Assessment of mouth breathing by Speech-Language Pathologists: an international Delphi consensus.
Morgane Warnier, Leonor Piron, Dominique Morsomme and 1 others
PMID 37255206WHAT IT FOUND
Experts agreed preschoolers should be classified as nasal, oral, or mixed breathers.
Observation at rest for three minutes in three different situations is the priority. Mouth posture and tongue position matter most. The grid is a prototype requiring validation before clinical use.
Key findings
01Experts agreed to classify breathing patterns into three distinct categories: nasal breathing, mouth breathing, and oronasal (mixed) breathing.
02Observation at rest is the primary context, requiring three consecutive minutes in three different situations (e.g., watching a movie, drawing).
03The proportion of time spent with an open mouth and tongue position were considered the most important criteria, outweighing lip position or noisy breathing.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The number of experts was small (9-15 per round), barely meeting minimum thresholds for Delphi studies. The clinical grid is a prototype and has not been validated for reliability, sensitivity, or specificity in real-world clinical settings. The study did not include objective measures (like CO2 sensors) to verify the accuracy of the visual signs. Experts were selected for their expertise, which may bias the consensus toward specific theoretical views not shared by the general SLP population.
The easy way to misread this
Do not implement this grid as a diagnostic tool yet. It is a content-validated prototype that has not been tested for clinical accuracy or reliability against objective measures.