Background Guidance during Meals is a two-week inpatient intervention undertaken at the Folke Bernadotte Regional Habilitation Centre, Sweden, to help parents deal with children's eating problems. Parents are given advice about medical and/or behavioural reasons for food selectivity and possible treatment strategies. Aims To identify the way parents handle mealtimes and associated difficulties and investigate parents' opinion on children's progress using Guidance during Meals. Method A questionnaire, consisting of 30 statements and answered by 41 parents, was used to investigate parents' opinions regarding the success of the intervention in altering their child's eating habits at home. Findings Most parents thought that the intervention had helped them and their child, by teaching them how to guide their child during mealtimes, what made it easier for their child to eat, and how to communicate with their child in an encouraging way. Most children retained their increased interest in eating once back at home. These results were not dependent on time of onset of eating problems, number of intervention periods, length of time since the intervention, or gastrostomy. Conclusion The Guidance during Meals intervention helps parents develop knowledge about factors that hinder or facilitate eating in their child and tools that can help their child finish meals, and gives them a sense of hope that positive change can occur.
Background Pilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and treated mainly with surgery. These tumours have low mortality, but knowledge concerning its long‐term outcome is sparse. Aims The aim was to investigate if patients treated for pilocytic astrocytoma in the posterior fossa had motor complications, including balance, motor and process skills. Methods and Results This descriptive single‐centre study includes eight children and 12 adults, treated for pilocytic astrocytoma as children. Motor performance was investigated with Bruininks–Oseretsky Test of Motor Proficiency, Second Edition, and dynamic balance with the mini‐balance evaluation systems test. Physiological cost index, six‐minute walk test, hand grip strength and assessment of motor and process skills were also evaluated. Ten patients reported motor difficulties, mainly from the upper limbs. The motor performance test showed results within normal limits except for manual dexterity, which was significantly below mean ( p = .008). In the dynamic balance test patients had significantly lower results compared with controls ( p = .036). Physiological cost index, six‐minute walk tests and hand grip strength showed results within normal limits. In the Assessment of Motor and Process Skills, patients over 16 years had significantly lower results compared with test norms for motor activities of daily living (ADL) and 30% of all patients scored below the cut‐off level for difficulties with motor skills. Conclusions Motor performance for patients treated for pilocytic astrocytoma in the posterior fossa in childhood is satisfactory but some patients display difficulties with balance, manual dexterity and ADL motor skills. Thus, it is important to identify those in need of motor follow‐up and training.
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