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Kalhoff H, Kersting M, Sinningen K, Lücke T. Development of eating skills in infants and toddlers from a neuropediatric perspective. Ital J Pediatr 2024; 50:110. [PMID: 38831369 PMCID: PMC11149262 DOI: 10.1186/s13052-024-01683-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
Early infant feeding and swallowing are complex motor processes involving numerous muscles in coordination, e.g. the orofacial muscles as well as the muscles of the pharynx, larynx and esophagus. The newborn's reflexive drinking develops into the ability to ingest pureed complementary food as infancy progresses. Finally, in the last part of the first year of life, a differentiated eating, chewing and swallowing process develops allowing the voluntary intake of different foods of the family diet. The dietary schedule for the first year of life, which describes the recommended nutrition of infants in Germany, corresponds to these milestones in eating development. Disturbances in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere with the development of eating skills. Swallowing disorders (dysphagia) in children can have a detrimental effect on food intake and pose a serious risk to growth and development. Their prevention treatment requires a multidisciplinary approach with the aim of enabling the child to eat independently in the long term.
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Affiliation(s)
- Hermann Kalhoff
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
- Pediatric Clinic, Klinikum Dortmund, Beurhausstrasse 40, D-44137, Dortmund, Germany.
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Kathrin Sinningen
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Thomas Lücke
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
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Nachalon Y, Broer M, Nativ-Zeltzer N. Using ChatGPT to Generate Research Ideas in Dysphagia: A Pilot Study. Dysphagia 2024; 39:407-411. [PMID: 37907728 DOI: 10.1007/s00455-023-10623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/20/2023] [Indexed: 11/02/2023]
Abstract
Current research in dysphagia faces challenges due to the rapid growth of scientific literature and the interdisciplinary nature of the field. To address this, the study evaluates ChatGPT, an AI language model, as a supplementary resource to assist clinicians and researchers in generating research ideas for dysphagia, utilizing recent advancements in natural language processing and machine learning. The research ideas were generated through ChatGPT's command to explore diverse aspects of dysphagia. A web-based survey was conducted, 45 dysphagia experts were asked to rank each study on a scale of 1 to 5 according to feasibility, novelty, clinical implications, and relevance to current practice. A total of 26 experts (58%) completed the survey. The mean (± sd) rankings of research ideas were 4.03 (± 0.17) for feasibility, 3.5 (± 0.17) for potential impact on the field, 3.84 (± 0.12) for clinical relevance, and 3.08 (± 0.36) for novelty and innovation. Results of this study suggest that ChatGPT offers a promising approach to generating research ideas in dysphagia. While its current capability to generate innovative ideas appears limited, it can serve as a supplementary resource for researchers.
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Affiliation(s)
- Yuval Nachalon
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel-Aviv, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Maya Broer
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Gosa MM. Pediatric Feeding Disorder and the School-Based SLP: An Evidence-Based Update for Clinical Practice: Epilogue. Lang Speech Hear Serv Sch 2024; 55:469-472. [PMID: 38573169 DOI: 10.1044/2023_lshss-23-00175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Affiliation(s)
- Memorie M Gosa
- Department of Communicative Disorders, The University of Alabama, Tuscaloosa
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Akaltun MS, Umay E, Altindag O, Karaahmet OZ. Effectiveness of kinesiotape and sham kinesiotape application in children with cerebral palsy with dysphagia: A randomized controlled study. Turk J Phys Med Rehabil 2023; 69:434-443. [PMID: 38766591 PMCID: PMC11099860 DOI: 10.5606/tftrd.2023.11066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/01/2023] [Indexed: 05/22/2024] Open
Abstract
Objectives This study aimed to investigate the short- and long-term effects of kinesiotaping (KT) on dysphagia in children with cerebral palsy (CP). Patients and methods One hundred one CP patients (59 males, 42 females; mean age: 49.3±18.8 years; range, 2 to 6 years) with dysphagia referred between October 2017 and January 2020 were enrolled in the randomized controlled study. Children who met the study criteria were randomly assigned to the kinesiotape group (n=54) or the sham group (n=47). Specific swallowing evaluations were performed on all patients before the therapy. The KT or sham application protocole combined with conventional rehabilitaion therapy was conducted for six weeks. Evaluation parameters were repeated at 6 and 18 weeks. The evaluated parameters were compared within and between groups. Results Drooling, weak tongue movement, chewing difficulty, coughing/choking and retching/vomiting during/after feeding, functional oral intake score, and meal time were found to be significantly improved at six weeks in the kinesiotape group compared to the sham group, and the clinical improvements were present at 18 weeks (p<0.05). There was no statistically significant difference in any parameter in the sham group at 6 and 18 weeks compared to the pretreatment (p>0.05). Conclusion The addition of KT to a home exercise program is an effective method for dysphagia in CP.
