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Videofluoroscopy in the assessment of feeding disorders of children with neurological problems
R E Morton1, R Bonas, B Fourie
1Centre for Child Development, Derbyshire Royal Infirmary, Derby.
Insights
Videofluoroscopy assessment helps determine optimal feeding positions for children with neurological feeding difficulties. Specific trunk positions, erect or reclined, improve oral and pharyngeal swallowing phases.
Area of Science:
- Pediatric Neurology
- Swallowing Disorders
- Rehabilitation Medicine
Background:
- Children with neurological impairments often experience significant feeding difficulties.
- Multidisciplinary assessment is crucial for addressing complex feeding issues.
- Videofluoroscopy plays a key role in evaluating the mechanics of swallowing.
Purpose of the Study:
- To assess the impact of multidisciplinary recommendations on pediatric feeding difficulties.
- To determine the optimal trunk positioning for feeding in children with neurological conditions.
- To correlate swallowing phase difficulties with preferred feeding positions.
Main Methods:
- A multidisciplinary team conducted assessments on 14 children with neurological feeding issues.
- Videofluoroscopy was utilized to analyze swallowing mechanics and determine optimal trunk positions (erect vs. reclined).
- Parental interviews were conducted post-intervention to gather feedback on the helpfulness of recommendations.
Main Results:
- Recommendations provided by the multidisciplinary team were reported as helpful by parents.
- Optimal trunk positioning varied based on the primary phase of swallowing difficulty.
- Children with oral phase difficulties benefited most from a reclined position; those with pharyngeal phase issues, especially with upper-esophageal sphincter spasm and tonic labyrinthine reflex, improved in an erect position.
Conclusions:
- Videofluoroscopy-guided, individualized trunk positioning is effective in managing feeding difficulties in neurologically impaired children.
- Tailoring feeding positions to specific swallowing phase deficits can significantly improve outcomes.
- Multidisciplinary feeding assessments offer valuable, actionable recommendations for parents.
Abstract:
A multidisciplinary assessment, including videofluoroscopy, was carried out on 14 children with feeding difficulties associated with neurological problems. Recommendations were made on all aspects of feeding and the trunk position was changed for half of the patients. A later interview with the parents confirmed that the recommendations had been helpful. The optimum trunk position for feeding was determined during videofluoroscopy by positioning the patient in the erect or reclined position, and also by analysis of relative difficulties during the oral and pharyngeal phases of swallowing. Those with difficulties mainly in the oral phase fed best in the reclined position; those with difficulties mainly in the pharyngeal phase fed best in the erect position, particularly if they had upper-oesophageal sphincter spasm in association with a tonic labyrinthine reflex.