motor Evaluation and Meal Observation Destination: subsubsection.2.4.1 Item: Title: Clinical Swallow Evaluation for OD (V-VST) Destination: subsubsection.2.4.2 Item: Title: Eating and Drinking Ability Classification System (EDACS) Destination: subsubsection.2.4.3 Item: Title: Masticatory Capacity Destination: subsubsection.2.4.4 Item: Title: Oral Health (OH) Assessment Destination: subsection.2.5 Children: Item: Title: Occlusion Assessment Destination: subsubsection.2.5.1 Item: Title: Oral Hygiene Destination: subsubsection.2.5.2 Item: Title: Periodontal Assessment Destination: subsubsection.2.5.3 Item: Title: Nutritional and Hydration Assessment Destination: subsection.2.6 Children: Item: Title: Anthropometric Measurements Destination: subsubsection.2.6.1 Item: Title: Bioimpedance Destination: subsubsection.2.6.2 Item: Title: Nutritional and Food Intake Assessment. Dietary Records Destination: subsubsection.2.6.3 Item: Title: Data Analysis of Nutritional Variables Destination: subsection.2.7 Children: Item: Title: Grow Charts Based on z-Score (WHO) for Healthy Children Destination: subsubsection.2.7.1 Item: Title: Growth Charts Based on Percentiles (Brooks) for Children with CP Destination: subsubsection.2.7.2 Item: Title: Waterlow Classification Destination: subsubsection.2.7.3 Item: Title: Assessment of Energy Expenditure Destination: subsubsection.2.7.4 Item: Title: Quantitative and Qualitative Assessment of Food Intake Destination: subsubsection.2.7.5 Item: Title: Statistical Analysis Destination: subsection.2.8 Item: Title: Results Destination: section.3 Children: Item: Title: Demographic, Clinical, and Educational Characteristics of Study Group Destination: subsection.3.1 Children: Item: Title: Health Status, Medical Conditions, Medication Destination: subsubsection.3.1.1 Item: Title: Gross Motor Function (GMFCS) and Social Factors Destination: subsubsection.3.1.2 Item: Title: Oral-Motor Evaluation and Meal Observation, Swallowing Function (V-VST), EDACS, and Masticatory Capacity Destination: subsection.3.2 Children: Item: Title: Oral-Motor Assessment Results and Meal Observation Destination: subsubsection.3.2.1 Item: Title: Prevalence of OD and Effect of Bolus Volume and Viscosity (V-VST) Destination: subsubsection.3.2.2 Item: Title: Eating and Drinking Classification System (EDACS) Destination: subsubsection.3.2.3 Item: Title: Masticatory Capacity Destination: subsubsection.3.2.4 Item: Title: Oral Health (OH) Status Destination: subsection.3.3 Children: Item: Title: Occlusion Assessment Destination: subsubsection.3.3.1 Item: Title: Oral Hygiene Destination: subsubsection.3.3.2 Item: Title: Periodontal Assessment Destination: subsubsection.3.3.3 Item: Title: Nutritional and Hydration Status Destination: subsection.3.4 Children: Item: Title: Anthropometric Measurements Destination: subsubsection.3.4.1 Item: Title: Bioimpedance Results: Body Composition and Hydration Status Destination: subsubsection.3.4.2 Item: Title: Nutritional Intake Assessment Destination: subsubsection.3.4.3 Item: Title: Food Intake Assessment Results and Dietary Pattern Destination: subsubsection.3.4.4 Item: Title: Prevalence and Severity of Malnutrition Destination: subsubsection.3.4.5 Item: Title: Energy Requirements Destination: subsubsection.3.4.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy Author: Alicia Costa, Alberto Martin, Viridiana Arreola, Stephanie A. Riera, Ana Pizarro, Cristina Carol, Laia Serras and Pere Clavé Subject: Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions. 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