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Affiliation(s)
- Mazlum Serdar Akaltun
- Department of Physical Medicine and Rehabilitation, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Ebru Umay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Ozlem Altindag
- Department of Physical Medicine and Rehabilitation, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Ozgur Zeliha Karaahmet
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
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Adams SN, Matsimela N. Feeding children with autism in South Africa: The teachers' perspectives. Afr J Disabil 2023; 12:1252. [PMID: 38059155 PMCID: PMC10696580 DOI: 10.4102/ajod.v12i0.1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/11/2023] [Indexed: 12/08/2023] Open
Abstract
Background Over 80% of children diagnosed with autism spectrum disorders (autism) exhibit disruptive behaviours during mealtimes, highlighting the need for personalised care. In South Africa, teachers often take on the responsibility of feeding due to resource constraints and the time children spend at school. Moreover, children with autism have unique and individualised feeding requirements, which many teachers may not have the necessary training or skills to address adequately. Objectives To explore the ways in which teachers of autistic children manage feeding difficulties in the classroom. Method A qualitative research design was employed using semi-structured interviews. Eight teachers were interviewed on feeding autistic children between the ages of 3 years - 9 years in Johannesburg, South Africa. Data were transcribed and analysed using thematic analysis. Results The findings revealed that teachers encountered distinct challenges when it came to feeding autistic children in the classroom, particularly concerning the management of associated feeding difficulties. Teachers employed several strategies to encourage eating in the classroom setting including: (1) bolus modification, (2) behaviour modelling, (3) positive reinforcement and (4) offering choices and alternatives. Conclusion The study concludes the need for specialised support and training for teachers to address the individualised feeding needs of children with autism. Implementing targeted interventions and providing resources for teachers could enhance their abilities to effectively support children with autism during mealtimes and promote a more inclusive classroom environment. Contribution This study highlighted the importance of including the teacher in the multidisciplinary team when managing the feeding challenges in children with autism.
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Affiliation(s)
- Skye N Adams
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Nthabiseng Matsimela
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
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Sheikh-Mohamed SO, Wilson H, Fucile S. Interventions to Enhance Achievement to Independent Oral Feeds in Premature Infants: A Scoping Review. Phys Occup Ther Pediatr 2023; 44:295-315. [PMID: 37867325 DOI: 10.1080/01942638.2023.2271064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
AIM To assess the effectiveness of interventions aimed at facilitating the transition from full tube to independent oral feeds in premature infants. METHODS Scoping review methodology using the Preferred Reporting items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA_ScR). A search of six databases (EMBASE, MEDLINE, CINAHL, Web of Science, COCHRANE, and OT Seeker), using keywords related to oral feeding and premature infants retrieved 11,870 articles. Full-text screening was completed for 36 articles, and 21 articles were included in this review. RESULTS Review of the 21 articles revealed five intervention types: oral stimulation (n = 14), swallow/gustatory stimulation (n = 3), olfactory stimulation (n = 2), tactile/kinesthetic stimulation (n = 1), and auditory stimulation (n = 1). Oral stimulation had the most studies with consistent evidence supporting its beneficial effect to facilitate achievement to independent oral feeds, swallow/gustatory stimulation appeared to have some benefit, but evidence for olfactory, tactile/kinesthetic, and auditory stimulation was sparse. CONCLUSION Oral stimulation has the most studies with consistent evidence, and thus is suggested as a suitable early intervention strategy that can be used by health providers to facilitate the achievement to independent oral feeds in premature infants. The alternate forms of stimulation have limited evidence and necessitate further studies to confirm their benefits.
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Affiliation(s)
| | - Hillary Wilson
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Sandra Fucile
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
- Department of Pediatrics, Queen's University, Kingston, Canada
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Çelik TÖ, Borman P, Tayman C, Kavakçi M, Çelebi F, Yaşar E. Effects of kinesiology taping on swallowing functions in newborns with swallowing difficulties: a randomized controlled pilot study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230383. [PMID: 37820176 PMCID: PMC10561914 DOI: 10.1590/1806-9282.20230383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE This study investigated the efficacy of kinesiology taping application in premature infants with dysphagia. METHODS A total of 60 premature newborns (born ≤37weeks' gestational age who reached the age ≥34 weeks of postmenstrual age) with sucking and swallowing problems were randomly assigned to the kinesiology taping group [n=31; 18 males, 13 females; mean postmenstrual age 35.4 weeks (SD 0.9 weeks, range 34-38 weeks)] or control group without kinesiology taping application [n=29; 16 males, 13 females; mean postmenstrual age age 35.6 weeks (SD 1.4 weeks, range 34-40 weeks)]. RESULTS Kinesiology taping group yielded significant improvement in the oral reflexes (p<0.001) and in the sucking functions including tongue movement, sucking power, number of sucks and sucking pause, maintenance of alertness, jaw movement, tongue cupping, and maintenance of rhythm (p<0.001, p=0.011, p=0.002, and p=0.001, respectively). There was a significant difference in favor of the taping group with respect to the number of neonates whose feeding improved (26 (84%) vs. 7 (24%), p<0.001). CONCLUSION The results of this study show that kinesiology taping can be applied as a safe and effective method to improve feeding functions in premature infants with sucking and swallowing difficulties.
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Affiliation(s)
- Tuğba Özüdoğru Çelik
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Physical Medicine and Rehabilitation – Ankara, Turkey
| | - Pınar Borman
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Physical Medicine and Rehabilitation – Ankara, Turkey
| | - Cüneyt Tayman
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Pediatrics – Ankara, Turkey
| | - Mariam Kavakçi
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Physical Medicine and Rehabilitation – Ankara, Turkey
| | - Feyza Çelebi
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Physical Medicine and Rehabilitation – Ankara, Turkey
| | - Evren Yaşar
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Physical Medicine and Rehabilitation – Ankara, Turkey
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Fucile S, Dow K. A Unique Clinical Tool for the Evaluation of Oral Feeding Skills in Infants. Can J Occup Ther 2023; 90:240-248. [PMID: 36314405 PMCID: PMC10422857 DOI: 10.1177/00084174221134738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background. Occupational therapy practice for oral feeding assessment is based on clinical observation of infants' sucking, swallowing, and breathing ability, which is influenced by clinical experience and provides poor evidence on explanatory factors. Purpose. To test the clinical utility and safety of a nipple monitoring device for the quantitative evaluation of oral feeding skills. Method. Sixteen infants, with no severe medical complications, participated in a pre-experimental pilot study. Oral feeding performances (duration, intake volume, and rate of transfer), and occurrence of adverse events (apnea, bradycardia, and oxygen desaturations) were recorded to ensure the tool does not interfere with infant's feeding ability or does not create any adverse effects. Findings. There was no significant difference in duration, intake volume, rate of transfer between the two monitored sessions, and no occurrence in adverse events. Implications. The findings suggest that the nipple monitoring device may be used for quantitative assessment and intervention planning of oral feeding difficulties in infants.
