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This article discusses the issues of children with cerebral palsy and the feeding difficulties that come along with it. The study was done in Bangladesh, which is a resource-poor country, and it is a challenge to have all the proper medical equipment for children with cerebral palsy. The purpose of the study was to assess how functional a low-technology, cost-efficient approach to feeding practices for children with moderate-severe cerebral palsy and feeding difficulties can improve. Additionally, the goal was to encourage child health by amplifying their nutritional intake, reducing any risk of infection, and decreasing stress during mealtimes. The participants were recruited from a non-governmental organization (NGO) network of healthcare programs, which consisted of 37 caregivers and 37 children aged 1-11 years old. Improvements in feeding were almost significant, the stress of the caregivers decreased, as well as the length of mealtime decreased. The limitations include a small sample size due to logistical restrictions, and 13 children dropping out of the study due to moving or financial obligations. Overall, the study showed positive results in a reduction of aspiration, advanced nutritional levels in 13 children, and increased child and caregiver mood.
In this article, the purpose of the study was to assess the clinical presence and severity of dysphagia in a sample of children. The participants included 166 children, 85 males and 81 females who were between 2 and 19 years old. They were recruited from specialized daycare centers in the Western region of the Netherlands. The Dysphagia Disorders Survey (DDS) was a tool used to evaluate signs of difficulty in all phases of swallowing. About 99% of the study participants were affected by dysphagia, and about 91% had signs of the pharyngeal phase and were fed by tube. A limitation is a team approach is not the best approach for screening purposes due to the logistical and time restrictions and growth after one year of intraoral appliance therapy in moderately dysphagic children with cerebral palsy.
In this article, researchers were testing to see if intraoral appliance therapy would be beneficial to children with cerebral palsy. The participants include 20 children, 11 girls and 9 boys all ranging between 4.2 to 13.1 years old. All children were diagnosed with cerebral palsy with tetraparesis and moderate motor impairment. The study was tested in a school environment, a school nursing office, and a dental clinic. They aimed to measure changes in feeding skills one year after the use of the Innsbruck Sensorimotor Activator and Regulator (ISMAR). By using the ISMAR, it’s purpose is to improve tissue connection between lips, tongue, soft palate, cheeks, and pharynx. The results show that oral motor skills improved during the stabilization phase. Additionally, there were improvements shown for spoon-feeding, biting, chewing, cup drinking, straw drinking, and swallowing. They found that in order to be successful the child must be able to breathe through the nose, and caretakers have to be willing to participate in therapy for over a year. A limitation is that ISMAR is a complex device, and may not be suggested for children with cognitive impairments.
This article focuses on the benefits of telehealth to patients that don’t have access to dysphagia experts. The researchers hypothesized that asynchronous swallowing evaluations performed over a computer screen would work just as well as face-to-face interaction. The participants included 19 children, 12 males and 7 females who ranged from 6.9 to 17.5 years old. The children were recruited from a convenience sample, from a summer camp of the Cerebral Palsy Research Center of Teachers College, Columbia University. In order to qualify for the study, the child had to be between 5 to 18 years old, have a confirmed diagnosis of cerebral palsy, and be able to eat by mouth. The purpose of the study was to see how dependable telehealth practices can be. The limitations of the study include the clinician's different levels of experience, the evaluator having difficulty identifying the specific foods that the child was eating, and the clinical not being able to request changes in the evaluation process. The findings indicate significant results when comparing face-to-face therapy, and remote therapy. This type of therapy can be extremely promising for patients who do not have easy access to clinicians in their area.
The researchers of this study were testing to see the characteristics of dysphagia in children with cerebral palsy, as well as, the clinical benefits of the Videofluoroscopic Swallow Study (VFSS) for an accurate evaluation of dysphagia. The participants were recruited from St. Vincent’s Hospital in Korea and consisted of twenty-nine children, 18 males and 11 females. Evaluation of swallowing in the oral preparatory phase, oral phase, and pharyngeal phase were done. The results showed that almost all the children in the moderate and severe groups had malformations in oral preparatory, oral, and pharyngeal phases, indicating that dysphagia is related to gross motor function in children with cerebral palsy. The limitations include a small number of participants, and the effect of age not being considered.
