Validity based on the response processes of the MMBGR Protocol Infants and Preschoolers: Instructional and Orofacial Myofuncional Clinical History

Santos, Alexia Stéfanny Menezes da Conceição dos; Goes, Yasmim Dourado; Assis, Herick Santos; Alves, Maria Vanessa Martins; Melo, Amanda Tafnes Soares de; Barbora, Geovania Dias; Barreto, Íkaro Daniel de Carvalho; Jesus, Elisdete Maria Santos de; Berretin-Felix, Giédre; Medeiros, Andréa Monteiro Correia

doi:10.1590/2317-1782/20242023109en

Alexia Stéfanny Menezes da Conceição dos Santos

data collection

organization

article writing

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

https://orcid.org/0000-0002-9382-1742

Yasmim Dourado Goes

data collection

organization

article writing

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

https://orcid.org/0000-0003-4313-5071

Herick Santos Assis

data collection and organization

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

https://orcid.org/0000-0002-6122-6463

Maria Vanessa Martins Alves

data collection and organization

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

https://orcid.org/0000-0003-3609-921X

Amanda Tafnes Soares de Melo

data collection and organization

Prefeitura Municipal de São Cristóvão - São Cristóvão (SE), Brasil

https://orcid.org/0000-0002-8658-0012

Geovania Dias Barbora

data collection and organization

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

https://orcid.org/0000-0002-0448-4327

Íkaro Daniel de Carvalho Barreto

statistical analysis

English manuscript translation

Centro Brasileiro de Pesquisa em Avaliação e Seleção e de Promoção de Eventos – CEBRASPE - Brasília (DF), Brasil.

https://orcid.org/0000-0001-7253-806X

Elisdete Maria Santos de Jesus

text revision

guidance on analysis of collected data

Faculdade de Ciências Farmacêuticas – FCF, Universidade Estadual de Campinas – UNICAMP - Campinas (SP), Brasil.

https://orcid.org/0000-0002-9503-7433

Giédre Berretin-Felix

text revision

final approval of the version

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

https://orcid.org/0000-0002-8614-2805

Andréa Monteiro Correia Medeiros

study project conception

design

coordination

article guidance

final approval of the version

Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

Departamento de Fonoaudiologia, Faculdade de Odontologia de Bauru – FOB, Universidade de São Paulo – USP - Bauru (SP), Brasil.

Programa de Pós-graduação em Ciências da Saúde – PPGCS, Universidade Federal de Sergipe – UFS - São Cristóvão (SE), Brasil.

https://orcid.org/0000-0002-4930-7623

Conflict of interests: nothing to declare.

Correspondence address: Andréa Monteiro Correia Medeiros Departamento de Fonoaudiologia, Universidade Federal de Sergipe – UFS Avenida Marechal Rondon Jardim, s/n, Rosa Elze, São Cristóvão (SE), CEP: 49100-000. E-mail: andreamedeiros@academico.ufs.br

Characteristics (N=10)	Variables	N	%
Gender	Female	10	100
	Male	0	0
Age Group	Between 20 and 30 years	2	20
	Between 31 and 40 years	4	40
	Between 41 and 50 years	2	20
	Over 50 years	2	20
Postgraduate studies	Yes	8	80
	No	2	20
Academic background	Bachelor's degree	2	20
	Specialist	3	30
	Master's degree	2	20
	Doctorate	2	20
	Post-doctorate	1	10
	Associate Professor	0	0
Experience in Orofacial Motricity (MO)	Less than 5 years	2	20
	Between 5 and 10 years	2	20
	Between 11 and 15 years	2	20
	Between 16 and 20 years	2	20
	Between 21 and 25 years	0	0
	Between 26 and 30 years	1	10
	More than 30 years	1	10
Work in the Orofacial Motricity (OM) field (infants)	Does not work	4	40
	Less than 5 years	2	20
	Between 5 and 10 years	0	0
	Between 11 and 15 years	1	10
	Between 16 and 20 years	1	10
	Between 21 and 25 years	1	10
	Between 26 and 30 years	0	0
	More than 30 years	1	10
Work in the Orofacial Motricity (OM) field (preschoolers)	Does not work	0	0
	Less than 5 years	3	30
	Between 5 and 10 years	4	40
	Between 11 and 15 years	0	0
	Between 16 and 20 years	1	10
	Between 21 and 25 years	0	0
	Between 26 and 30 years	1	10
	More than 30 years	1	10
Teaching	Non-teaching	5	50
	Less than 5 years	1	10
	Between 5 and 10 years	2	20
	Between 11 and 15 years	1	10
	Between 16 and 20 years	0	0
	Between 21 and 25 years	0	0
	Between 26 and 30 years	0	0
	More than 30 years	1	10
Region (BR) where the profession is practiced	North	1	10
	Northeast	2	20
	Center-West	1	10
	Southwest	3	30
	South	3	30