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Affiliation(s)
- Sandra Fucile
- Sandra Fucile, Watkins 4.4.321, 76 Stuart Street, Kingston, Ontario K7L 2V7.
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Cerchiari A, Giordani C, Franceschetti S, Mazzafoglia S, Carosi F, Pizza F, Bella GD, Raponi M, Tofani M. The Efficacy of the Global Intensive Feeding Therapy on Feeding and Swallowing Abilities in Children with Autism Spectrum Disorder: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1241. [PMID: 37508738 PMCID: PMC10377905 DOI: 10.3390/children10071241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times a day. GIFT focused on (a) encouraging desensitization; (b) widening the food repertoire (in terms of both variety and quantity); (c) reducing inappropriate mealtime behaviors; and (d) encouraging the development of appropriate chewing and swallowing abilities. GIFT was preliminarily implemented among 11 children with a diagnosis of ASD. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the Brief Autism Mealtime Behavior Inventory (BAMBI), and food repertoire were investigated using Wilcoxon signed-rank test in three different times: baseline (T1), after treatment (T2), and one month after treatment (T3). Using Bonferroni correction, statistically significant differences were found between T1 and T2 for behavioral issues, as measured with BAMBI (p = 0.007), as well as for chewing abilities as measured with KCPS (p = 0.005) and for food acceptance (p = 0.005). These improvements were maintained after a month of follow-up, thanks to the collaboration of families and/or primary caregivers. In conclusion, GIFT seems to be an effective approach to improving behavioral issues, food acceptance, and chewing abilities in children with ASD.
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Affiliation(s)
- Antonella Cerchiari
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Carolina Giordani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Silvia Franceschetti
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Serena Mazzafoglia
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Flavia Carosi
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Francesca Pizza
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Gessica Della Bella
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Massimiliano Raponi
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Marco Tofani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00183 Rome, Italy
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Matuleviciene A, Siauryte K, Kuiper E. Consensus recommendations on chewing, swallowing and gastrointestinal problems in Phelan-McDermid syndrome. Eur J Med Genet 2023; 66:104763. [PMID: 37054968 DOI: 10.1016/j.ejmg.2023.104763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/15/2023]
Abstract
Gastrointestinal (GI) problems are common in Phelan-McDermid syndrome (PMS). Chewing and swallowing difficulties, dental problems, reflux disease, cyclic vomiting, constipation, incontinence, diarrhoea, and nutritional deficiencies have been most frequently reported. Therefore, this review summarises current findings on GI problems and addresses the fundamental questions, which were based on parental surveys, of how frequent GI problems occur in PMS, what GI problems occur, what consequences (e.g., nutritional deficiencies) GI problems cause for individuals with PMS, and how GI problems can be treated in individuals with PMS. Our findings show that gastrointestinal problems have a detrimental effect on the health of people with PMS and are a significant burden for their families. Therefore, we advise evaluation for these problems and formulate care recommendations.
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Affiliation(s)
- Ausra Matuleviciene
- Dept. of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| | - Kamile Siauryte
- Dept. of Human and Medical Genetics, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Els Kuiper
- Patient Representative from the European Consensus PMS Group, the Netherlands
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Mayerl CJ, Gould FDH, Adjerid K, Edmonds C, German RZ. The Pathway from Anatomy and Physiology to Diagnosis: A Developmental Perspective on Swallowing and Dysphagia. Dysphagia 2023; 38:33-41. [PMID: 35441265 PMCID: PMC9579268 DOI: 10.1007/s00455-022-10449-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/04/2022] [Indexed: 01/29/2023]
Abstract
Dysphagia results from diverse and distinct etiologies. The pathway from anatomy and physiology to clinical diagnosis is complex and hierarchical. Our approach in this paper is to show the linkages from the underlying anatomy and physiology to the clinical presentation. In particular, the terms performance, function, behavior, and physiology are often used interchangeably, which we argue is an obstacle to clear discussion of mechanism of pathophysiology. We use examples from pediatric populations to highlight the importance of understanding anatomy and physiology to inform clinical practice. We first discuss the importance of understanding anatomy in the context of physiology and performance. We then use preterm infants and swallow-breathe coordination as examples to explicate the hierarchical nature of physiology and its impact on performance. We also highlight where the holes in our knowledge lie, with the ultimate endpoint of providing a framework that could enhance our ability to design interventions to help patients. Clarifying these terms, and the roles they play in the biology of dysphagia will help both the researchers studying the problems as well as the clinicians applying the results of those studies.
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Affiliation(s)
- C J Mayerl
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, 44272, USA
| | - F D H Gould
- Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - K Adjerid
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, 44272, USA
| | - C Edmonds
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, 44272, USA
| | - R Z German
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, 44272, USA.
