Guest: Pediatric Feeding and Swallowing Flashcards

1
Q

Medical and physiological factors of PFD

A
  • Neurological impairment
  • Neurodevelopmental impairment
  • Oropharyngeal and/or laryngeal impairment
  • GI Tract dysfunction
  • Pulmonary System
  • Cardiac System
  • Musculoskeletal System
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2
Q

Nutritional factors of PFD

A
  • Restricted quality, quantity and/or variety (dysphagia, selective)
  • Increased risk for malnutrition, overnutrition, micronutrient deficiency
  • Risk of dehydration
  • Adversely impacting growth, development and health
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3
Q

Development and skill factors with PFD

A

Altered feeding experiences due to illness, injury, developmental delay, specific sensory or oral motor impairments may lead to impaired feeding skills
* sensory (narrow take on foods, like consistency and know what to expect)
* oral-motor skill & pharyngeal function
* delayed feeding skills (typically matches what is going on with the rest of the body)

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4
Q

Behavioural & psychosocial factors of PFD

A

Child
* Anxiety, disordered thinking, dysregulated temperament
* Learned feeding aversion
* Disruptive mealtime behavior
* Picky Eating
* Grazing

Caregiver
* Force feeding
* Misinterpreting hunger/fullness cues
* Only offering preferred foods
* Mismatch of child’s skill with foods caregiver provides
* Stress & Distress

Environment
* Using distractions
* Feeding when asleep
* Inconsistent mealtime schedule

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5
Q

Interdisciplinary Approach to Feeding

A

Interdisciplinary team provides a comprehensive assessment
* Registered Dietitian (RD)
* Occupational Therapist (OT)
* Speech Language Pathologist (SLP)
* Psychologist (Psych)
* Social Work (SW)

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6
Q

Clinical Interview: How to talk to
caregivers about their concerns

A
  • Does your child cough or choke with food or drinks? If yes, then how often? with certain foods or textures? only fluids)
  • Does your child eat a good variety of foods? Do you feel like they eat enough food?
  • Does your child ever refuse to eat? How often? What foods?
  • Does your child need distractions to help them eat?
  • Does your child have a way to communicate that they are hungry, thirsty or full?
  • What do mealtimes look like for your family?
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7
Q

Red flags that might indicate a PFD (dysphagia)

A
  • Coughing with intake
  • Choking episodes
  • History of pneumonia or chest infection
  • Difficulty with texture progression
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8
Q

Assessment considerations for dysphagia

A
  • VFSS
  • Positioning (ideally sitting, well supported, midline position, feet on the ground)
  • Pacing (how fast fluid going into mouth; different bottles, nipple flow rate, thickening agent)
  • Sustainability of feeding schedule
  • Safe texture and fluid consistency
  • Are they able to meet growth and nutrition/hydration
  • Consider alternative to oral feeds
  • Oral hygiene practices
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9
Q

How can bottle feeding be adjusted?

A
  1. flow rate
  2. positioning
  3. thickening
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10
Q

T.S. case study

A

Notes

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11
Q

Red flags that might indicate picky/selective eating

A
  • dropping foods
  • Limited food repertoire (<20 foods, may be missing a food group)
  • Growth concerns (overweight/under weight)
  • Hydration concern
  • Micronutrient deficiencies or anemia
  • Sensory concerns
  • Behaviour & mealtime dynamics
  • Need to use distractions
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12
Q

considerations for picky/selective eating

A
  • Rule out any oral motor/functional reasons for food avoidance
  • Are they avoiding certain food groups/food textures?
  • Assess growth and nutrition
  • Do they need supplements and what form might they best tolerate?
  • Target foods/food groups to work towards
  • Assess family’s capacity/motivation to change
  • Setting realistic goals/strategies
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13
Q

Picky eating strategies

A
  1. Food exposure
  2. Mealtime routines
  3. Sitting at the table
  4. Reducing mealtime distractions
  5. Parent & child roles
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14
Q

Picky eating case study

A

Notes

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