Comorbidities and their definition
| Aspiration pneumonia | Documented episodes of aspiration of saliva and or food requiring admission to hospital with changes on X-ray consistent with the diagnosis |
| Bronchiectasis | Disease where there is permanent enlargement of parts of the airways or lungs. Clubbed (usually) with history of recurrent chest infections or chronic lung disease confirmed by respiratory physician or bronchiectasis confirmed on CT scan of chest |
| Dysphagia | Difficulties with swallowing associated with poor oromotor control (requires a modified diet, thickened fluids or gastrostomy feeds, pain on swallowing). May have choking on thin fluids or swallowing abnormalities confirmed on modified barium swallow |
| Epilepsy | Recurrent seizures requiring anticonvulsant medication prn or daily |
| Gastro-oesophageal reflux (GOR) | Obvious regurgitation on observation by clinician, has had cardioplasty or fundoplication due to GOR or diagnosis made by paediatric gastroenterologist. Reflux demonstrated on pH study or imaging study (eg, barium swallow, milk scan), abnormalities on endoscopy (eg, stricture or Barrett’s oesophagus) |
| Hydrocephalus shunted | Ventriculoperitoneal or ventriculoatrial shunt in situ |
| Hydrocephalus unshunted | Diagnosis confirmed by neurosurgeon |
| Intellectual disability | Confirmed by psychometric testing or on interview with school counsellor or psychologist |
| Oesophagitis | Endoscopy evidence of or biopsy proven oesophagitis where direct observation is ‘normal’ |
| Osteoporosis | Low impact fracture(s) or wedged vertebrae on lateral spine X-ray plus low bone mineral density on bone density scan/peripheral quantitative CT |
| Respiratory failure | Documented hypoxia and carbon dioxide retention/elevated bicarbonate in the appropriate clinical setting. Polysomnography may assist in this diagnosis. Non-invasive respiratory support may be considered |