MMBRG Protocol - Infants and Preschoolers: Myofunctional Orofacial Clinic Examination.
Andréa Monteiro Correia Medeiros, Irene Queiroz Marchesan, Katia Flores Genaro and 2 others
PMID 35475847WHAT IT FOUND
The MMBGR protocol is now validated for infants and preschoolers aged 6 to 71 months.
Expert review confirmed its content, and image-based testing showed good reliability for breathing, swallowing, and speech across all ages. Tone and facial symmetry items showed poor agreement when assessed from video.
Key findings
01The new protocol for orofacial myofunctional examination in infants and preschoolers (6-71 months) was developed to fill a gap, as previous standardized tools like MBGR and OMES-E only covered children aged 6 years and older.
02Content validation by ten experienced speech therapists resulted in 90.5 percent agreement, with 100 percent of the scores deemed adequate by at least 90 percent of the experts.
03Reliability testing on 155 children showed that while most domains had fair to excellent agreement, the 'Tone' and 'Face' items demonstrated poor inter-rater agreement across all age groups when assessed via video images.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The reliability analysis was based on video images rather than direct patient examination, which significantly lowered agreement scores for domains requiring tactile feedback (Tone) or precise measurement (Face). The study did not include children with neurological issues or those who refused assessment, so results may not apply to complex clinical populations. Criterion and construct validity have not yet been established; further studies are needed to confirm how well the test measures what it claims to measure compared to other tools. The protocol was developed for Brazilian Portuguese-speaking children, so cross-cultural validation is required before use in other populations.
Declared interests
The study was part of a research project approved by the Universidade Federal de Sergipe's Ethics Committee. No specific financial conflicts of interest or commercial sponsorships were declared in the provided text.
The easy way to misread this
Do not assume the protocol is equally reliable for all domains. The poor agreement for 'Tone' and 'Face' in this study was due to the video-based methodology. In clinical practice, these items should be assessed through direct physical examination and palpation, not just observation, to avoid inaccurate scoring.