Positioning improves the oral and pharyngeal swallowing function in children with cerebral palsy

Many children with cerebral palsy have feeding difficulties. The aim of this study was to investigate if trunk and neck positioning influenced oral and pharyngeal swallow. Five children with feeding problem aged 3-10 years with cerebral palsy were examined using videofluoroscopy. All children had tetraplegia with dystonia, i.e. poor head control and poor trunk stability. All children had gross aspiration and posterior oral leak. The pharyngeal phase was delayed in relation to the oral phase. Two children had pharyngeal retention. The children were positioned with both an extended and flexed neck. The flexed neck position was combined with a 30 degrees reclined sitting position. In both positions they were given purée with barium and liquid barium during video recording. In the reclined position with the neck flexed, aspiration decreased in all five children, oral leak diminished in two children and retention improved in one child.