Related Experiment Videos
Videofluoroscopic investigation of feeding disorders of children with multiple handicap
C A Griggs1, P M Jones, R E Lee
1Community Mental Handicap Team, Newcastle General Hospital, Newcastle upon Tyne.
Insights
Videofluoroscopic modified barium swallows revealed delayed swallow reflexes and inefficient pharyngeal peristalsis in children with severe impairments. Interventions improved feeding behaviors and reduced aspiration risks.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Speech-Language Pathology
Background:
- Children with severe physical and intellectual impairments often experience feeding difficulties.
- Dysphagia, or swallowing disorders, can lead to aspiration and malnutrition in this population.
Purpose of the Study:
- To investigate swallowing function in children with severe impairments using videofluoroscopy.
- To identify specific videofluoroscopic findings related to feeding difficulties.
- To provide evidence-based recommendations for improving swallowing and feeding in this cohort.
Main Methods:
- Ten patients (9 months to 24 years) with severe physical and intellectual impairments underwent repeated videofluoroscopic modified barium swallow studies.
- Swallowing function, including swallow reflex and pharyngeal peristalsis, was assessed.
- Aspiration and feeding behaviors were monitored.
Main Results:
- Delayed swallow reflex observed in 9 out of 10 patients.
- Inefficient pharyngeal peristalsis noted in 7 patients.
- Aspiration occurred in 7 patients, predominantly with paste-consistency foods.
Conclusions:
- Videofluoroscopy is crucial for diagnosing dysphagia in children with severe impairments.
- Modified recommendations for positioning, food consistency, and feeding techniques can mitigate aspiration risks.
- Interventions based on videofluoroscopic findings led to improved mealtime behavior and reduced aspiration events.
Abstract:
Ten patients aged from nine months to 24 years with severe physical and intellectual impairments who had feeding difficulties were investigated by videofluoroscopy of repeated modified barium swallows. In all but one case the swallow reflex was delayed, and seven had poor and inefficient pharyngeal peristalsis. Four aspirated large amounts and three small amounts, all tending to do so with pastes rather than liquids. Recommendations, based on the videofluoroscopic findings, included changes in body and head position and consistency of food and of feeding technique. There were noticeable improvements in meal-time behaviour and reduced coughing and choking.