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

Publication date: October 2017
Source:Research in Developmental Disabilities, Volume 69
Author(s): Justine Joan Sheppard, Georgia A. Malandraki, Paula Pifer, Jill Cuff, Michelle Troche, Bronwyn Hemsley, Susan Balandin, Avinash Mishra, Roberta Hochman
BackgroundRisk assessments are needed to identify adults with intellectual and developmental disability (IDD) at high risk of choking and pneumonia.AimTo describe the development and validation of the Choking Risk Assessment (CRA) and the Pneumonia Risk Assessment (PRA) for adults with IDD.MethodsTest 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.ResultsThe 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).ConclusionsThe 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.



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