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Swallowing-related quality of life in children with oesophageal atresia: a national cohort study. Eur J Pediatr 2023; 182:275-283. [PMID: 36331620 PMCID: PMC9829586 DOI: 10.1007/s00431-022-04677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
UNLABELLED Swallowing and feeding disorders are a major concern for children with oesophageal atresia (OA) after primary or staged OA repair. Primary OA repair is associated with higher rates of short-term complications in preterm infants with very low birth weight (VLBW) or extreme low birth weight (ELBW). On the other hand, primary repair may have the benefit of early commencement of oral feedings. We hypothesize that also in the medium-term, swallowing-related quality of life is better after primary oesophageal repair. We conducted a prospective cross-sectional study on swallowing quality in a national cohort of former VLBW and ELBW children with OA, using the structured paediatric swallowing quality of life (pedSWAL-QOL) questionnaire. Results were correlated with surgical approach and baseline clinical data. Principal component analysis of pedSWAL-QOL domains was performed. In total, 44 complete data sets of 78 children were available. The mean age of children was 8.5 years (SD = 7.4), and 23 children (52%) had primary OA repair. The overall median pedSWAL-QOL score was 2 (IQR = 0-3), representing a high swallowing-related quality of life, independent of surgical technique (p = 0.086). Children with a history of intracranial haemorrhage (ICH) (p = 0.002) and those with VACTERL association (p = 0.008) had significantly decreased enjoyment with eating. In addition, children with VACTERL association had problems to find suitable foods (p = 0.04). CONCLUSION In this national cohort of VLBW and ELBW preterm-born children with OA, swallowing-related quality of life is good, mostly independent of initial surgery. Children with OA and ICH or VACTERL association may require more intense support with feeding. WHAT IS KNOWN • Dysphagia, resembling feeding and swallowing disorders, is common in children and adults with repaired oesophageal atresia. Nevertheless, dysphagia in children with oesophageal atresia decreases with age. • Parents of younger children suffer from increased anxiety and fear regarding eating and swallowing abilities of their children. WHAT IS NEW • Swallowing-related quality of life in former preterm children with oesophageal atresia is good, independent of initial surgical approach (primary vs. staged repair), even in very low birth weight or extreme low birth weight infants. • Children suffering from VACTERL association or intracranial haemorrhage show decreased enjoyment with eating.
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Heo JS, Kim EK, Kim SY, Song IG, Yoon YM, Cho H, Lee ES, Shin SH, Oh BM, Shin HI, Kim HS. Direct swallowing training and oral sensorimotor stimulation in preterm infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2022; 107:166-173. [PMID: 34281934 DOI: 10.1136/archdischild-2021-321945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/21/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the effects of direct swallowing training (DST) alone and combined with oral sensorimotor stimulation (OSMS) on oral feeding ability in very preterm infants. DESIGN Blinded, parallel group, randomised controlled trial (1:1:1). SETTING Neonatal intensive care unit of a South Korean tertiary hospital. PARTICIPANTS Preterm infants born at <32 weeks of gestation who achieved full tube feeding. INTERVENTIONS Two sessions per day were provided according to the randomly assigned groups (control: two times per day sham intervention; DST: DST and sham interventions, each once a day; DST+OSMS: DST and OSMS interventions, each once a day). PRIMARY OUTCOME Time from start to independent oral feeding (IOF). RESULTS Analyses were conducted in 186 participants based on modified intention-to-treat (63 control; 63 DST; 60 DST+OSMS). The mean time from start to IOF differed significantly between the control, DST and DST+OSMS groups (21.1, 17.2 and 14.8 days, respectively, p=0.02). Compared with non-intervention, DST+OSMS significantly shortened the time from start to IOF (effect size: -0.49; 95% CI: -0.86 to -0.14; p=0.02), whereas DST did not. The proportion of feeding volume taken during the initial 5 min, an index of infants' actual feeding ability when fatigue is minimal, increased earlier in the DST+OSMS than in the DST. CONCLUSIONS In very preterm infants, DST+OSMS led to the accelerated attainment of IOF compared with non-intervention, whereas DST alone did not. The effect of DST+OSMS on oral feeding ability appeared earlier than that of DST alone. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT02508571).
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Affiliation(s)
- Ju Sun Heo
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Ee-Kyung Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Sae Yun Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Catholic University of Korea Yeouido Saint Mary's Hospital, Seoul, Korea (the Republic of)
| | - In Gyu Song
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Korea University Guro Hospital, Seoul, Korea (the Republic of)
| | - Young Mi Yoon
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Jeju National University Hospital, Jeju, Korea (the Republic of)
| | - Hannah Cho
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Korea University Anam Hospital, Seoul, Korea (the Republic of)
| | - Eun Sun Lee
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Paediatrics, Chung-Ang University Hospital, Seoul, Korea (the Republic of)
| | - Seung Han Shin
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea (the Republic of).,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Han-Suk Kim
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
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14
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Feeding Problems in Patients with Noonan Syndrome: A Narrative Review. J Clin Med 2022; 11:jcm11030754. [PMID: 35160209 PMCID: PMC8836779 DOI: 10.3390/jcm11030754] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/22/2022] [Accepted: 01/27/2022] [Indexed: 01/16/2023] Open
Abstract
Noonan syndrome (NS) belongs to the group of Noonan syndrome spectrum disorders (NSSD), which is a group of phenotypically related conditions. Feeding problems are often present not only in infancy but also in childhood, and even beyond that period. We describe the different aspects of feeding problems using a (theoretical) concept proposed in 2019. More than 50% of infants with NS develop feeding problems, and up to half of these infants will be tube-dependent for some time. Although, in general, there is a major improvement between the age of 1 and 2 years, with only a minority still having feeding problems after the age of 2 years, as long as the feeding problems continue, the impact on the quality of life of both NS infants and their caregivers may be significant. Feeding problems in general improve faster in children with a pathogenic PTPN11 or SOS1 variant. The mechanism of the feeding problems is complex, and may be due to medical causes (gastroesophageal reflux disease and delayed gastric emptying, cardiac disease and infections), feeding-skill dysfunction, nutritional dysfunction with increased energy demand, or primary or secondary psychosocial dysfunction. Many of the underlying mechanisms are still unknown. The treatment of the feeding problems may be a medical challenge, especially when the feeding problems are accompanied by feeding-skill dysfunction and psychosocial dysfunction. This warrants a multidisciplinary intervention including psychology, nutrition, medicine, speech language pathology and occupational therapy.