Clinical routine (N)	%	Research routine (N)	%	Authors	Name	Objective	Age group
5	50	3	30	Katia Flores Genaro, et al. (2009)	Avaliação Miofuncional Orofacial: protocolo MBGR(¹⁰10 Genaro KF, Berretin-Felix G, Rehder MIBC, Marchesan IQ. Orofacial myofunctional evaluation: MBGR protocol. Rev CEFAC. 2009;11(2):237-55. http://doi.org/10.1590/S1516-18462009000200009. http://doi.org/10.1590/S1516-18462009000... )	Establish assessment, diagnosis, and prognosis in Orofacial Myofunctional Therapy	Children aged 6 to 12 years old.
1	10	1	10	Andréa Monteiro Correia Medeiros, et al. (2022)	Protocolo MMBGR – Lactentes e Pré-escolares(⁶6 Medeiros AMC, Marchesan IQ, Genaro KF, Barreto ÍDC, Berretin-Felix G. MMBGR Protocol – Infants and Preschoolers: Myofunctional Orofacial Clinic Examination. CoDAS. 2022;34(5):e20200325. http://doi.org/10.1590/2317- 1782/20212020325. PMid:35475847. http://doi.org/10.1590/2317- 1782/202120... )	Establish assessment, diagnosis, and prognosis in Orofacial Myofunctional Therapy	Children between 6 and 71 months old (Infants and Preschoolers).
1	10	1	10	Cristina Ide Fujinaga, et al. (2013)	Preterm Oral Feeding Readiness Assessment Scale (POFRAS)(¹²12 Fujinaga CI, Moraes SA, Zamberlan-Amorim NE, Castral TC, Silva AA, Scochi CGS. Clinical validation of the Preterm Oral Feeding Readiness Assessment Scale. Rev Lat Am Enfermagem. 2013;21(spe):140-5. http://doi.org/10.1590/S0104-11692013000700018 PMid:23459901. http://doi.org/10.1590/S0104-11692013000... )	Assist health professionals in determining the appropriate timing to initiate breastfeeding in premature infants	Corrected gestational age ≤36 weeks and 6 days (Premature infants).
2	20	2	20	Cláudia Maria de Felício, et al. (2008)	Protocolo de Avaliação Miofuncional Orofacial com Escores (AMIOFE)(¹¹11 Felício CM, Ferreira CLP. Protocol of orofacial myofunctional evaluation with scores. Int J Pediatr Otorhinolaryngol. 2008;72(3):367-75. http://doi.org/10.1016/j.ijporl.2007.11.012 PMid:18187209. http://doi.org/10.1016/j.ijporl.2007.11.... )	Identify and grade orofacial myofunctional disorders	Children, adolescents, and adults.
1	10	1	10	Participant-authored instrument	Not specified	Not specified	Not specified

	Variables	N	%
Number of applications of the Clinical History Protocol - MMBGR Infants and Preschoolers, with caregivers of infants and preschoolers	1	1	10
	2	1	10
	3	7	70
	4	1	10
	5	0	0
Institution type where the protocol was applied	Public	3	30
	Private	6	60
	Mixed	1	10
Sector of protocol usage	Office / Outpatient Clinic	9	90
	Clinic	1	10
	Hospital	0	0
	Home Care	1	10
	Basic Health Unit	0	0
Time spent to complete the protocol application	Less than 30 minutes	1	10
	Between 30 and 45 minutes	4	40
	More than 45 minutes	5	50

	Agreements (n)	CVI (%)	p-value
1. Protocol application ease	10	100	1,000
2. Protocol filling ease	10	100	1,000
3. Protocol utility in speech therapy clinic	9	90	0,972
4. Protocol use in professional practice	10	100	1,000
5. Utility of the Instructions for protocol filling	8	80	0,851
6. Need for prior reading of the Instructions for protocol application	7	70	0,617

Questions and justifications
The execution of the protocol was easy to apply?
F6 – There was a question that seemed difficult to understand both for me and for the guardians - in the current feeding item where it asks “most of the time, with whom, how, and where do they eat?”.
Was the MMBGR Protocol for Infants and Preschoolers - Clinical History easy to fill out?
F3 - In some sections, I was unsure if it applied to preschoolers or if it was specific to infants, like the “Current feeding pattern” section.
Did the “Instruction Manual” for the MMBGR Infants and Preschoolers clinical history protocol assist in filling out the protocol?
F8 - I had some doubts that were not in the instruction manual and left them marked on the forms, especially in section 8.A.
Do you consider it important for the Instruction Manual of the MMBGR Infants and Preschoolers clinical history protocol to be read before applying the protocol?
F8 - The clinical history section of the instruction manual doesn't have such specific information that would prevent its use before reading it.
F9 - I found the protocol to be quite self-explanatory.
Comments inserted in the protocols used with guardians of infants and preschoolers.
F8 - In the anamnesis/clinical history, we usually include the patient's impressions. Therefore, in this item, I would consider asking the guardian what they think about the general motor development. But I got the impression that in the protocol, I mark whether it's altered or normal based on the expected age. And if the informant doesn't remember, how can I say normal or altered? *The father said: “I don't remember, but everything was normal!” (Motor development);
Do I ask the first items for 5-year-old children too? (Current feeding pattern);
If they never eat using the tablet, do I leave it blank? (Most of the time, with whom, how, and where do they eat - Current feeding).

[1] Conflict of interests: nothing to declare.

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Brasil

Validity based on the response processes of the MMBGR Protocol Infants and Preschoolers: Instructional and Orofacial Myofuncional Clinical History

ABSTRACT

Purpose

Methods

Results

Conclusion