Interventions and outcomes for children with dysphagia

Gisel, Erika G.

doi:10.1002/ddrr.21

Cited by 42 publications

(28 citation statements)

References 74 publications

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“…Similarly, data at higher levels of evidence than case studies or case series are needed for all types of interventions. 25 Opportunities for production of purposeful swallows are important for oral skill development and for pleasure. Stimulation with 'tastes' can be part of the daily routine for children with CP, with rare exceptions.…”

Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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Children with cerebral palsy (CP) are at risk for aspiration with oral feeding with potential pulmonary consequences, and commonly have reduced nutrition/hydration status and prolonged stressful meal times. There is considerable variability in the nature and severity of swallowing problems in these children whose needs change over time. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. This review is focused on dysphagia in children with CP: types of deficits, clinical and instrumental evaluation, management decision making and evidence of effectiveness of interventions.European Journal of Clinical Nutrition (2013) 67, S9-S12; doi:10.1038/ejcn.2013.224Keywords: cerebral palsy; dysphagia; pediatrics; feeding; swallowing INTRODUCTIONChildren with cerebral palsy (CP) commonly have feeding disorders and swallowing problems (dysphagia) that in many instances place them at risk for aspiration with oral feeding, with potential pulmonary consequences. They also commonly have reduced nutrition/hydration status and prolonged stressful meal times. The specific nature and severity of the swallowing problems may differ, at least to some degree, in relation to sensorimotor impairment, gross and fine motor limitations, and cognitive/ communication deficits. Children with generalized severe motor impairment (for example, spastic quadriplegia) are likely to experience greater swallowing deficits 1,2 than those with diplegia, but oropharyngeal dysphagia is prevalent even in children with mild CP. 3 Concerns are multifactorial and include issues of reduced volume of food and liquid consumed orally, nutrition deficits, inadequate hydration and limited range of textures with slow advance of oral skills.Children with moderate-to-severe dysphagia usually are managed most effectively with an interdisciplinary team that allows for multiple factors to be addressed in a coordinated way. These factors include, but are not limited to, gastrointestinal issues, pulmonary status, nutrition/hydration, oral sensorimotor skills, behavioral issues and family interactions. The importance of a structured approach is stressed to handle these multiple problems. 4 It is critical that all decisions for the management of feeding and swallowing problems are made in consideration of the primary needs of the child that is, a stable airway with adequate nutrition and hydration. In addition, any feeding/ swallowing intervention should be pleasurable and non-stressful for patients and care givers. In some instances, tube feeding may be needed either temporarily or long term. [5][6][7][8] It is expected, with rare exceptions, that these children can cope with at least minimal tastes for pleasure, a practice that may have a positive impact on management of saliva/secretions while maintaining oral function and swallowing.This review paper is focused on dysphagia: types of deficit...

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Section: Feeding/swallowing Interventions: Evidence Of Effectiveness mentioning

confidence: 99%

Feeding children with cerebral palsy and swallowing difficulties

2013

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“…This disturbance in state regulation, similar to disturbances in sleep or crying, will not be included in the next issue of the DSM-V [34]. Feeding is the first competent motor skill of infants [41] and is also an early indicator of self-regulation [33]. Therefore, specific aspects of feeding problems that also coincide with the behavior characteristics of ASD, might become 'red flags' for its diagnosis.…”

Section: Feeding Disorder Of State Regulationmentioning

confidence: 99%

“…the infant should not fall asleep at the onset of feeding, be too agitated or too distressed to feed [33]. Infants triple their body weight in the first year of life [41]. Therefore, a child who does not gain weight will not be able to maintain his established growth curve, or tends to cross over into a lower growth curve, which is interpreted as 'losing weight'.…”

Section: Feeding Disorder Of State Regulationmentioning

confidence: 99%

“…These oral-motor problems are often overlooked, because it is generally a small group when compared to the whole population of children with ASD. However, careful evaluation may be particularly helpful for this group of children, because specific treatments exist, and have been shown to be effective for other neurologically based feeding problems [41].…”

Section: Parent Reported Feeding Problemsmentioning

confidence: 99%

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Feeding Issues Associated with the Autism Spectrum Disorders

Nadon¹,

Feldman²,

Gisel³

2013

Recent Advances in Autism Spectrum Disorders - Volume I

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“…Also, they are oriented in relation to the daily maintenance of stimulation, optimizing the therapeutic results 13,14 .…”

mentioning

confidence: 99%

Intervenção fonoaudiológica e anuência familiar em caso de criança com encefalopatia crônica não progressiva

et al. 2015

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O objetivo foi descrever como a não aderência ao tratamento fonoaudiológico em um caso de disfagia na encefalopatia crônica não progressiva pode levar a pneumonias de repetição. É seguida no HCPR uma criança, atualmente com cinco anos de idade, com diagnóstico de encefalopatia crônica não progressiva e disfagia desde o nascimento, com episódios repetidos de pneumonia cuja mãe não seguia as orientações terapêuticas determinadas pela fonoaudióloga. Na videofluoroscopia foi observada aspiração com a consistência liquida e não com a pastosa. Foi indicada gastrostomia para alimentação e hidratação, sendo permitida a ingestão via oral da consistência pastosa. A família não seguiu as orientações indicadas, a criança continuou ingerindo líquidos por via oral e, sendo assim, teve vários episódios de pneumonia. Embora a mãe tenha sido orientada a não fornecer alimentação líquida por via oral e sim pela gastrostomia, tal orientação não foi seguida, sem motivo aparente para que tal fato ocorresse. Fica evidente a importância da aderência familiar às orientações terapêuticas para que sejam evitadas complicações pulmonares decorrentes da aspiração de alimentos.

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Interventions and outcomes for children with dysphagia

Cited by 42 publications

References 74 publications

Feeding children with cerebral palsy and swallowing difficulties

Feeding children with cerebral palsy and swallowing difficulties

Feeding Issues Associated with the Autism Spectrum Disorders

Intervenção fonoaudiológica e anuência familiar em caso de criança com encefalopatia crônica não progressiva

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