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15
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Wilson E, Simione M, Polley L. Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1316-1333. [PMID: 34423521 PMCID: PMC8585681 DOI: 10.1111/1460-6984.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Chewing dysfunction can have adverse effects on growth, development and quality of life. There is a lack of evidence-based consensus guidelines for sensorimotor intervention. To address this, we need to understand the current state of the science in clinical sensorimotor interventions for paediatric chewing dysfunction and systematically plan a research agenda and priorities for the field. AIMS The purpose of this scoping review was to examine the extent, range and nature of evidence for oral sensorimotor interventions for paediatric chewing dysfunction. METHODS & PROCEDURES This scoping review entailed five phases that included: identification of the research question; identification of relevant studies; study selection; data charting; and collation, summarization and report of the results. Treatment studies that were peer-reviewed and written in English were included. All studies involved a paediatric population and included an oral sensorimotor and/or chewing intervention. Information regarding study design, population, intervention, comparator, outcome measures and findings were extracted. MAIN CONTRIBUTION Of the 21 studies included in this scoping review, 53% were specific to children with cerebral palsy. All interventions were multi-component in nature and the treatment studies included a range of study designs, but few were controlled trials with comparators. A wide variety of outcomes measures were used within and across studies to determine treatment effectiveness. CONCLUSIONS & IMPLICATIONS The findings suggest that in a small number of studies, sensorimotor interventions provide preliminary evidence for effectiveness in specific populations. These and other treatment protocols must be trialled in additional clinical populations and settings to improve the evidence base for sensorimotor treatment of paediatric chewing dysfunction. This review also serves to help prioritize research agendas and further motivates the need for consensus-based clinical guidelines for paediatric chewing treatment. WHAT THIS PAPER ADDS What is already known on the subject Paediatric feeding disorders are highly prevalent and children often have chewing dysfunction that results in significant negative consequences. We lack evidence-based sensorimotor treatment approaches for chewing dysfunction, which directly impacts the care clinicians can provide children. What this study adds to existing knowledge This scoping review is the first step in examining the literature to understand the current state of the science for oral sensorimotor interventions for paediatric chewing dysfunction. Few randomized controlled studies were identified and a majority included children with cerebral palsy. Most of the interventions were multi-component and included a variety of treatment approaches. What are the potential or actual clinical implications of this work? The results of this scoping review can be used as an initial reference for clinicians selecting treatment approaches for chewing dysfunction. It also serves to help prioritize research agendas and further motivates the need for consensus-based clinical guidelines for paediatric chewing treatment.
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Affiliation(s)
- Erin Wilson
- Speech and Feeding Disorders Laboratory, MGH Institute of Health Professions, Boston, MA, USA
| | - Meg Simione
- Division of General Pediatrics, Mass General Hospital for Children, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Lydia Polley
- Department of Speech Pathology, Akron Children's Hospital, Akron, OH, USA
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16
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Genna CW, Saperstein Y, Siegel SA, Laine AF, Elad D. Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns. Physiol Rep 2021; 9:e14685. [PMID: 33547883 PMCID: PMC7866619 DOI: 10.14814/phy2.14685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022] Open
Abstract
Tongue motility is an essential physiological component of human feeding from infancy through adulthood. At present, it is a challenge to distinguish among the many pathologies of swallowing due to the absence of quantitative tools. We objectively quantified tongue kinematics from ultrasound imaging during infant and adult feeding. The functional advantage of this method is presented in several subjects with swallowing difficulties. We demonstrated for the first time the differences in tongue kinematics during breast- and bottle-feeding, showing the arrhythmic sucking pattern during bottle-feeding as compared with breastfeeding in the same infant with torticollis. The method clearly displayed the improvement of tongue motility after frenotomy in infants with either tongue-tie or restrictive labial frenulum. The analysis also revealed the absence of posterior tongue peristalsis required for safe swallowing in an infant with dysphagia. We also analyzed for the first time the tongue kinematics in an adult during water bolus swallowing demonstrating tongue peristaltic-like movements in both anterior and posterior segments. First, the anterior segment undulates to close off the oral cavity and the posterior segment held the bolus, and then, the posterior tongue propelled the bolus to the pharynx. The present methodology of quantitative imaging revealed highly conserved patterns of tongue kinematics that can differentiate between swallowing pathologies and evaluate treatment interventions. The method is novel and objective and has the potential to advance knowledge about the normal swallowing and management of feeding disorders.
