The functional chewing training for chewing dysfunction in children with repaired EA-TEF.

Area of Science:

• Pediatric gastroenterology
• Speech-language pathology
• Developmental pediatrics

Background:

• Chewing disorders (CD) affect 37% of children with esophageal atresia-tracheoesophageal fistula (EA-TEF), impacting solid food intake.
• Functional Chewing Training (FCT) is a holistic approach designed to enhance chewing function (CF) in pediatric populations.

Purpose of the Study:

• To evaluate the efficacy of FCT in improving CF in children diagnosed with EA-TEF and CD.
• To assess changes in chewing performance and diet texture tolerance post-intervention.

Main Methods:

• A single-group treatment study involving 20 children with CD associated with EA-TEF.
• Participants underwent a 12-week FCT program incorporating impairment-based and adaptive strategies.
• Chewing performance was assessed using the Karaduman Chewing Performance Scale (KCPS), and diet texture tolerance was evaluated with the International Dysphagia Diet Standardization Initiative (IDDSI).

Main Results:

• Significant improvements were observed in both KCPS scores (p<0.01) and IDDSI levels (p=0.005) after 12 weeks of FCT.
• Pre-intervention, KCPS scores indicated significant chewing difficulties (levels 1, 3, 4), with 40% on IDDSI level-3 and 60% on level-7.
• Post-intervention, 15 children achieved KCPS level-0 and 5 achieved level-1, with all participants reaching IDDSI level-7.

Conclusions:

• Functional Chewing Training (FCT) is an effective intervention for improving chewing function in children with EA-TEF and associated chewing disorders.
• FCT facilitates progression to safer and more varied food textures, enhancing oral intake capabilities.