The efficacy of 3-ounce water swallow test as a screening tool for dysphagic children: a study in a tertiary hospital

Background In children, oropharyngeal dysphagia increases the risk of aspiration, pneumonia, and even mortality. It has been demonstrated that dysphagia screening improves health outcomes. The purpose of the study is to investigate the clinical value of the 3-oz water swallow test for detecting aspiration risk and the possibility for oral feeding in children and determine whether it is a suitable tool for identifying swallowing issues. Method This study included 90 children with dysphagia: 48 boys and 42 girls, aged 2–12 years old with an average age of 6.2 ± 2.3 years, and 80% of them were older than 3 years. Sixty percent were orally fed, while 40% were on modified oral feeding. More than half the children (53.3%) had dysphagia for more than 1 week. All study participants underwent 3-oz water swallow test and flexible endoscopic evaluation of swallowing test consecutively. Results The flexible endoscopic evaluation of swallowing revealed 42 positive cases (46.7%) and 48 negative (53.3%). The 3-oz water swallow test yielded 39 positive cases (i.e., failed) and 51 negatives (i.e., passed the test), with no statistically significant difference from the flexible endoscopic evaluation of swallowing test results ( p = 0.701). There were no statistically significant differences between positive and negative cases regarding their age, gender, or mode of feeding. However, positive cases had significantly longer duration of dysphagia than negative cases ( p = 0.001). The best-fit model (3-oz water swallow test model) includes the following: the 3-oz water swallow test result, age, gender, and the dysphagia duration. This model accurately identified aspiration risk among dysphagic children in 76.7% compared to 70.0% by the 3-oz water swallow test alone. Conclusion The use of 3-oz water swallow test in children with dysphagia was recommended in consideration with the three mentioned predictor variables with a well-trained, good observer clinician who will be ready for any complications in order to be able to take the best and safest decision to the patient.