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Background: Prioritized research agendas are viewed internationally as an important method for ensuring that health research meets actual areas of clinical need. There is growing evidence for speech-language therapy-prioritized research agendas, particularly in disorder-specific areas. However, there are few general research priority agendas to guide speech-language therapy research. Aims: To collaboratively develop a prioritized research agenda for an Australian public health context with clinical speech-language therapists (SLTs), academic SLTs and consumers of speech-language therapy services. Methods & Procedures: An initial stimulus list of potential research areas for prioritization was collected from SLTs via an online survey. Two categories (service delivery and expanded scope of practice) were selected from this list for prioritization due to their relevance across multiple health services. The Nominal Group Technique (NGT) was used to develop a prioritized research agenda for each of the two categories. One NGT session was conducted with each of the three participant groups (clinical SLTs, academic SLTs, consumers) for each category (total NGT sessions = six). The prioritization data for each group within each category were summed to give a single, ranked prioritized research agenda for each category. Outcomes & Results: Two prioritized research agendas were developed. Within each agenda, SLTs and consumers prioritized a need for more research in areas related to specific practice areas (e.g., Alternative and Augmentative Communication, Communication Partner Training), as well as broader professional issues (e.g., telehealth, working with culturally and linguistically diverse families). Conclusions & Implications: The current findings support the need for funding proposals and targeted projects that address these identified areas of need.

Purpose: Clinician experience and confidence can negatively impact pediatric feeding service availability, but limited research has investigated what training allied health professionals (AHPs) need to increase these factors. This study developed and distributed a survey investigating Australian AHPs’ self-reported confidence and anxiousness, training needs, factors impacting training access, and training preferences. Method: This study was conducted over two phases. Phase 1 involved development and refinement of the survey, and Phase 2 involved distribution to Australian AHPs. Questions pertained to general demographics, feeding experience, feeding confidence and skills perception, and training needs. The questions were composed of multiple-choice, Likert scale, and short-response options. Results: Overall, 198 complete responses were received. Participants reported significantly lower confidence and higher anxiousness working with infants compared to older children (p < .01). Increased frequency of service provision predicted higher self-reported confidence and lower anxiousness (p < .01). Practical training opportunities including case discussion, videos, and clinical feedback were preferred. Access facilitators were online, on-demand training; however, respondents reported preferring hands-on training opportunities. Common barriers included cost, time, competing professional development priorities, and distance/travel. Conclusions: Findings have highlighted that recency and frequency of practice impact self-reported confidence and anxiousness, and that AHPs self-report lowest confidence and highest anxiety working with infants compared to older age groups. Overall, the findings highlight the need for flexible, practical, and remotely accessible training opportunities, as well as the need for access to regular clinical supervision and a pediatric feeding caseload. [ABSTRACT FROM AUTHOR]

Feeding disorders can have a significant impact on children and their families. Access to supportive multidisciplinary care is central to improving outcomes; however, there are numerous factors that can impact service access. Using a mixed methods design, the current study examined parents' experiences and satisfaction with accessing a state-wide government-funded tertiary pediatric feeding clinic in Australia. Parents of 37 children (aged 7 weeks to 17 years) participated in the study, residing 6-1435 km from the service. Each completed questionnaires regarding satisfaction (Client Satisfaction Questionnaire-8 Child Services) and costs, and participated in a semi-structured interview. Costs were measured as both direct (e.g., accommodation) and indirect (measured as lost productivity) associated with accessing their feeding appointment. Results revealed parents were highly satisfied with their child's feeding services, but considerable impacts were reported in accessing the service with 85% of the group noting that attending their child's appointment took at least half a day. The total cost per appointment ranged between $53 and $508 Australian dollars. Interviews identified three main barrier themes: distance and travel, impact on daily activities (e.g., work, school), and parent perception of inaccurate representation of their child's feeding skills within the clinic environment. The issues raised were also tempered by an overarching theme of parental willingness to do "whatever was needed" to meet their child's needs, regardless of these barriers. Service providers should be cognizant of the factors that impact access for families and consider alternative service-delivery models where appropriate to help reduce family burden associated with accessing necessary care. [ABSTRACT FROM AUTHOR]

The provision of speech-language pathology (SLP) services via telepractice is expanding. However, little is known about the use of telepractice to deliver pediatric feeding services. The current study aimed to investigate SLPs perceptions, and current use of, telepractice in pediatric feeding. An electronic survey was distributed to SLPs with pediatric feeding experience within Australia. Questions pertained to general demographics, feeding experience, telepractice experience and perceptions of telepractice. Most questions were multiple choice, with some short response questions. Eighty-four complete responses were received. Overall, 41% of the cohort were interested in providing telepractice services but only 20% reported experience delivering pediatric feeding services via telepractice. Most telepractice users reported commencing telepractice services within the last 12 months. Most clinicians identified a range of age groups and feeding services that they believed could be offered via telepractice and a range of benefits to telepractice feeding services were identified. Benefits included natural environment, reduced distance and travel, opportunities to increase services and increased supervision and support. Although most respondents reported access to technology, most had difficulty accessing this on a daily basis to establish regular telepractice services. Clinician concerns regarding the safety and efficacy of conducting pediatric feeding assessments via telepractice were also identified. Overall, although the delivery of pediatric feeding services via telepractice remains limited, many clinicians were interested in using telepractice and had positive perceptions regarding its use. Continued efforts to enhance clinician access to technology and further evidence for the efficacy of this service delivery model for pediatric feeding will aid clinical implementation. [ABSTRACT FROM AUTHOR]

