Australian Speech-Language Pathologists’ perspectives on using cervical auscultation in the detection of aspiration in infants and children

PURPOSE: Cervical auscultation (CA), a technique based on listening to swallow and breath sounds, has high diagnostic accuracy in detecting aspiration risk in children. Despite this, most Australian Speech-Language Pathologists (SLPs) do not routinely use CA in clinical practice. This study aimed to identify barriers and enablers of CA use from the perspectives of Australian paediatric SLPs. METHOD: Participants were recruited using email-based purposive sampling for individual semi-structured interviews and completion of an online 63-item survey. The survey assessed their accuracy in detecting aspiration by rating 40 swallows, and answering 18 multiple-choice questions on perceived task competence, pressure and usefulness using the Intrinsic Motivation Inventory. Interviews were analysed using Gibb's framework for thematic coding and categorisation and relationships between accuracy, perceived competence, pressure and value were explored with distance correlation coefficients. RESULT: Overall, 13 SLPs demonstrated that their frequency and confidence in using CA varied widely across practice settings, training attended and available peer support. Accuracy in detecting aspiration was high (80-97%), with perceived competence (dCor = 0.74, 95%CI 0.50-0.94, p < 0.01) positively correlated with accuracy. CONCLUSION: Translation of CA into Australian clinical practice could be facilitated by supporting SLPs confidence in their skills through optimal training availability, peer supervision/support and practice opportunities.