Purpose: Autism-specific behaviors begin with some preliminary symptoms and can be detected during the pre-verbal languagestage or after diagnosis. Early diagnosis and early intervention can begin if caregivers or parents identify these precursors ofbehaviors during the pre-diagnostic period, and the person with autism can receive effective and timely training. The goal ofthis study was to find out what non-typical language and communication behavior parents or caregivers of children with autismmight have noticed before they were diagnosed.Design/Methodology/Approach: After applying exclusion criteria, fifty participants (47F, 3M) who are primary carers of 3-10-year-old children with autism were accepted into the study Data was gathered using a two-part interview form with 37questions. Face-to-face interviews were held.Findings: Descriptive and situational analysis methods were used to analyze the data. Following the analysis of the findings,behaviors such as not making eye contact, not responding when their name is called, and indifference toward their parentswere observed in the children of the participants who were diagnosed with autism till the age of 18 months.Highlights: When the findings were evaluated, it was discovered that the individuals' issues began at an early age. In terms ofautism suspicion, family observations are crucial; early symptoms are predictors of various developmental stages. Accordingly,families should follow their children more closely and they should be informed more by experts so that families can notice thedifferences in developmental areas.

Aims: This study aimed to investigate the impact of the presence or absence of verbal communication skills in pediatric intensive care unit (PICU) patients who are unable to eat orally and are fed via enteral or parenteral methods, on the stress levels perceived by their parents. Methods: The study included 49 children hospitalized in the PICU with dysphagia and feeding difficulties. The participants’ information regarding tracheostomy, intubation, ability/inability to engage in verbal communication, and type of enteral feeding was recorded. Patients were retrospectively assessed using PRISM (pediatric risk of mortality) scores, and the Turkish version of the Parental Stress Scale was administered to one parent per patient. The participants were grouped based on their child’s verbal communication ability and feeding method (enteral vs. parenteral), and statistical comparisons were made using the Mann-Whitney U test. ROC (receiver operating characteristic) analysis was conducted to identify which of the recorded clinical variables had the most significant effect on parental stress. Results: The mean age of the children was 7.69 years, with 59.2% being male. Of the 49 children included, 31 (63.3%) were classified as non-verbal and 18 (36.7%) as verbal, according to their ability to communicate. While 81.6% were non-intubated, 42.9% had tracheostomies. Feeding methods included nasogastric tube (46.9%), total parenteral nutrition (38.8%), and percutaneous endoscopic gastrostomy (10.2%). The mean PRISM score was 4.0, and the average parental stress score was 69.1. Parents of non-verbal children reported significantly higher stress levels than those of verbal children (p=0.002). Although parental stress appeared higher in the parenteral nutrition group, the difference was not statistically significant (p=0.077). PRISM scores showed no significant differences between groups based on communication or feeding method. According to the ROC analysis [area under the curve (AUC)=0.728], the most significant indicator of parenteral stress was found to be the inability to engage in verbal communication. Conclusion: The findings demonstrate that the inability of children in PICU to verbally communicate significantly increases parental stress levels, independent of illness severity. Although feeding method did not significantly impact parental stress, a trend toward higher stress in parents of parenterally fed children was observed. These results emphasize the importance of preserving or supporting communication abilities in PICU patients. Implementing augmentative and alternative communication strategies (e.g., speaking valves, communication boards) and integrating psychosocial support for caregivers may contribute to improved family-centered care in pediatric critical care settings.

Background and Objectives: Central facial paralysis following stroke may affect oral motor control and swallowing function; however, its role in dysphagia-related impairments remains unclear. This study aimed to investigate the relationship between facial motor impairment, swallowing function, and oral motor dysfunction in patients with post-stroke central facial paralysis. Methods : This cross-sectional observational study included 80 patients with ischemic or hemorrhagic stroke accompanied by central facial paralysis. Facial motor function was evaluated using the Sunnybrook Facial Grading System. Swallowing function was assessed using the Eating Assessment Tool-10 (EAT-10), Repetitive Saliva Swallowing Test (RSST), and Functional Oral Intake Scale (FOIS). Oral motor dysfunction was evaluated using a clinician-based oral motor assessment form. Correlation and exploratory regression analyses were performed. Results: Significant associations were identified between facial motor function, swallowing measures, and oral motor parameters (all p < 0.001). Sunnybrook scores showed strong negative correlations with EAT-10 scores (r = −0.954) and positive correlations with RSST (r = 0.914) and FOIS scores (r = 0.915). In exploratory regression analyses, NIHSS emerged as an important contributor to swallowing-related outcomes. Labial and tongue functions were independently associated with RSST performance, whereas labial, velar, and buccal functions were independently associated with EAT-10 scores. Velar function was the only oral motor variable independently associated with FOIS levels. Conclusions: Facial motor function, oral motor dysfunction, and swallowing-related measures were significantly associated in individuals with post-stroke central facial paralysis. Overall, neurological severity also contributed substantially to swallowing-related outcomes. These findings may suggest a potential association between oral motor dysfunction and swallowing-related outcomes and may warrant consideration in comprehensive dysphagia evaluation. However, the observed relationships should be interpreted as exploratory and require confirmation in future studies using validated assessment tools and instrumental swallowing measures.

