Reilly, Sheena; (1995) The objective assessment of oral motor function during feeding: development and validation of the schedule for oral motor assessment (SOMA). Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

No satisfactory method with established reliability and validity exists for evaluating oral motor functioning and identifying the extent of any dysfunction in infants and young children. Furthermore, the nature and extent of oral motor difficulties in children with cerebral palsy is unknown. The objectives of the thesis are twofold: first, to develop an instrument capable of identifying children with clinically significant oral motor deficits and capable of discriminating them from children with normal oral motor function; second, to ascertain the reliability and validity of the instrument. The Schedule for Oral Motor Assessment (SOMA) was developed to record oral motor skills objectively in infants with ages between 12 and 24 months. The procedure is rated largely from a videorecording of a structured feeding session. A series of foodstuffs of varying textures, including liquids, is presented to the child in a standardised manner. Oral motor skills are evaluated in terms of discrete oral motor movements. One hundred and twenty-seven children have been studied with the instrument, including normal healthy infants and samples of children with non- organic failure to thrive, and cerebral palsy. Excellent inter-rater and test- retest reliability was established. Discriminant validity was investigated by means of a novel 'seeded cluster analysis' procedure. A further validation study on an independent sample of children with cerebral palsy was undertaken. Discriminant validity was satisfactorily established by the analysis and an abbreviated version of the SOMA, suitable for screening purposes, was developed. The screening version has been shown to have positive predictive values greater than 90% and sensitivity greater than 85% for the detection of children with clinically significant oral motor dysfunction.

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