Pediatric Eating Assessment Tool-10 as an indicator to predict aspiration in children with esophageal atresia

J Pediatr Surg. 2017 Oct;52(10):1576-1579. doi: 10.1016/j.jpedsurg.2017.02.018. Epub 2017 Mar 14.


Aim: Airway aspiration is a common problem in children with esophageal atresia (EA). Pediatric Eating Assessment Tool-10 (pEAT-10) is a self-administered questionnaire to evaluate dysphagia symptoms in children. A prospective study was performed to evaluate the validity of pEAT-10 to predict aspiration in children with EA.

Methods: Patients with EA were evaluated for age, sex, type of atresia, presence of associated anomalies, type of esophageal repair, time of definitive treatment, and the beginning of oral feeding. Penetration-aspiration score (PAS) was evaluated with videofluoroscopy (VFS) and parents were surveyed for pEAT-10, dysphagia score (DS) and functional oral intake scale (FOIS). PAS scores greater than 7 were considered as risk of aspiration. EAT-10 values greater than 3 were assessed as abnormal. Higher DS scores shows dysphagia whereas higher FOIS shows better feeding abilities.

Results: Forty patients were included. Children with PAS greater than 7 were assessed as PAS+ group, and scores less than 7 were constituted as PAS- group. Demographic features and results of surgical treatments showed no difference between groups (p>0.05). The median values of PAS, pEAT-10 and DS scores were significantly higher in PAS+ group when compared to PAS- group (p<0.05). The sensitivity and specificity of pEAT-10 to predict aspiration were 88% and 77%, and the positive and negative predictive values were 22% and 11%, respectively. Type-C cases had better pEAT-10 and FOIS scores with respect to type-A cases, and both scores were statistically more reliable in primary repair than delayed repair (p<0.05). Among the postoperative complications, only leakage had impact on DS, pEAT-10, PAS and FOIS scores (p<0.05).

Conclusions: The pEAT-10 is a valid, simple and reliable tool to predict aspiration in children. Patients with higher pEAT-10 scores should undergo detailed evaluation of deglutitive functions and assessment of risks of aspiration to improve safer feeding strategies.

Level of evidence: Level II (Development of diagnostic criteria in a consecutive series of patients and a universally applied "gold standard").

Keywords: Aspiration; Deglutition; Esophageal atresia; Pediatric Eating Assessment Tool-10; Respiratory problems.

Publication types

  • Validation Study

MeSH terms

  • Child
  • Deglutition Disorders / diagnosis*
  • Deglutition Disorders / prevention & control
  • Deglutition*
  • Eating
  • Esophageal Atresia / complications*
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*