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Selected Works of Avinash Mishra
Article
Validation of the Choking Risk Assessment and Pneumonia Risk Assessment for adults with Intellectual and Developmental Disability (IDD)
Research in Developmental Disabilities (2017)
  • Justine J. Sheppard
  • Georgia A. Malandraki
  • Paula Pifer
  • Jill Cuff
  • Michelle Troche
  • Bronwyn Hemsley
  • Susan Balandin
  • Avinash Mishra, Sacred Heart University
  • Roberta Hochman
Link
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.
Keywords
  • Intellectual disability,
  • Dysphasia,
  • Choking,
  • Pneumonia,
  • Risk assessment
Disciplines
Publication Date
2017
DOI
10.1016/j.ridd.2017.07.016
Citation Information
Sheppard, J.J., Malandraki, G.A., Pifer, P., Cuff, J., Troche, M., Hemsley, B., Balandin, S., Mishra, A., Hochman, R. Validation of the Choking Risk Assessment and Pneumonia Risk Assessment for adults with Intellectual and Developmental Disability (IDD). Research in Developmental Disabilities 2017, 69:61-76.