title: Oral motor, communication, and nutritional status of children during intrathecal baclofen therapy: a descriptive pilot study.
abstract: OBJECTIVE
  To describe the oral motor, communication, and nutritional status of children receiving intrathecal baclofen (ITB) therapy for spasticity of cerebral origin.
  
  
  METHODS
  Observational cross-sectional design.
  
  
  METHODS
  Tertiary-care regional children's hospital.
  
  
  METHODS
  Thirty children with spasticity of cerebral origin receiving ITB therapy.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  One interviewer administered a structured in-person interview tool designed for this pilot study, data from which were collapsed into 4 change categories: communication and speech, feeding and nutrition, oral motor function, and gastrointestinal function. Functional severity was ranked with the Gross Motor Function Classification System (GMFCS).
  
  
  RESULTS
  Speech: 10 improved (5 in GMFCS level V) and 2 worsened. Use of assistive technology to communicate: 6 improved (5 in GMFCS level V). Appetite: 10 improved (6 in GMFCS level V) and 4 worsened. Self-feeding: 9 improved (2 in GMFCS level III, 4 in level IV, 3 in level V) and 2 worsened. Saliva control: 10 improved (1 in GMFCS level III, 1 in level IV, 8 in level V) and 8 worsened. Cup drinking: 12 improved (5 in GMFCS level V) and 2 worsened. Indicates thirst: 9 improved (4 in GMFCS level IV, 5 in level V) and none worsened. Stool frequency: 8 improved (8 in GMFCS level V) and 14 worsened.
  
  
  CONCLUSIONS
  Some aspects of speech, communication, and saliva control seemed to have improved, with bowel movement frequency decreased in some children receiving ITB. Fewer changes in feeding and nutritional status were reported. On the basis of this pilot study, prospective management guidelines are proposed that relate objective outcome measures of oral motor function, communication, and nutrition to changes in spasticity with ITB.
authors.affiliation: Children's Hospital and Regional Medical Center, Neurodevelopmental Clinic, Spasticity Management Clinic, Seattle, WA, USA. kristie.bjornson@seattlechildrens.org
authors.forename: Kristie F
authors.initials: KF
authors.lastname: Bjornson
authors.forename: John F
authors.initials: JF
authors.lastname: McLaughlin
authors.forename: John D
authors.initials: JD
authors.lastname: Loeser
authors.forename: Kim M
authors.initials: KM
authors.lastname: Nowak-Cooperman
authors.forename: Mark
authors.initials: M
authors.lastname: Russel
authors.forename: Kathy A
authors.initials: KA
authors.lastname: Bader
authors.forename: StarRina A
authors.initials: SA
authors.lastname: Desmond
mesh_terms: D000293:Adolescent; D000328:Adult; D001418:Baclofen / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D003142:Communication; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000534:rehabilitation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal / Q000379:methods; D007322:Instillation, Drug; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009752:Nutritional Status; D010865:Pilot Projects; D013060:Speech; D011795:Surveys and Questionnaires
chemical_list: D009125:Muscle Relaxants, Central; D001418:Baclofen