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Affiliation(s)
| | - Yiela Saperstein
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
| | - Scott A. Siegel
- School of Medicine/School of Dental MedicineStony Brook UniversitySuffolk CountyNYUSA
| | - Andrew F. Laine
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
| | - David Elad
- Department of Biomedical EngineeringColumbia UniversityNew YorkNYUSA
- Department of Biomedical EngineeringTel‐Aviv UniversityTel‐AvivIsrael
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17
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Lima JADCD, Collet N, Baggio MA, Almeida AMD. Aleitamento materno na experiência de mães de crianças traqueostomizadas e o uso da válvula Passy-Muir®. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo compreender a experiência de mães de crianças traqueostomizadas, entre 0 e 24 meses de idade, que retomaram o aleitamento materno com o uso de válvula de deglutição Passy-Muir®. Método pesquisa descritiva, de natureza qualitativa, com 11 mães de crianças traqueostomizadas que adaptaram a válvula de deglutição Passy-Muir®, acompanhadas em um centro de reabilitação e fonoaudiologia, mediante entrevistas semiestruturadas, nos meses de junho a agosto de 2017. A análise foi fundamentada nos pressupostos da análise de conteúdo temática. Resultados na experiência das mães, após a traqueostomia da criança, o uso da válvula de deglutição Passy-Muir® minimizou as dificuldades no aleitamento materno. Superado o processo de adaptação da válvula, foram percebidos seus benefícios. São descritos os sentimentos das mães nesse processo, suas expectativas quanto ao uso do dispositivo e o prazer e plenitude para a mulher no retorno do aleitamento materno. Conclusões e implicações para a prática observaram-se segurança ao aleitar, menor produção de secreção, reduções no número de aspirações de vias áreas, melhora no padrão respiratório, vocalizações (balbucios e choro), melhora na qualidade do sono da criança. Novas pesquisas que abordem o aleitamento materno de crianças traqueostomizadas são necessárias para aprofundar conhecimentos nesta área.
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18
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Fukatsu H, Nohara K, Tanaka N, Fujii N, Sakai T. The impact of different medical complications on the feasibility of removing the feeding tube from infants with dysphagia. J Pediatr Rehabil Med 2021; 14:371-377. [PMID: 34459423 DOI: 10.3233/prm-200786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study examined whether certain medical complications influence the feasibility of tube removal. METHODS 42 subjects with dysphagia who were under the age of 2.5 years were nourished entirely through feeding tubes. Additionally, they were judged to have no aspiration. The following data about the infants were collected through a retroactive survey: age at which oral feeding training commenced, gender, and whether certain medical complications (cardiovascular, respiratory, digestive, neurological, or oral) had been present at birth. The data were analyzed to determine which type of medical complication affected the likelihood of removing the feeding tube from the infant at 3 years of age. RESULTS Of the five medical complications examined, cardiovascular complications significantly affected the feasibility of tube removal (p = 0.049). CONCLUSION Pediatric dysphagia patients with cardiac complications, compared to those with other complications, may take longer to transition off tube feeding.
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Affiliation(s)
- Hikari Fukatsu
- Division for Oral and Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Kanji Nohara
- Division for Oral and Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Nobukazu Tanaka
- Division for Oral and Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Nami Fujii
- Division for Oral and Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Takayoshi Sakai
- Division of Functional Oral Neuroscience, Osaka University, Osaka University Graduate School of Dentistry, Osaka, Japan
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19
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Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2020. [DOI: 10.1007/s11726-020-1203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Is sensory-level electrical stimulation effective in cerebral palsy children with dysphagia? A randomized controlled clinical trial. Acta Neurol Belg 2020; 120:1097-1105. [PMID: 30604337 DOI: 10.1007/s13760-018-01071-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
Abstract
Dysphagia is one of the common findings in children with cerebral palsy (CP). Electrical stimulation (ES) has been demonstrated to positively contribute to swallowing functions, particularly in adult patients with various neurological disorders. Therefore, the objective of this study was to assess the effects of sensory-level ES treatment combined with conventional dysphagia rehabilitation in pediatric age group CP patients who had any oropharyngeal dysphagia symptoms and/or findings. Participants were randomly assigned to either the experimental group (Group 1, n = 52) who underwent intermittent galvanic stimulation to bilateral masseter muscles for 5 days/week, for 4 weeks combined with conventional dysphagia rehabilitation or the control group (Group 2, n = 50) who received sham stimulation with conventional dysphagia rehabilitation. The experimental group achieved significantly more improvement in swallowing functions including drooling, tongue movements, chewing, eating large food ability, feeding duration, as well as dysphagia screen test and dysphagia level, compared to control group. This study suggested that sensory-level ES might be a useful and safe therapeutic modality to improve oropharyngeal symptoms, symptom severity and dysphagia level in children with CP and dysphagia. Further research is needed to determine the long-term effects of ES on dysphagia, especially in different neurological disorders such as CP.
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21
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Schie KE, Spies E, Hyams LB, Singh S, Bell NC, Vallabhjee AL, Hazle M, Chatzkelowitz K, Maposa I. Paediatric dysphagia within the context of South Africa's quadruple burden of disease, seen at a tertiary level hospital. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:466-474. [PMID: 31672066 DOI: 10.1080/17549507.2019.1669710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: To inform service provision, this study explored feeding and swallowing difficulties in children within the context of South Africa's quadruple burden of disease (BOD) (i.e. conditions characterised as communicable, non-communicable, maternal and/or perinatal and trauma).Method: A retrospective chart review of 1432 paediatric inpatients (under 12 years of age) who met the inclusion criteria of presenting with dysphagia and being referred for speech-language pathology services was conducted.Result: Participants with diagnoses within the maternal and/or perinatal BOD category were noted most frequently (61.2%), followed by non-communicable (59.7%), communicable (43.4%) and trauma (4.2%). The majority of participants were under 1 year of age (82.2%) and 56.2% presented with comorbidities in multiple BOD categories. Mortality was 5.9%, with a higher rate (67.7%) in more complex cases. Mortality was associated with non-communicable BOD (p = 0.001), and maternal and/or perinatal BOD (p = 0.003). Pharyngeal phase swallowing difficulties were a significant risk for mortality (OR = 2.96; 95% CI: 1.01-8.65, p = 0.047).Conclusion: The majority of children with dysphagia presented with multiple comorbidities and were at high risk for mortality. Education and service delivery models should be designed to improve health outcomes and reduce mortality rates.
