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Peds FAll 2024 > Pediatric Feeding > Flashcards

Pediatric Feeding Flashcards

(51 cards)

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1
Q

Feeding:

A

Setting up arranging, and bringing food or fluid from the vessel to the mouth (include self-feeding and feeding others)

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2
Q

Eating:

A

Keeping and manipulating food or fluid in the mouth, swallowing it (ie moving it from the mouth to the stomach)

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3
Q

Phases of swallowing
Oral Prep phase

A

Jaw, lips tongue, teeth, cheeks and palate manipulate food.

When you are forming the bollus of food.

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4
Q

Phases of swallowing
Oral Phase:

A

Begins when tongue elevates against alveolar ridge of the hard palate, moving bolus posteriorly. Ends with the onset of the pharyngeal swallow

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5
Q

Phases of swallowing
Pharyngeal Phase:

A

Hyoid and larynx move upward and anteriorly and the epiglottis retroflexes to protect the opening of the airway.

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6
Q

Kids who are low tone are at a high risk for

A

aspiration

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7
Q

Phases of swallowing
Esophageal Phase:

A

Muscles at the top of the esophagus open to allow food or liquid to enter.
parislosis

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8
Q

paristolsis is impacted by

A

tone.

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9
Q

Stages and ages of newborn for eating

A

Newborn - Breast or bottle fed, Reflex driven
Positioning: being held, swaddled.

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10
Q

What reflexes are good for eating

A

sucking, moro, gag, thenar eminance one.

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11
Q

Between 2 and 6 months - feeding

A

Breast or bottle fed, reflexes integrating

Positioning - reclined,

Skills - hands to midline

Soft, smooth solids introduced by spoon.

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12
Q

Feeding for kids 6-12 months- More advanced food textures

A

Positioning - sitting upright

Skills acquired - grasping skills, sitting upright, raking, index finger isolation, pincer grasp

Oral motor skills - Uses tongue to transfer foods from side to center and center to side of mouth

Types of food - Begins to eat ground or finely chopped food.

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13
Q

Feeding 12-24 months

A

More indepence with self feeding

Positioning - independent sitting
Skills acquired - , mature grasp, using utensils

Adult like chewing movements

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14
Q

factors influencing mealtimes

A

culture
social
environmental
personal

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15
Q

Feeding, Eating and Swallowing Difficulties reported numbers stats

A

10-25% of all health children have difficulties

40-70% of premature infants

70-80% of children with developmental disabilities

May be due to medical, oral, sensorimotor and behavior factors alone or combined.

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16
Q

ARFID
avoidant / restrictive food intake disorder

A

Slowed growth or weight loss

emotional reactions to food

avoids food due to fear or anxiety

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17
Q

ASD and how it relates to eating, feeding swallowing

A

mealtime rituals

sensory defensiveness

oral-motor coordination and planning

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18
Q

cerebral palsy - feeding and eating swallowing difficultues

A

tone issues (high, low or fluctuating)

postural instability

difficulty with suck, swalllow, breathe patterns,

sensory difficulty

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19
Q

sensory processing disorder

A

Oral-motor planning difficulties

Sensory defensiveness

Hyporesponsiveness to input

Poor or delayed skills due to limited interactions with food

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20
Q

Referral for Feeding Evaluation

A
  • Increased congestion and/or wet vocal quality
  • Frequent occurrence of respiratory illness
  • Difficulty weaning from oxygen
  • Significant neurological diagnosis and/or neuromotor involvement
  • Coughing or choking during mealtime
  • Oral motor dysfunction
  • Prolonged mealtimes (longer than 30 mins)
  • Reliance on G-tube but still willing to eat something by mouth and safety of feeding is questioned
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21
Q

Feeding evaluation
Initial Interview and Chart Review

Study These Flashcards
A

Review chart:
Request completion of of feeding, developmental and/or nutritional questionnaire.

Information about family concerns and mealtime
- Obtain information about family cultural norms, social rules and mealtime routines.

Discussion of feeding problem from parent perspective (weight gain, length of time to eat, behavior etc.)

