Interventions and outcomes for children with dysphagia.
Feeding problems are common even in typically developing infants and children. However, they are more frequent and persistent in children with developmental disabilities. This article will provide an overview of current literature and a rationale underlying the interventions used for children with cerebral palsy (CP) who have eating impairments (dysphagia). The review is not intended to be exhaustive, but papers were selected that highlight some of the issues and challenges of the field. Normal oral-motor development is briefly discussed to show how it may inform clinical practice in the understanding of feeding problems. Description of the risk factors and the nature and extent of eating impairments will show how interventions need to be specific to the severity of eating impairments. Examination of sensorimotor therapies, using oral stimulation exercises or an intra-oral appliance, will highlight the range of their effectiveness, as well as their limitations. Similarly, an examination of tube feeding, used for nutritional rehabilitation of the most severely affected children, will address the benefits, controversies as well as moral issues encountered by caregivers and professionals. Multi-center studies will be needed to obtain more homogeneous samples, large enough to address questions of early interventions and their subsequent effect on later development.
Gisel
Erika
E
School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. erika.gisel@mcgill.ca
D002547:Cerebral Palsy / Q000453:epidemiology*; D002648:Child; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000628:therapy*; D002149:Energy Intake; D004750:Enteral Nutrition; D019959:Feeding and Eating Disorders of Childhood / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D009752:Nutritional Status; D011596:Psychomotor Disorders / Q000453:epidemiology; D016896:Treatment Outcome