Pediatric Feeding Disorders and Severe Developmental Disabilities

Kleinert, Jane O’Regan

doi:10.1055/s-0037-1599109

Cited by 25 publications

(8 citation statements)

References 31 publications

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“…To evaluate this relationship, we once again began with the genetics of human developmental disorders and their consequences for morphological and behavioral disruption. The incidence of S/F/S difficulties from birth through early childhood -collectively referred to as pediatric dysphagia -is significantly elevated in genetic developmental syndromes as well as children with clinically diagnosed behavioral neurodevelopmental disorders (Berlin et al, 2011;Kleinert, 2017;Robertson et al, 2017;Bianco and Rota, 2018;Maynard et al, 2020b;Nordstrom et al, 2020), including infants and toddlers with 22q11DS (Eicher et al, 2000). Craniofacial and brain anomalies characterize all of these developmental disorders, including 22q11DS.…”

Section: Putting It Together: Face Brain and Behaviormentioning

confidence: 99%

Why Does the Face Predict the Brain? Neural Crest Induction, Craniofacial Morphogenesis, and Neural Circuit Development

LaMantia

2020

Front. Physiol.

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Mesenchephalic and rhombencephalic neural crest cells generate the craniofacial skeleton, special sensory organs, and subsets of cranial sensory receptor neurons. They do so while preserving the anterior-posterior (A-P) identity of their neural tube origins. This organizational principle is paralleled by central nervous system circuits that receive and process information from facial structures whose A-P identity is in register with that in the brain. Prior to morphogenesis of the face and its circuits, however, neural crest cells act as “inductive ambassadors” from distinct regions of the neural tube to induce differentiation of target craniofacial domains and establish an initial interface between the brain and face. At every site of bilateral, non-axial secondary induction, neural crest constitutes all or some of the mesenchymal compartment for non-axial mesenchymal/epithelial (M/E) interactions. Thus, for epithelial domains in the craniofacial primordia, aortic arches, limbs, the spinal cord, and the forebrain (Fb), neural crest-derived mesenchymal cells establish local sources of inductive signaling molecules that drive morphogenesis and cellular differentiation. This common mechanism for building brains, faces, limbs, and hearts, A-P axis specified, neural crest-mediated M/E induction, coordinates differentiation of distal structures, peripheral neurons that provide their sensory or autonomic innervation in some cases, and central neural circuits that regulate their behavioral functions. The essential role of this neural crest-mediated mechanism identifies it as a prime target for pathogenesis in a broad range of neurodevelopmental disorders. Thus, the face and the brain “predict” one another, and this mutual developmental relationship provides a key target for disruption by developmental pathology.

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Section: Putting It Together: Face Brain and Behaviormentioning

confidence: 99%

Why Does the Face Predict the Brain? Neural Crest Induction, Craniofacial Morphogenesis, and Neural Circuit Development

LaMantia

2020

Front. Physiol.

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“…Es importante mencionar que las dificultades de la deglución en muchas ocasiones podrían ser causantes de experiencias negativas por sí mismas lo que generaría dificultades asociadas. Kleinert, 2017).…”

Section: Discussionunclassified

El fonoaudiólogo en los Trastornos de Alimentación, Más Allá de la Deglución

Moreira

Granatto²,

Fernandez³

2021

Rev. Areté

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Este articulo surge a partir de la necesidad de generar espacios de reflexión sobre el rol del fonoaudiólogo en las dificultades de alimentación infantil. Se debe tener en cuenta que la alimentación es un proceso natural que trasciende a la cultura. En el ámbito pediátrico son cada vez más frecuentes las consultas por dificultades de esta índole. La fonoaudiología, estudia e interviene las alteraciones de la deglución y alimentación en diferentes rangos etarios. Particularmente, en bebés y niños pequeños, estas problemáticas pueden deberse a múltiples condicionantes que alteren o dificulten la seguridad y eficacia deglutoria; como también el confort durante la alimentación. A lo largo del manuscrito se intentan revisar ejes centrales en estrecha relación a este tema que posee múltiples aristas y como parte final en la discusión se aborda la complejidad que plantean los desafíos de la alimentación con especial énfasis en la necesidad del trabajo interdisciplinario. Por lo que se busca como meta final dar a conocer el rol del fonoaudiólogo en los trastornos de alimentación a la comunidad científica.