22
Q

Feeding evaluation overall

Study These Flashcards
A

Consider the WHOLE system

Eating and swallowing are complex and involve more than just the mouth, throat and stomach

23
Q

Things to consider if a kid isn’t eating

Study These Flashcards
A

Respiration
Digestion
Elimination
Structural alignment
Control
Sensory Input

24
Q

Clinical Assessment:

Study These Flashcards
A

Muscle Tone

Sensory Processing

Movement and Transition patterns

Play

25
Feeding Evaluation structured observations
Oral structures and oral motor patterns - do they have teeth. Child eating - what does typical eating look like? Informed clinical opinion
26
Diagnostic Evaluations
Upright Modified Barium Swallow Study (MBSS) Fiberoptic Endoscopic Evaluation of Swallowing (FEES) Upper Gastrointestinal (GI) series Esophagogastroduodenoscopy (EGD)- endoscopy
27
Dysphagia is
“dysfunction in any stage or process of eating. It include any difficulty in the passage of food, liquid or medicine, during any stage of swallowing that impairs the client’s ability to swallow independently or safely”
28
Pediatric Dysphagia
Can occur in one or more of the phases of swallowing. Results in aspiration. Long term effects: - Food aversion - Aspiration pneumonia - Dehydration - GI complications - Psychosocial impact
29
Avoidant/Restrictive Food Intake Disorder (ARFID)
An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following: Significant weight loss or faltering growth Significant nutritional deficiency Dependence on enteral feed or oral supplements Marked interference with psychosocial functioning.
30
Pediatric Feeding Disorder Functional Profile of patients across 4 axis:
- Medical dysfunction - Nutritional dysfunction - Feeding Skills dysfunction - Psychosocial dysfunction
31
Eating and Drinking Ability Classification System Measure eating and drinking ability including
safety, efficiency and amount of assistance a person with CP needs
32
Ability for Basic Feeding and Swallowing Scale for Children - What ages?
Ages 2 months-14 years 7 months
33
kids with down syndrome will do what when eating
overstuff their mouths due to underresponsiveness to sensory information
34
Feeding intervention considerations
Occupational Therapist’s are continually considering: Medical and nutritional problems Prioritize areas of treatment Collaborate with other professionals Ensure carryover Realistic recommendations Overall plan for treatment
35
Safety first considerations
Know person’s restrictions, food allergies, religious or cultural beliefs – During first year avoid certain foods * Monitor risk for aspirations – Until age 4 children do not have molars for grinding foods—be cautious * Consider ongoing nutritional status (Work with Dietitians when necessary) * Use universal precautions * Educate and train others to establish competency. Document this.
36
Feeding intervention considerations
Environmental influences and adaptations Positioning modifications Adaptive equipment and oral motor techniques used in sessions Behavior techniques Developmental considerations (cognitive, motor and sensory) Interprofessional collaboration Inclusion of parents and caregivers
37
Environmental Adaptations for feeding interventions
Schedule of meals Location of meals Length of meal periods Sensory stimulation Order of foods presented
38
Positioning Adaptations for feeding interventions
Proximal support influences distal movement External support Positioning options Stability
39
Adaptive Equipment can
Improve oral motor control Increase independence Compensate for motor and/or sensory impairment
40
Causes of self-feeding difficulty
Physical or neuromuscular deficits Cognitive or behavioral Visual Sensory processing difficulties
41
Delayed Transition of Textured Foods
Oral Sensitivity and Oral Motor Problems Non nutritive oral motor activities
42
Delayed transition -Bottle to Cup
Hypersensitive child Structural
43
Sensory based oral motor problems are never seen in isolation, but are part of the child’s total body sensory processing problems
True
44
Sensory Processing Disorders
Hypersensitivity - Difficulty with touch near or within the mouth Play and Positive Experiences Deep pressure/ calming activities Low sensory regulation
45
Food Chaining
Level I- Maintain and expand current taste and texture Level II- Vary taste and maintain texture Level III- Maintain taste and vary texture Level IV-Vary taste and texture
46
Feeding intervention suggestions.
- Offer one new food with one snack and/or one meal a day. - Offer a new food with an accepted food (different from the new food). The child doesn’t have to eat it right away. You can model eating it, then let child approach it on own. - Keep offering new foods even if they have been rejected. It may takes multiple exposures. Typically-developing children can reject new foods 12-15 times before trying them. - Place food on plate next to (but not touching!) other food. Use a divided plate, if you wish. - Use transitional foods between bites of new foods (i.e. piece of accepted food, or drink of accepted fluid).
47
Behavioral Interventions
Food refusal behaviors Effects on caregivers Offering choices and turn taking Behavior management
48
Food Refusal or Selectivity
- Take into account Consultation from providers - Gradually Offering new foods - Environmental adaptations may be necessary - Sensory
49
Sequential Oral Sensory (SOS)
Research based Play with a Purpose Detailed Steps to Eating
50
Steps to Eating Sequential oral sensory
Tolerates Interacts With Smells Touch Taste Eating
51

Peds FAll 2024 (21 decks)

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