MMBGR protocol – diagnostic accuracy of clinical examination in preschoolers

Purpose  To present the diagnostic accuracy of the scored Clinical Examination of the MMBGR Orofacial Myofunctional Assessment Protocol for the age range of 24 to 71 months.

Methods  Diagnostic accuracy validation study with a convenience sample. Fourteen speech-language pathologists analyzed images of 132 participants from the database of previous validation stages, divided into two groups (G1 = 24 to 35 months and 29 days; G2 = 36 to 71 months and 29 days). Each image was analyzed individually and independently by a panel of three expert speech-language pathologists, with agreement between at least two evaluators considered valid. Opinions regarding domains of the orofacial myofunctional examination, Orofacial Myofunctional Disorder (OMD), and referral needs were recorded using an electronic form. The speech-language pathologists’ responses based on clinical experience, without using the protocol (gold standard), were compared with those obtained using the Protocol (index test). Receiver Operating Characteristic (ROC) curve analysis was applied, cutoff points were established, and sensitivity and specificity values were obtained using R Core Team software (2022).

Results  Diagnostic accuracy in preschool children in G1 was ideal and in G2 was reasonable for orofacial structures. For orofacial functions, accuracy was ideal in G1 and reasonable in G2; for tone, accuracy was reasonable in both groups. For OMD, accuracy was reasonable for both G1 and G2. The cutoff point for OMD was 15 (24–35 months) and 22 (36–71 months). Accuracy was reasonable for predicting multidisciplinary and speech-language pathology referrals.

Conclusion  The MMBGR Protocol demonstrated adequate diagnostic accuracy for orofacial structures and functions in preschool children. It showed reasonable accuracy for diagnosing OMD and for predicting multidisciplinary and speech-language pathology referrals.

Keywords:
Speech, Language and Hearing Sciences; Preschoolers; Clinical Diagnosis; Validation Study; Sensitivity and Specificity; Myofunctional Therapy; Stomatognathic System