Validation of choking and pneumonia risk assessments for adults with IDD

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

Aims: This study aimed to develop and validate the Choking Risk Assessment (CRA) and Pneumonia Risk Assessment (PRA) tools to differentiate adults with Intellectual and Developmental Disabilities (IDD) who were at high risk of choking and pneumonia from those with low risk,

Results: The study was conducted in three phases.

1. Risk factors and assessment items were identified through a review of relevant literature. Focus group discussions and consensus then identified ten items for inclusion in each of the final assessments.
2. A chart review identified adults with IDD who had experienced non-fatal choking or pneumonia events. Participants were assigned to one of four groups: positive or negative for choking, or positive or negative for pneumonia.
3. The psychometric properties of the assessment tools for differentiating those at high or low risk were tested. The assessments were administered to the participant cohort.

Predictor variables were used to identify choking risk on the CRA and pneumonia risk on the PRA. Using a 15% cutoff, the CRA successfully identified 92% of the choking group at risk. The PRA successfully identified 86.5% of participants at risk of pneumonia.

Implications: Both the CRA and PRA were found to be valid and reliable tools to differentiate adults with IDD at high risk from those at low risk. Their high specificity indicated that the tools could be successfully used to predict choking and pneumonia in adults with IDD.

Our onward queries: How will the CRA/PRA be implemented across the population of adults with I/DD, to improve risk management and prevent choking and pneumonia? What is the contribution of a person’s communication impairment contribute to the risk of choking or pneumonia?

Full reference of article:

Sheppard, J. J., Malandraki, G. A., Hemsley, B., Troche, M., Balandin, S., Hochman, R., Pifer, P., Cuff, J., & Mishra, A.  (2017) Validation of the Choking Risk Assessment and Pneumonia Risk Assessment for Adults with Intellectual and Developmental Disability (IDD). Research in Developmental Disabilities, 69, 61-76. doi: 10.1016/j.ridd.2017.07.016

Link to article: https://www.sciencedirect.com/science/article/pii/S0891422217301890?via%3Dihub