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“…The prevalence of pediatric feeding disorders (PFD) among infants and children ranges between 10% and 32% (Kovacic et al, 2021; Stewart et al, 2019) with higher rates reported for infants and children with developmental disabilities (Kleinert, 2017; Mercado‐Deane et al, 2001; Milnes & Piazza, 2013; Motion, Northstone, Emond,, & Team, 2001; Uhm et al, 2013). It is estimated that between 30% and 50% of infants and children with PFD demonstrate oropharyngeal aspiration (abbreviated to aspiration), where fluids enter the trachea below the level of the vocal cords pre‐, during and/or post‐swallowing (Frakking et al, 2016; Patel et al, 2020; Uhm et al, 2013; Weir et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Properties of Australian thickened formulae for infants and children: Influence of preparation and nutritional content on IDDSI properties

Frakking

Whillans²,

Rogash³

et al. 2023

Journal of Texture Studies

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Between 30% and 50% of infants and children with pediatric feeding disorders demonstrate oropharyngeal aspiration. Thickening fluids are a compensatory strategy that is commonly recommended by speech pathologists for the management of oropharyngeal aspiration. Ongoing variability in the preparation of thickened fluids across infant formulas and healthcare facilities continue to limit the standardization of the preparation of thickened infant and pediatric formulas. No studies exist which examine the influence of nutritional properties of different infant formula types on IDDSI thickness levels. Our study aimed to describe the impact of standardized resting times; and understand the influence of nutritional properties on a variety of ready‐to‐feed liquid and powder‐based Australian thickened formulae. A total of 27 ready‐to‐feed liquid and powder‐based formulas were tested for viscosity level at baseline and when thickener was added on at least two trials. Frequency counts and percentages were used to describe categorical data. Logistic regression was used to model the binary outcome and calculate the odds ratios and their 95% confidence intervals. A total of 18 formulas proceeded to IDDSI flow testing of at least two trials because 7 formulae tested as slightly or mildly thick at baseline; while 2 formulae only had one trial of IDDSI flow testing completed. Of the 18 formulae tested, 72.22% (13/18) of commonly used powder‐based and ready‐to‐feed formulas in Australia thickened to IDDSI slightly thick (level 1) were prepared in a standardized manner and allowed to rest for 5 min. Formulas with higher protein totals were more likely to thicken sufficiently (AOR: 7.45; 95% CI: 2.06–26.89), while formulas with higher sugar totals or those used for enteral feeds were less likely to thicken sufficiently (AOR: 0.02; 95% CI: 0.01–0.29). There was good test–retest reliability (ICC: 0.76; 95% CI: 0.22–0.97), indicating that standardizing the preparation of thickened fluids was consistently achievable. Given that not all formulae were observed to thicken to the intended consistency using standardized preparation and resting time, this study highlights the importance of using the IDDSI Flow Testing Method regularly in practice when recommending thickened infant formula recipes for managing aspiration in infants and children.

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Pediatric Feeding Disorders and Severe Developmental Disabilities

Cited by 25 publications

References 31 publications

Why Does the Face Predict the Brain? Neural Crest Induction, Craniofacial Morphogenesis, and Neural Circuit Development

Why Does the Face Predict the Brain? Neural Crest Induction, Craniofacial Morphogenesis, and Neural Circuit Development

El fonoaudiólogo en los Trastornos de Alimentación, Más Allá de la Deglución

Properties of Australian thickened formulae for infants and children: Influence of preparation and nutritional content on IDDSI properties

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