Speech Pathology Services to Children With Cancer and Nonmalignant Hematological Disorders

Abstract

Children with cancer and nonmalignant hematological disorders may require speech pathology (SP) support; however, limited evidence is available describing prevalence and severity of swallowing/feeding and communication impairments in this population. A retrospective chart review of 70 children referred to SP at the newly formed Queensland Children's Cancer Centre was conducted to describe the prevalence and severity of swallowing/feeding and communication dysfunction, and the association between impairment, oncology and hematology diagnosis, and service utilization (time and occasions of service). Swallowing/feeding disorders were the most commonly observed impairments at initial assessment (58.6%). Children with central nervous system tumors (P = .03) and nonmalignant hematological disorder (P = .03) had significantly higher rates of feeding impairment than other oncology and hematology diagnostic groups. Children with central nervous system tumors had the highest rates of oral phase (P = .01) and pharyngeal phase (P = .01) dysphagia (swallowing disorder). No significant difference was found between diagnostic groups for intensity of SP service delivery. Prospective research is required to examine prevalence and severity of disorders, and service utilization in a more established clinic, and to investigate interactions between cancer treatment and swallowing/feeding and communication dysfunction.

Participation in an occupational therapy referral program for children with retinoblastoma

“…Reasons for this referral included language or cognitive delay on standardized testing, parental or therapist’s concern about language development, and feeding disorders. Evidence of feeding, swallowing, or language disorders in children with RB is limited; however, swallowing/feeding and communication disorders have been reported in various oncology and hematology diagnostic groups [28]. Some anticancer treatments (e.g., chemotherapy) can cause swallowing/feeding impairment and communication delays.…”

Prevalência de distúrbios da comunicação, deglutição e motricidade orofacial em crianças e adolescentes no momento da matrícula em um hospital oncológico

“…Among the disorders observed, 23% corresponded to impairments in the orofacial muscular system, 16% to difficulties in speech (stuttering, dysarthria, and articulation disorders), 17% to dysphagia, 14% to dysphonia, 14% to language impairment, 9% to hearing impairments, and 6% to facial paralysis (4) . A retrospective investigation conducted in Australia (7) was the first study to describe the prevalence and severity of swallowing/feeding and communication disorders in children diagnosed with cancer and nonmalignant hematological diseases cared at a Speech-language Pathology and Audiology Service. Of the 70 patients analyzed, 44.3% had swallowing disorders, 34.3% presented receptive language impairment, 38.6% showed expressive language impairment, 31.4% had speech disorders, and 5.7% presented voice dysfunction.…”

“…Difficulties in swallowing and feeding may occur as an adverse effect of chemotherapy and radiotherapy, involving changes in taste, food refusal, mucositis, xerostomia, and dysphagia (7) . In addition, the use of ototoxic antineoplastic agents may be a cause of hearing loss in children and adolescents with cancer (1,4) .…”

“…The literature addressing the prevalence of speech-language disorders in a heterogeneous group of patients with pediatric tumors is scarce, with predominance of studies investigating groups of children and adolescents with some specific cancer diagnosis, especially neurological tumors (2)(3)(4) . TAYLOR, WARE, and WEIR (2012) analyzed the prevalence and severity of swallowing/feeding and communication disorders in children diagnosed with cancer and nonmalignant hematological diseases cared at a speech-language pathology service in Australia (7) . In Brazil, Gonçalves et al (2007) reported the incidence of speech-language disorders in children and adolescents with CNS tumors and observed that 81% of the patients presented some type of disorder.…”

Communication and swallowing outcomes of children diagnosed with childhood brain tumor or leukemia: A systematic review

“…31,54,65,71 Voice problems were also reported, including: hoarseness, decreased pitch variation/monopitch, roughness, breathiness, instability, hypernasality, and tremor. 20,22,31,35,63,[65][66][67]71 Dysfluency, 34,35,70 labored speech, 69 and telegraphic speech 68 were also described. Detailed reporting of speech characteristics was only available for children diagnosed with brain tumor.…”