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Affiliation(s)
- Kathryn E Schie
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Elizca Spies
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Leanne B Hyams
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Shajila Singh
- Division of Communication Sciences and Disorders, University of Cape Town, Cape Town, Western Cape, South Africa
- Northwestern University, Evanston, IL, USA
| | - Nicoll C Bell
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Annika L Vallabhjee
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Melissa Hazle
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Kelly Chatzkelowitz
- Speech Therapy & Audiology Department, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Innocent Maposa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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22
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McKay R, Smart S, Cocks N. Investigating Tongue Strength and Endurance in Children Aged 6 to 11 Years. Dysphagia 2019; 35:762-772. [PMID: 31792616 DOI: 10.1007/s00455-019-10081-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
Abstract
Objective measures of tongue strength and endurance are used to assess lingual weakness and fatigue, and may have significant clinical value for dysphagia management. Recent studies investigating age and gender effects on tongue strength in children are limited by small sample sizes. The current study investigated age and gender effects on tongue strength with a larger sample size, and collected preliminary normative data for a paediatric population. This study also investigated the reliability of tongue endurance measures in children using a modified method, which has not previously been investigated. Using a cross-sectional design, this study examined tongue strength and endurance in 119 children aged 6 to 11 years, with no history of speech sound disorders, oro-motor deficits, dysphagia or cognitive impairment. Measures were collected using the Iowa Oral Performance Instrument. Children participated in two sessions, 45 min and 10 min in duration. Tongue strength was found to significantly increase with age (p < 0.001), while no gender effects were found. Modified tongue endurance measures involved using only one measure of maximal tongue strength to set parameters for tongue endurance scores. Despite this modification, data did not reach acceptable test-retest reliability, ICC = 0.68, p < 0.001; however, reliability improved from previous studies. These findings provide normative data for tongue strength, as a basis to compare individuals, and highlights the need for more reliable protocols for measuring tongue endurance. Normative data was collected from city-dwelling Australian children.
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Affiliation(s)
- R McKay
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - S Smart
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - N Cocks
- Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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23
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Abstract
Advances in high-resolution ultrasound have provided clinicians with unique opportunities to study diseases of the peripheral nervous system. Ultrasound complements the clinical and electrophysiology exam by showing the degree of abnormalities in myopathies, as well as spontaneous muscle activities in motor neuron diseases and other disorders. In experienced hands, ultrasound is more sensitive than MRI in detecting peripheral nerve pathologies. It can also guide needle placement for electromyography exam, therapeutic injections, and muscle biopsy. Ultrasound enhances the ability to detect carpal tunnel syndrome and other focal nerve entrapment, as well as pathological nerve enlargements in genetic and acquired neuropathies. Furthermore, ultrasound can potentially be used as a biomarker for muscular dystrophy and spinal muscular atrophy. The combination of electromyography and ultrasound can increase the diagnostic certainty of amyotrophic lateral sclerosis, aid in the localization of brachial plexus or peripheral nerve trauma and allow for surveillance of nerve tumor progression in neurofibromatosis. Potential limitations of ultrasound include an inability to image deeper structures, with lower sensitivities in detecting neuromuscular diseases in young children and those with mitochondrial myopathies, due to subtle changes or early phase of the disease. As well, its utility in detecting critical illness neuromyopathy remains unclear. This review will focus on the clinical applications of neuromuscular ultrasound. The diagnostic values of ultrasound for screening of myopathies, neuropathies, and motor neuron diseases will be presented.
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24
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Budhan J, Scarborough D, Kuren MBV. The Impact of a Novel Gaming Reinforcement System on Oral Intake Outcomes in Pediatric Feeding Therapy: A Single Case Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:394-407. [PMID: 31136237 DOI: 10.1044/2018_ajslp-18-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The aim of this study was to implement a novel reinforcement strategy into traditional dysphagia therapy with a school-age child diagnosed with a rare genetic syndrome, anxiety, and a hypersensitive gag reflex response. This clinical focus article evaluated the impact of a computer-based straw-drinking game on total liquid volume intake and the relationship between motivation and its role in feeding therapy. Method A longitudinal pilot study was used and required the development and implementation of a computer-based straw-drinking game as a novel reinforcement strategy. The gaming system was implemented to supplement ongoing dysphagia treatment in a single-subject case study design utilizing a client with pediatric dysphagia. Results The participant exhibited a trend of increased endurance during therapy sessions, allowing for increased volume per sip, increased trials per session, and decreased time between sequential trials. Average daily volume of oral intake remained less than 30 ml. Conclusions The gaming system maximized opportunities for orosensory desensitization of tactile input, resulting in increased comfort and endurance during therapy sessions, leading to more opportunities to practice the swallow. A novelty effect was observed as motivation and interest in the gaming system appeared greatest at the onset of the study. Generalized fatigue and anxiety continue to serve as barriers to more significant progress.
