Development of a Multimodal Assessment of Mastication Protocol

Purpose: Within the field of speech-language pathology, the only validated noninstrumental assessment of mastication is the Test of Mastication and Swallowing Solids. This assessment protocol offers limited applicability and ecological validity, as it does not reflect typical meals, which involve greater volume and varied textures. Recognizing the need for a more comprehensive evaluation of mastication, this study aims to develop and evaluate a novel assessment protocol of the oral preparatory phase in healthy participants with typical chewing/swallowing. This protocol includes literature-based measures of masticatory parameters, a color-changing gum, and motion analysis. Method: Using a within-subject design, 50 participants chewed a color-changing gum that was analyzed using Commission Internationale de l'Eclairage L*a*b* (CIELAB) values. Participants chewed a baby carrot, a shortbread cookie, and a Hi-Chew candy. The number of chews was manually counted and further measured using two-dimensional motion analysis. Participants completed a social validity questionnaire evaluating the assessment protocol. CIELAB values were correlated with masticatory parameters using Pearson's r . Agreement between manually counted and motion analysis data was examined using intraclass correlation coefficients. Descriptive statistics were analyzed from Likert scale responses on the social validity questionnaire. Results: Mean CIELAB values reflected existing normative data; however, no significant correlation was observed between colorimetric data and masticatory parameters. The accuracy of two-dimensional motion analysis varied by texture. Chews for the carrot demonstrated the highest reliability, chews for the Hi-Chew candy had moderate reliability, and chews for the shortbread cookie had the lowest reliability. Participants rated the protocol favorably, emphasizing value in the assessment battery rather than individual components. Conclusions: Findings provide preliminary evidence in support of a multidimensional evaluation of mastication. Nonsignificant correlations between masticatory parameters and gum outcomes suggest that each captures distinct aspects of mastication. Two-dimensional motion analysis shows promise for semi-automated chew counting, though further refinement is needed for broader texture applications. Overall, positive participant perceptions support continued exploration of the assessment protocol in clinical populations. Supplemental Material: https://doi.org/10.23641/asha.34033494