Measurement model for respiratory-swallowing impairment

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DESCRIPTION (provided by applicant): Obstructive airway disorders are complex, involve multiple body systems, have high morbidity, and are prevalent in fragile patients at the extremes of the age continuum. We believe that an investigation of the role of swallowing and, in particular, respiratory-swallowing coordination is ideally suited for the goals and objectives of this planning grant, targeting multiple sites and multidisciplinary collaboration. The Specific Aims are based on the working premise that pediatric and adult patients with obstructive airway disorders suffer from problems with coordinative respiratory-swallowing function that may accelerate and/or exacerbate the pulmonary symptoms and condition. The critical components and measures required for optimal study of integrated respiratory and swallowing function will be identified and prioritized by our collaborative team through a consensus validation process. Specific Aim 1. Convene a multidisciplinary, collaborative team of researchers with established, focused expertise in respiratory and swallowing coordination, airway abnormalities, and obstructive airway disorders. 2. Prioritize and stratify the subgroups of pediatric and adult obstructive airway disorders that warrant immediate study based on an at-risk model for aspiration and clinical relevance of the potential findings. 3. Obtain consensus validation for a standardized evaluation protocol and multi-metric approach to quantify the severity of respiratory and swallowing impairment(s) and to relate the contribution of these potentially- linked impairments to the clinical outcomes of infants, children, and aging adults with upper and lower obstructive airway disorder. 4. Obtain consensus validation for the functional and health status measures that capture the overall patient outcome. 5. Develop a multi-site clinical study (R01) that tests the respiratory-swallowing measurement model vis-a- vis assessment of reliability and construct validity of the measures, and their relationship to patient outcomes.