The Influence of Age, Sex, Visual Feedback, Bulb Position, and the Order of Testing on Maximum Anterior and Posterior Tongue Strength in Healthy Belgian Children


Tongue strength and its role in the pathophysiology of dysphagia in adults are well accepted and studied. An objective and reliable measurement of tongue strength in children necessitates equally good methodology, knowledge of influencing factors, and normative data. Only limited data on testing tongue strength in children are available thereby limiting its potential use. The present study examined tongue strength and several parameters known to be important in adults in the largest sample of healthy children from 3 to 11 years old to date using the Iowa Oral Performance Instrument with standard bulbs. Tongue strength increases markedly for children between 6 and 7 years, with slower increases before and after this age. Unlike adults, no influence of sex or location was found on the maximum tongue strength in children, and visual feedback was found to be counterproductive in obtaining the highest tongue pressures. The normative data obtained can be used for objective assessment of tongue weakness and subsequent therapy planning in dysphagic children.

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The authors wish to thank Ellen De Keersmaecker and Janne Fret for their invaluable help in collecting the data.

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Correspondence to Jan Vanderwegen.

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Vanderwegen, J., Van Nuffelen, G., Elen, R. et al. The Influence of Age, Sex, Visual Feedback, Bulb Position, and the Order of Testing on Maximum Anterior and Posterior Tongue Strength in Healthy Belgian Children. Dysphagia 34, 834–851 (2019).

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  • Tongue
  • Strength assessment
  • Children
  • Age-related changes
  • Deglutition
  • Deglutition disorders