Background and Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease frequently associated with dysphagia and aspiration risk. This study aimed to investigate the relationship between clinical dysphagia assessment tools (EAT-10, GUSS, RSST, and sialorrhea severity) and videofluoroscopic swallowing study (VFSS) findings in patients with ALS. Materials and Methods: This retrospective observational study included 60 patients with ALS classified as spinal-onset (n = 38) or bulbar-onset (n = 22). Relationships between clinical assessments and VFSS findings were analysed using Spearman correlation analysis. Exploratory multivariable regression and receiver operating characteristic (ROC) analyses were performed to evaluate associations and aspiration risk discrimination. Results: Strong negative correlations were observed between PAS–Liquid and RSST and GUSS scores, whereas EAT-10 showed a strong positive correlation (all p < 0.001). ROC analyses demonstrated good discriminative ability for aspiration risk for GUSS (AUC = 0.89), RSST (AUC = 0.88), and EAT-10 (AUC = 0.82). Patients with bulbar-onset ALS demonstrated higher penetration–aspiration severity and lower functional oral intake. Conclusions: Clinical dysphagia assessment tools showed significant associations with instrumental swallowing findings in ALS. GUSS and RSST demonstrated good discriminative ability for aspiration risk and may be clinically useful bedside screening tools. However, instrumental swallowing assessment remains essential whenever feasible.

Background/Objectives: Dysphagia is common in tracheostomized patients with traumatic brain injury (TBI) and may be influenced by airway pathology and tracheostomy-related factors. This study investigated whether tracheostomy cannula type is independently associated with swallowing function and pharyngeal residue after accounting for airway stenosis and clinical variables. Methods: This retrospective observational study included 80 tracheostomized TBI patients using a speaking valve. Participants were grouped according to cannula type (non-fenestrated vs. fenestrated). Swallowing function was evaluated using Fiberoptic Endoscopic Evaluation of Swallowing (FEES), and pharyngeal residue severity was assessed using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Airway stenosis severity was graded using the Cotton–Meyer classification. Multivariable ordinal logistic regression analyses were performed to identify independent predictors of pharyngeal residue. Results: Higher pharyngeal residue scores were observed in the fenestrated cannula group under selected conditions, particularly for 5 mL liquid (p = 0.039) and 5 mL semi-solid boluses (p = 0.004) in the vallecular region, and for 5 mL semi-solid boluses in the pyriform sinuses (p < 0.001). Airway stenosis grade was strongly associated with increased pharyngeal residue and reduced SpO₂ levels (p < 0.001). In multivariable analyses, airway stenosis emerged as the factor most consistently associated with pharyngeal residue severity (e.g., OR = 4.909, 95% CI: 1.646–14.646, p = 0.004), whereas cannula type was not independently associated with most outcomes. Condition-specific associations were identified between fenestrated cannula use and pharyngeal residue in two models (vallecular residue for 5 mL semi-solid: OR = 0.354, 95% CI: 0.143–0.876, p = 0.025; pyriform sinus residue for 10 mL liquid: OR = 0.190, 95% CI: 0.073–0.495, p = 0.001); however, the direction of these associations differed from unadjusted comparisons, indicating prominent confounding by stenosis severity. Conclusions: FEES-estimated airway stenosis appeared to be the factor most consistently associated with pharyngeal residue severity in tracheostomized TBI patients, whereas the effect of cannula type appeared to be limited. Comprehensive airway assessment may therefore be important in dysphagia management.

Background/Objectives: Oral health is important for safe oral feeding after stroke. However, the relationships among oral health-related quality of life, functional oral intake, and eating-related quality of life remain unclear. This study examined these associations in older adults with stroke. Methods: This cross-sectional observational study included 100 adults aged ≥65 years with stroke receiving oral feeding (FOIS ≥ 4). Oral health-related quality of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile-14 (OHIP-14), and eating-related quality of life using selected Swallowing Quality of Life Questionnaire (SWAL-QOL) domains. Correlation, multiple linear regression, and exploratory parallel indirect-effect analyses were performed. Results: GOHAI was most strongly correlated with Desire to Eat (r = 0.632, p < 0.001), whereas OHIP-14 showed the strongest negative correlation with Desire to Eat (r = −0.603, p < 0.001). FOIS was positively associated with GOHAI (ρ = 0.487, p < 0.001) and negatively associated with OHIP-14 (ρ = −0.571, p < 0.001). Desire to Eat, Food Selection, and Eating Time were independently associated with GOHAI. The exploratory parallel analysis showed a statistically supported total indirect association between FOIS and GOHAI through these eating-related domains collectively (indirect effect = 2.7496, 95% bootstrap CI 0.6070 to 4.9102), while no specific indirect effect was individually supported. Conclusions: Functional oral intake, eating-related experiences, and oral health-related quality of life were significantly interrelated. The exploratory findings suggest a collective statistical indirect association through eating-related domains without establishing temporal or causal mediation.