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Affiliation(s)
- Jamie Budhan
- Department of Speech Pathology and Audiology, Miami University, Oxford, OH
| | - Donna Scarborough
- Department of Speech Pathology and Audiology, Miami University, Oxford, OH
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25
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Sjögreen L, Gonzalez Lindh M, Brodén M, Krüssenberg C, Ristic I, Rubensson A, McAllister A. Oral Sensory-Motor Intervention for Children and Adolescents (3-18 Years) With Dysphagia or Impaired Saliva Control Secondary to Congenital or Early-Acquired Disabilities: A Review of the Literature, 2000 to 2016. Ann Otol Rhinol Laryngol 2018; 127:978-985. [PMID: 30296844 DOI: 10.1177/0003489418803963] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES: Dysphagia and impaired saliva control are common in children and adolescents with congenital and developmental disabilities. The aim of the present review was to investigate the evidence base for oral sensory-motor interventions in children and adolescents with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities and to make recommendations regarding methods for intervention. METHODS: A review of the literature from 2000 to 2016, including oral sensory-motor intervention studies for children and adolescents (3-18 years of age) with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities, was performed. The literature search included the PubMed, CINAHL, Medline, SpeechBITE, OVID, ERIC, Cochrane, and Google Scholar databases. Primary studies were evaluated on a 4-grade scale using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: Twenty primary studies of oral sensory-motor interventions for dysphagia and 6 studies for the treatment of impaired saliva control fulfilled the inclusion criteria. Of these, 3 were randomized, controlled trials. Five systematic reviews and 16 narrative reviews were also included. Limited and moderately strong recommendations were made on the basis of the grading results from the primary studies. The studies reported good results, but study design was often insufficient, and the study groups were small. The systematic reviews confirmed the lack of high scientific support for oral sensory-motor interventions in children and adolescents with congenital and developmental disabilities. CONCLUSIONS: There is an urgent need for high-quality studies that could serve as the basis for strong recommendations relating to oral sensory-motor interventions for children with dysphagia and impaired saliva control.
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Affiliation(s)
- Lotta Sjögreen
- 1 Mun-H-Center Orofacial Resource Centre for Rare Diseases, Public Dental Service, Gothenburg, Sweden
| | | | - Madeleine Brodén
- 3 Child and Adolescent Habilitation Services, Kronoberg County, Växjö, Sweden
| | | | | | - Agneta Rubensson
- 6 The Queen Silvia Children's Hospital, Regional Rehabilitation Centre, Gothenburg, Sweden
| | - Anita McAllister
- 7 Division of Speech and Language Pathology, CLINTEC, Karolinska Institutet, Functional Area Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
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26
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Creech TN, Bailey-Van Kuren M, Sparks J, Becker SB, Kou RSN, Wnek OC, Scarborough DR. A Comparison of Measurements of a Pediatric Supplement. Dysphagia 2018; 34:257-268. [PMID: 30074060 DOI: 10.1007/s00455-018-9931-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Abstract
This study evaluated the flow properties of viscosity and flow rate for water and two common pediatric liquids. The flow properties of the test liquids are of interest to create a cup simulation model and "smart" prototype training cup. Two objective methods of determining flow properties were utilized: a rheometer to assess viscosity and a modified version of the International Dysphagia Diet Standardization Initiative (IDDSI) to assess flow rate. Rheometer results concluded that the pediatric supplements were less than 50 cP at all shear rates evaluated and exhibited shear-thinning properties, placing both liquids into the "thin" category. The IDDSI, which was performed according to standardized protocol and also with experimental modifications of varying syringe volumes, determined that all three test liquids had greater than 1 mL/s flow rate across all syringe types/sizes. The experimental modification of the IDDSI with 60 mL syringe volume was found to be the most consistent and applicable with discrete values obtained across all liquids tested. A flow rate factor equation can be determined with the use of a 60 mL syringe, with our laboratory setup, to create the cup simulation model. This computer-generated cup simulation model also aims to integrate engineering with clinical practice to develop a "smart" prototype training cup equipped with software to control flow rate.
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Affiliation(s)
- Taylor N Creech
- Department of Speech Pathology and Audiology, Miami University, 301 S. Patterson Dr, 26 Bachelor Hall, Oxford, OH, 45056, USA
| | | | - Jessica Sparks
- Department of Chemical, Paper, and Biomedical Engineering, Miami University, Oxford, OH, USA
| | - Samantha B Becker
- Department of Speech Pathology and Audiology, Miami University, 301 S. Patterson Dr, 26 Bachelor Hall, Oxford, OH, 45056, USA
| | - Rita S N Kou
- Department of Speech Pathology and Audiology, Miami University, 301 S. Patterson Dr, 26 Bachelor Hall, Oxford, OH, 45056, USA
| | - Olivia C Wnek
- Department of Speech Pathology and Audiology, Miami University, 301 S. Patterson Dr, 26 Bachelor Hall, Oxford, OH, 45056, USA
| | - Donna R Scarborough
- Department of Speech Pathology and Audiology, Miami University, 301 S. Patterson Dr, 26 Bachelor Hall, Oxford, OH, 45056, USA.
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27
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Backman E, Karlsson AK, Sjögreen L. Gastrostomy Tube Feeding in Children With Developmental or Acquired Disorders: A Longitudinal Comparison on Healthcare Provision and Eating Outcomes 4 Years After Gastrostomy. Nutr Clin Pract 2018; 33:576-583. [DOI: 10.1002/ncp.10056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ellen Backman
- School of Health and Welfare; Halmstad University; Sweden
- Regional Habilitation Center; Region Halland; Kungsbacka Sweden
| | | | - Lotta Sjögreen
- Mun-H-Center Orofacial Resource Center for Rare Diseases; Public Dental Service; Gothenburg Sweden
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