Feeding #2

Question 1

0 – 6 months mealtime participation

Answer 1

Largely dependent

Question 2

7-24 months

Answer 2

Emerging independence

Question 3

2 years

Answer 3

Predominantly independent

Question 4

Feeding development: Birth to 3 months

Answer 4

Oral reflexes (suck, swallow, rooting, gag), suckle/swallow 1:1:1

Question 5

Feeding development: 3 to 6 months

Answer 5

Suckle/swallow 20:1, first semi-solid foods, munching, should be able to hold head up by end

Question 6

Feeding development: 6 to 9 months

Answer 6

Sucking pattern ins predominant, lip movements can close around spoon, vertical chewing pattern, lateral tongue movements, poor bite (true bite, not reflex), cup drinking with single sips

Question 7

Feeding development: 9 to 12 months

Answer 7

Longer sucking than 6 months, cup driving (consecutive sip and swallow), improved grading of movement, Lips actively remove food from spoon, more jaw control, tongue begins lateral movement, more controlled bite, vertical some diagonal chewing pattern

Question 8

Down syndrome chewing issues

Answer 8

Enlarged tongue, can’t get diagonal and lateral movements to clear food out

Question 9

Feeding development: 12 to 18 months

Answer 9

Weaning from nipple, successful cup drinking, integrated chewing pattern (grinding, diagonal movements, more controlled lateral tongue movements), spoon use, prefer self-feed

Question 10

Feeding development: 18 to 24 months

Answer 10

Tongue movement refine, cup drinking (internal jaw stability begin), chewing (Mouth closed, rotary movements), transition to harder foods

Question 11

Feeding development: 24 to 36 months

Answer 11

Improved timing and precision, decreased chewing time, independent self-feeding, increased socialization

Question 12

Food transitions: 1 month

Answer 12

Only liquids from nipple

Question 13

Food transitions: 4 to 6 months

Answer 13

Liquids, introduce pureed foods

Question 14

Food transitions: 8 months

Answer 14

Liquids, pureed foods, ground or junior foods, mashed table foods

Question 15

Food transitions: 12 months

Answer 15

Liquids, coarsely chopped table foods (including easily chewed meats)

Question 16

Food transition: 18 months

Answer 16

Liquids, coarsely chopped table foods, most meats, many raw vegetables

Question 17

Why is it important to know food transitions?

Answer 17

Safety, adequate nutrition, digestive system needs to be ready for different food types, allergies, developmental milestones, texture progression (could identify sensory concerns)

Question 18

Atypical responses in oral prep and oral phase

Answer 18

Oral/facial tone, tongue retraction, tongue protrusion, reduced spontaneous mouth opening, excessive jaw movement, poor lip seal, oral/tactile sensitivity

Question 19

Tongue retraction

Answer 19

Atypical response. Tongue goes back down, hard to get child to close mouth around spoon

Question 20

Treatment for atypical responses in oral prep and oral phase

Answer 20

Tapping and sensory stimulation for increasing tone and activating muscles, food texture changes

Question 21

Atypical responses in pharyngeal phase

Answer 21

Delayed swallowing response, aspiration before swallow, aspiration during swallow, aspiration after swallow

Question 22

Delayed swallow response appearance

Answer 22

Not coordinated or purposeful

Question 23

Aspiration before swallow appearance

Answer 23

(Reduced oral phase) gasp when taking in liquid

Question 24

Aspiration after swallow appearance

Answer 24

Pooling-material left in mouth, pocketed liquid breathed in

Question 25

Treatment for atypical responses in pharyngeal phase

Answer 25

Modify texture modify position (chin tuck), modify pace

Question 26

Atypical responses in esophageal phase

Answer 26

Gastroesphageal reflux, sphincter doesn't close completely

Question 27

GERD treatment

Answer 27

Positioning to minimize pressure and improve swallowing

Question 28

Treatment for atypical responses in esophageal phase

Answer 28

Positioning, surgery, meds, treat for food aversion post GERD

Question 29

Want to know what about child's history with food

Answer 29

Allergies, problematic event, g-tube, dinner time behaviors, routines, preferences

Question 30

Haberman bottle use

Answer 30

For babies, used in absence of suck pattern

Question 31

Feeding postural alignment

Answer 31

90-90-90, supported feet, stable head (handling on page 409)

Question 32

Why support feet during feeding?

Answer 32

Utilize weight bearing to build muscle and teach proprioception

Question 33

Improving oral motor skills

Answer 33

Increase tongue lateralization and rotary jaw movement, increase tongue protrusion and motility, increase lip closure and overall motor stability, coordination of suck-swallow-breath, improve oral strength

Question 34

Why is tongue protrusion and motility important?

Answer 34

Helps control food/liquid, improves suck-swallow-breathe

Question 35

Sequential Oral Sensory Approach

Answer 35

``` -Tolerate the physical presence of the food (Might just be knowing food in the room) -Interact with the food without touch -Tolerate the smell of the food -Touch the food with his or her skin (Not usually on the face) -Place the food in his or her mouth to taste -Not necessarily eating food yet ```

Question 36

the child will reject a new food how many times simply on the basis that it is new

Answer 36

10

Question 37

Food chaining definition

Answer 37

Emphasizes the systematic progression from an accepted food to a novel food by changing one sensory characteristic per presentation.

Question 38

Food chaining steps

Answer 38

1. Expand diet/enjoy foods 2. Build on oral motor skills: sequence motor patterns/teach mechanics. 3. Techniques: Flavor mapping, transitional foods, flavor masking

Question 39

Problem feeder

Answer 39

May consume less than 20 foods Does not add foods to repertoire Rejects new food and new qualities with extreme emotional response Consumed foods tend to fall within a texture or food group

Question 40

Picky eater

Answer 40

Lower range and varieties of foods (20+) Foods consumed remain in repertoire Accepts new foods and new qualities of foods at slower rate Consumes at least one food from most food groups and textures