Feeding and Eating Considerations in Cerebral Palsy: Difference between revisions

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== Feeding and Swallowing Disorders ==
== Feeding and Swallowing Disorders ==
<blockquote>Paediatric '''Feeding Disorder''' is "an impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction."<ref>Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, Kraus de Camargo O, Browne J, Phalen JA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314510/pdf/jpga-68-124.pdf Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework.] J Pediatr Gastroenterol Nutr. 2019 Jan;68(1):124-129.</ref></blockquote>Dysphagia is a '''swallowing problem''' that places the child at risk for aspiration with oral feeding. Aspiration may lead to a life-threatening  pulmonary consequences. <ref>Arvedson JC. [https://www.nature.com/articles/ejcn2013224 Feeding children with cerebral palsy and swallowing difficulties.] Eur J Clin Nutr. 2013 Dec;67 Suppl 2:S9-12. </ref>
<blockquote>Paediatric '''Feeding Disorder''' is "an impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction."<ref name=":1">Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, Kraus de Camargo O, Browne J, Phalen JA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314510/pdf/jpga-68-124.pdf Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework.] J Pediatr Gastroenterol Nutr. 2019 Jan;68(1):124-129.</ref></blockquote>Dysphagia is a '''swallowing problem''' that places the child at risk for aspiration with oral feeding. Aspiration may lead to a life-threatening  pulmonary consequences. <ref>Arvedson JC. [https://www.nature.com/articles/ejcn2013224 Feeding children with cerebral palsy and swallowing difficulties.] Eur J Clin Nutr. 2013 Dec;67 Suppl 2:S9-12. </ref>


== Healthcare Team Responsibilities ==
== Healthcare Team Responsibilities ==
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* Assessing the protective capacity of the respiratory system
* Assessing the protective capacity of the respiratory system
* Indicating alternative ways of eating
* Indicating alternative ways of eating
* Providing direct and indirect intervention with the patient which include strengthening facial muscles, teaching different strategies to develop sucking, chewing, and drinking skills, tasting new food, and drink with rich flavours, aromas, and modifying food liquid to improve swallowing
* Providing direct and indirect intervention with the patient which include strengthening facial muscles, teaching different strategies to develop sucking, chewing, and drinking skills, tasting new food, and drink with rich flavours, aromas, and modifying food liquid to improve swallowing<ref name=":2">Darchia T. Considerations for feeding in cerebral palsy. Plus Course 2024</ref>
* Guiding staff and care givers in better management of the feeding difficulties
* Guiding staff and care givers in better management of the feeding difficulties<ref name=":2" />


=== Occupational Therapist ===
=== Occupational Therapist ===
occupational therapy intervention focuses on the following issues. Oral motor skills, sensory processing, promoting correct functional posture, selecting adaptive devices, and suggesting different strategies to use them correctly. Adjusting, adapting the environment, also working with parents, caregivers, and teaching them how to use different feeding methods or techniques.
The occupational therapy assessment of the child with cerebral palsy feeding and eating needs, independence and safety, should include the following:<ref name=":1" />


assess the child's feeding skills, motor skills, sensory skills, and strength, as well as the behaviour and environmental factors surrounding mealtimes. Following this, our occupational therapists can input a plan to ensure your child is reaching their full potential with self feeding, independence and safety.
* Motor and sensory skills assessment
* Muscle strength
* Behaviour and environmental factors surrounding mealtimes


== Sub Heading 3 ==
The occupational therapist's intervention focuses on the following:<ref name=":2" />
 
* Improving oral motor skills
* Sensory processing
* Promoting correct posture
* Selecting adaptive devices and choosing strategies to use them functionally
* Adjusting and adapting the environment to promote independent eating
* Working with parents and caregivers on using different feeding methods or techniques.
 
