ArticleEuropean journal of pediatrics2026
Establishing a preliminary normative database of oral efficiency for children: the Test of Masticating and Swallowing Solids Application (ToMaSSApp).
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The Test of Masticating and Swallowing Solids (ToMaSS) is a diagnostic tool that measures oropharyngeal efficiency of solid bolus consumption through the number of bites, mastication cycles, swallows, and time taken. An application (ToMaSSApp™) has been used to administer the assessment. The project aimed to establish a preliminary normative database for the ToMaSS-C in children administered with the ToMaSSApp™ and to make comparisons to previously manually collected data. A total of 114 healthy children (57 boys and 57 girls) aged 4 to 19 years (M = 9 years, SD = 4.6 years) were asked to consume a cracker. The efficiency measures were obtained via the ToMaSSApp™. A generalized linear regression model was fitted for each measure and used to obtain normative tables from the data. Equivalence testing was used to compare the data collected via ToMaSSApp™ to the older manually collected data. A normative dataset for the ToMaSS-C in children was established based on the data collected using the ToMaSSApp™. Within the normative dataset, age affected boys and girls similarly and had a statistically significant effect on ToMaSS-C measures (p < 0.05). No equivalence was found between the historical manual and App-based test administration for any ToMaSS-C parameters with larger differences for younger ages.
conclusionThe ToMaSSApp™ is shown to be a feasible and efficient tool in the administration of the ToMaSS-C in the paediatric population. Establishing normative data for the ToMaSS-C is essential for understanding typical processes of oropharyngeal efficiency of solid food consumption as well as identifying and managing dysphagia or oral motor delays. WHAT'S KNOWN: • ToMaSS can be administered to children (ToMaSS-C) using a manual recording method. • The ToMaSSApp™, as a digital alternative, has recently been used to establish a normative dataset in adults. WHAT IS NEW: • The ToMaSSApp™ is feasible for paediatric ToMaSS-C administration. • A preliminary normative dataset for children was established using the App-based recording method.
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