Purpose: This article explores the challenges of risk feeding from an Australian Paediatric Palliative Care perspective. There is currently limited evidence to guide risk feeding in pediatric clinical practice. Therefore, this article uses evidence from the adult palliative and end-of-life care context (extrapolating to pediatric application), in addition to the authors' clinical experience in supporting children and their families with risk feeding. Recommendations for the clinical management of pediatric risk feeding are discussed, including the suggested focus for families and the interprofessional team along the different phases of the palliative care continuum. Conclusion: There is currently limited information to guide decision making regarding risk feeding in pediatrics. Overall, in the absence of evidence-based practice guidelines, it is the authors' recommendation that a risk feeding plan is developed in consultation and collaboration with the family, treating physician, and interprofessional team. Further research is required to support guidance for clinicians working in this area. [ABSTRACT FROM AUTHOR]

The aim of this study was to document information from allied health clinicians about children on their caseload with autism spectrum disorders and feeding difficulties. An electronic survey was disseminated to clinicians working with this group around Australia, where 150 responses were returned and 96 were able to be analysed. Variability in responses was observed for service delivery models, frequency of input, referral reasons, and intervention choices. The majority of respondents identified limited-to-average knowledge of feeding therapy options for this population. Clinician confidence was significantly correlated with perceived therapy success. Results of the survey suggest a need for clinical guidelines in the area to direct practice. Low levels of clinician confidence and perceived therapy success also highlight a need for ongoing research and training. [ABSTRACT FROM AUTHOR]

Thickened feeds may be useful in supporting improved suck-swallow-breath coordination and airway protection in infants with dysphagia. Unfortunately, the stability of thickened feeds for infant formulas is unpredictable, which makes use of this strategy challenging. This study aimed to propose a set of Level 1 (slightly thick) recipes for Australian infant formulas/thickeners. A secondary aim was to test whether formula could be batch prepared. A set of powdered, ready-to-feed, and specialized formulas were mixed with two thickening products (Aptamil Feed Thickener® and Supercol®) and tested at 5-, 10-, 15-, 20-, 25-, 30-, and 45-min intervals using the International Dysphagia Diet Standardization Initiative (IDDSI) Flow Test. Formula/thickener samples were mixed following manufacturer instructions, but recipes were adapted to determine an ideal recipe for Level 1 (slightly thick) consistency that would be maintained over a feed. Samples were refrigerated, reheated after 12 h, and retested. Each combination was tested six times. Overall, 1,353 IDDSI Flow Tests were conducted using 14 formula/thickener combinations. In all combinations, recipe alterations were made using metric spoon measurements as opposed to the manufacturer-provided scoop. All samples were most variable at the 5-min timepoint. Formulas thickened with Supercol® generally reached a more stable consistency by 10 min, whereas formulas thickened with Aptamil Feed Thickener® were more stable by 15 min. Samples tested after 12 h were more variable with Aptamil Feed Thickener®. This study provides practical recommendations for clinicians working with infants requiring thickened feeds for dysphagia management. Further study under controlled laboratory conditions is required., (© 2023. Crown.)

Aims: This study aimed to collect data on Australian children with regard to feeding difficulties using a standardised questionnaire, compare these data to international data collected using the same tool, assess the short-term reliability of this tool and determine the sensitivity and specificity of this tool in detecting feeding difficulties., Methods: Parents completed the Behavioral Pediatric Feeding Assessment Scale. Data on 54 typically developing children and 81 children with feeding difficulties aged 2-6 years are presented., Results: Our Australian sample performed comparably to normative data from Canada and the UK. Reliable results were demonstrated over a 2-week period, and the scale was shown to have high specificity. There was a significant difference between typically developing children and children with feeding difficulties in frequency of undesirable mealtime behaviours (P < 0.01) and the number of behaviours reported as a problem by parents using this tool (P < 0.01)., Conclusions: This study confirmed that the Behavioral Pediatric Feeding Assessment Scale is a valid tool for identifying Australian children with feeding difficulties. Given that it is simple to administer and has a high reliability and specificity, it is suggested as a useful screening tool for physicians working with young children. Data collected using this tool found that typically developing children display few undesirable feeding behaviours, and few behaviours are perceived as problems by parents. Therefore, any child presenting with a large number of feeding problems on this parent-reported measure should be referred for further multidisciplinary evaluation and treatment as required., (© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)