Speech-language pathologist involvement in the paediatric intensive care unit

Abstract

Purpose

To measure the prevalence of speech-language pathologist (SLP) involvement and associated trends for critically ill children in United States (US) paediatric intensive care units (PICU) through secondary analysis of the Prevalence of Acute Rehab for Kids in the PICU (PARK-PICU) study data.

Method

A secondary analysis of cross-sectional point prevalence study conducted over 1 day in 82 US PICUs. Data collected included SLP presence, patients’ age, length of stay, medical interventions, aetiology, admission data, Glasgow Coma Scale scores, staffing involvement, and family presence.

Result

Among 961 patients, 82 were visited by an SLP on the study day for a prevalence of 8.5%. Most visits were for children <3 years old. The odds of SLP involvement were lower for children who were 7–12 years old (vs. age 0–2; adjusted odds ratio [aOR] 0.28; 95% CI 0.1–0.8), were mechanically ventilated via endotracheal tube (vs. room air; aOR 0.02; 95% CI 0.005–0.11), or had mild or severe disability (mild vs. no disability; aOR 0.34; 95% CI 0.16–0.76 and severe vs. no disability; aOR 0.39; 95% CI 0.17–0.90). Concurrent physical and/or occupational therapy involvement was associated with higher odds of SLP involvement (aOR 3.6; 95% CI 2.1–6.4).

Conclusion

SLP involvement is infrequent in US PICUs. PICU teams should be educated about the scope of SLP practice, to support communication and oral feeding needs during early recovery from critical illness.

Keywords:

• augmentative and alternative communication
• critical illness
• paediatrics
• acute rehabilitation
• dysphagia
• intensive care unit

Acknowledgements

Dr. Kudchadkar was supported by the Johns Hopkins CTSA award number 5KL2RR025006 from the National Center for Advancing Translational Sciences of the National Institutes of Health, as well as the Johns Hopkins Department of Anesthesiology and Critical Care Medicine StAARter Clinical Research Core Grant. We would also like to thank Claire Levine, MS, ELS (Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University), for her editorial assistance with this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Center for Advancing Translational Sciences [5KL2RR025006] and Johns Hopkins Department of Anesthesiology and Critical Care Medicine StAARter Clinical Research Core Grant [UL1TR003098].