== Mechanics of Feeding and Swallowing ==
 
=== Feeding ===
The feeding and eating process takes place in several phases


== Resources  ==
== Resources  ==

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Introduction[edit | edit source]

Feeding is a vitally important process in everyday life. It is important for the development of the motor and cognitive functions of the child because a healthy and nutritious food is essential for a normal brain development. [1]Children with cerebral palsy are often diagnosed with poor nutritional status due to their feeding and swallowing problems. When untreated it may lead to growth failure, chronic aspiration, esophagitis, and respiratory infections. [1] It can also impact the child's social, emotional, and cognitive function, and can significantly increase caregiver stress. [2]This article will provide an overview of problems and solutions in feeding children with cerebral palsy who experience eating and swallowing difficulties.

Feeding and Swallowing Disorders[edit | edit source]

Paediatric Feeding Disorder is "an impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction."[3]

Dysphagia is a swallowing problem that places the child at risk for aspiration with oral feeding. Aspiration may lead to a life-threatening pulmonary consequences. [4]

Healthcare Team Responsibilities[edit | edit source]

Interdisciplinary team is needed to treat the child with feeding and eating difficulties because different areas of the child's life can be impacted.

Speech-Language Pathologist[edit | edit source]

Communication, speech and language pathologist is responsible for the following:[5]

  • Assessing the function of feeding
  • Contributing to the diagnosis and aetiology of dysphagia
  • Assessing the protective capacity of the respiratory system
  • Indicating alternative ways of eating
  • Providing direct and indirect intervention with the patient which include strengthening facial muscles, teaching different strategies to develop sucking, chewing, and drinking skills, tasting new food, and drink with rich flavours, aromas, and modifying food liquid to improve swallowing[6]
  • Guiding staff and care givers in better management of the feeding difficulties[6]

Occupational Therapist[edit | edit source]

The occupational therapy assessment of the child with cerebral palsy feeding and eating needs, independence and safety, should include the following:[3]

  • Motor and sensory skills assessment
  • Muscle strength
  • Behaviour and environmental factors surrounding mealtimes

The occupational therapist's intervention focuses on the following:[6]

  • Improving oral motor skills
  • Sensory processing
  • Promoting correct posture
  • Selecting adaptive devices and choosing strategies to use them functionally
  • Adjusting and adapting the environment to promote independent eating
  • Working with parents and caregivers on using different feeding methods or techniques.

Mechanics of Feeding and Swallowing[edit | edit source]

Feeding[edit | edit source]

The feeding and eating process takes place in several phases

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ 1.0 1.1 Ferluga ED, Archer KR, Sathe NA, Krishnaswami S, Klint A, Lindegren, McPheeters ML. Interventions for Feeding and Nutrition in Cerebral Palsy [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Mar. (Comparative Effectiveness Reviews, No. 94.) Introduction. Available from https://www.ncbi.nlm.nih.gov/books/NBK132442/ [last access 25.01.2024]
  2. ↑ Greer AJ, Gulotta CS, Masler EA, Laud RB. Caregiver stress and outcomes of children with pediatric feeding disorders treated in an intensive interdisciplinary program. J Pediatr Psychol. 2008 Jul;33(6):612-20.
  3. ↑ 3.0 3.1 Goday PS, Huh SY, Silverman A, Lukens CT, Dodrill P, Cohen SS, Delaney AL, Feuling MB, Noel RJ, Gisel E, Kenzer A, Kessler DB, Kraus de Camargo O, Browne J, Phalen JA. Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework. J Pediatr Gastroenterol Nutr. 2019 Jan;68(1):124-129.
  4. ↑ Arvedson JC. Feeding children with cerebral palsy and swallowing difficulties. Eur J Clin Nutr. 2013 Dec;67 Suppl 2:S9-12.
  5. ↑ Maggioni L, Araújo CM. Guidelines and practices on feeding children with cerebral palsy. Journal of Human Growth and Development. 2020 Apr;30(1):65-74.
  6. ↑ 6.0 6.1 6.2 Darchia T. Considerations for feeding in cerebral palsy. Plus Course 2024
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