This article concentrates on assessing swallowing performance in children with Spastic Cerebral Palsy (SCP) compared to a typically developing child, measuring airway protective behaviors, and identifying the connection between clinical swallowing in children with SCP and other measures. The participants were recruited from the United Cerebral Palsy Foundation of New York City and includes two different groups, the SCP children, and the typically developing control group (TDC group). In the SCP group, children were between 4-11 years old and had a primary diagnosis of SCP. In the TDC group, children were between 4-11 years old as well and had to be typically developed with language comprehension skills. The purpose of the study is to measure feeding, swallowing, and cough impairments in children with Spaspic Cerebral Palsy as compared to typically developing children. The results show that there are differences on clinical feeding and swallow performance, suprahyoid muscle activity, swallow coordination and voluntary cough success. The limitations include small sample size, power, and atypical administration of data.
The researchers of this study are testing to see the dependability of recent results of mealtime length, and the relationship to clinical swallowing performance in children with Spastic Cerebral Palsy (SCP). The participants were recruited from summer camps for cerebral palsy at Teachers College, Columbia University. There were 17 children in total, 8 being female and 9 being male. The Dysphagia Disorder Survey (DDS), was used to evaluate the child’s feeding and swallowing execution. The results indicate excellent intra- and inter-rater agreement for a total meal time duration, total solid duration, and total liquid duration showing that the measures are extremely dependable within raters. The limitations include a small sample size, and the subjects were mainstreamed in school and had no intellectual disabilities. Overall, it was interesting to read this article because I have volunteered at Cerebral Palsy League for a long time, and one of the major problems in the school is how prolonged their mealtime are. Obviously, it is extremely difficult to get all the kids to feed, since each child needs one-on-one help. Reading this article shows that by taking the correct steps, it is possible to shorten the length of mealtime.
In this article, researchers were using data collected from 13,971 births from the Avon Longitudinal Study of Parents and Children (ALSPAC). The birth cohort included delivery between April 1, 1991, and December 21, 1992. From the cohort, children between the age of 4 to 5 years old who were diagnosed with cerebral palsy, were checked using child health records, ALSPAC questionnaires, local hospital systems, or a formal inquiry to pediatricians. This took place in England, and 51 children were a part of the study. Parents were asked to complete a questionnaire documenting their child’s feeding behaviors, as well as rate on a scale of 1 to 5 if their child showed specific feeding behaviors. The results show that feeding challenges in the first 4 weeks of life was related to severe neurodevelopmental impairments. Exhaustion at 4 weeks old and additional feeding difficulties has a correlation with impairments in school-age children with cerebral palsy. An implication of this finding is that they did not use enough gastrostomies for feeding. The limitation of this study is limited by the timing of the questions in the ALSPAC study. Generally, it was unsettling to read about the correlation between infants with cerebral palsy and their difficulty throughout their life. However, it is reassuring to read about the different research out their trying to treat all the complications.
This article concentrates on the prevalence of feeding difficulties for children with cerebral palsy. Participants were recruited from district health authorities in London, where they recruited 49 individuals, 27 boys and 22 girls ranging between 12 months to 72 months. The purpose of the study was to document feeding histories, observe current feeding methods in the home, and use a standardized tool to evaluate oral motor function. The different types of feeding difficulties during the first 12 months included sucking (breast, bottle, or both), swallowing, spooned purees, puree containing lumps, semisolids requiring munching, solids requiring chewing, and solids requiring biting. The current problems children are having during mealtimes include struggling in drinking liquids, problems with spooned purees, issues with semisolids, difficulty with solids, choking episodes, regurgitation, and vomiting. Over 36% were shown to have severe oral motor dysfunction. Those who scored moderate to severe, often have difficulties with textures and were related with tetraplegia and hypotonia. Unfortunately, they were unable to test the frequency of pharyngeal and esophageal dysphagia. The implications depend on the sample and vary on the prevalence rates of different types of cerebral palsy. Limitations include not being able to assess the frequency of pharyngeal or esophageal dysphagia.
In this study, the researchers were trying to recognize the effect of oral motor therapy on cerebral palsy patients with feeding problems. The participants include 81 children that range between 12-42 months old. Patients were recruited if they have been diagnosed with cerebral palsy, had oral motor dysfunction, and were watched over at the Pediatric Neurology clinic at Istanbul University. There were two groups in which patients were divided up into the control group and the training group. The purpose was to strengthen oral motor functions, increase daily life activities, and decrease drooling and feeding issues. The study did not include any limitations or implications. Additionally, improvement was shown in all areas which were spoon feeding, biting, chewing, drinking, and swallowing. The results indicate that the training group decreased in drooling compared to the control group. Overall, oral motor therapy will benefit children with cerebral palsy in many different aspects including, eating, drinking, and daily activities. It was reassuring to read this article because when I volunteered at Children’s Specialized Hospital, they would use Z-vibe as oral motor therapy, and it seemed to help the child’s muscles wake up and increase oral awareness.
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