Chapters 15

1. Some syndromes are low muscle tone, delayed motor development, and physical deformities affecting the oral-motor area. Cerebral Palsy can result from many causes for example lack of oxygen to the infant’s brain during birth, and CP is a risk factor for dysphagia. Other conditions where dysphagia is seen are hard and soft plates, tongue, lips, tonsils, and pharynx. In addition in some chrontic or recurrent respiratory problems e.i pneumonia, and cardiopulmonary diseases are also associated with high rate of dysghagia

2. Cleft Palate helps achieve a good oral seal, because the hole in the palate creates a loss of pressure during sucking, which can end with formula, breast milk or solid foods entering the nasal cavity.

3. Inefficiency feeding and swallow cause the child to be unable to meet their caloric and nutritional needs. Some characteristics can be fatigue too easily, or become breathless. Overselectivity feeders are “picking” in what they eat, meaning in the taste, type, texture, or volume of food they will eat. Refusal feeders don’t want to eat at all, for a matter of reasons only known to them. Some of those reasons are that the child may have a physical or Medical issue that has not yet been resolved, a child could have what is called gastrointestinal distress (reflux), and the child may have experienced a traumatic event resulting in refusal to eat. Development delay, illnesses, trauma, or some children’s experiences can result in delayed feeding skills.

3.1. Some causes and risk factors can be abuse, accidents, illnesses, premature birth, prenatal drugs exposure, diet restrictions,

4. Inefficiency feeding and swallow cause the child to be unable to meet their caloric and nutritional needs. Some characteristics can be fatigue too easily, or become breathless. Overselectivity feeders are “picking” in what they eat, meaning in the taste, type, texture, or volume of food they will eat. Refusal feeders don’t want to eat at all, for a matter of reasons only known to them. Some of those reasons are that the child may have a physical or Medical issue that has not yet been resolved, a child could have what is called gastrointestinal distress (reflux), and the child may have experienced a traumatic event resulting in refusal to eat. Development delay, illnesses, trauma, or some children’s experiences can result in delayed feeding skills. Some causes and risk factors can be abuse, accidents, illnesses, premature birth, prenatal drugs exposure, diet restrictions,

5. Newborns usually stay in the hospital for 48-72 hours; there they are usually checked to see if everything is running fine, the feeding is being monitored if anything strange appears. If for some reasons the doctors or nurses don’t catch to something and the parents does keep an eye on them, but the well-child visit are helpful as well. The SLP conducts a comprehensive assessment, including case history, a physical feeding/swallowing evaluation (observing the lips, jaw, tongue, teeth etc.) and observation of mealtime interactions. The treatment goals ae that nutritional needs are met for a healthy growth and developement and that feeding/swallowing do not in any way danger a child's life. Treatment focuses on improving the coordination of the swallow to achieve efficiency and safety. Also by shaping the child’s consumption of food, condition and reinforcement, and systematic desensitization. There are also other ways to be feed for example by a tube.

6. Dysphagia can be characterized by the phase affected to identify the site at which the swallowing system breaks down. Some disorders that may result in an oral preparatory dysphagia are a stroke, PD, head and neck cancers. Oral phase dysphagia happens with strokes, progressive neurological diseases (for example ALS), and tooth loss; Pharyngeal phase occurs with neurological disorders, and head and neck cancer.

7. Dysphagia can range from mild to severe; the mild impairment comes with some difficulties with the oral preparation and pharyngeal functioning but overall good mastication and safe independent feeding and swallowing. Moderate impairment, indicates some dangers of aspiration and penetration into the airway, problems chewing solid foods, and a slow trigger of swallow. Severe impairment indicates risk of aspiration and penetration, and the inability to safely swallow, requiring other means of nutrition, for example tube feeding.

8. Adult dysphagia is identified by a clinical swallowing examination which involves reviewing current and past records, complete a comprehensive client interview to learn medical, social and family records, conduct a thorough oral mechanism examination of the mouth, attempt of trial feedings or observe client during a meal, making feeding recommendations, refer to client instrumental assessment of swallowing, and refer client to other professionals for any specialized testing. Instrumental examination studies the phases more thoroughly.

9. Instrumental Examinations, there are different types of machines or instruments you can use. Fiberoptic endoscopic examination of swallowing provides direct visualization; it’s a flexible tube that contains a small camera which is passed through the nose and into the pharynx, helping us have a picture of before and after the swallow. Another instrument is called the Ultrasonograohy, same technology used to see the fetus in the nother’s womb. Most beneficial in oral phase, but it is without knowing what is the risk. Another interment is called Videofluoroscopy, most commonly used for swallowing evaluation, uses radiation so the client must be considered and minimized.

10. Two different ways for treating dysphagia are compensatory approach and restorative technique. Compensatory approach, are strategies that compensate for a specific problem in order to make swallowing sage and efficient, and how individuals take in food and; restorative technique, is intended on improving or restoring swallow function.

11. Individuals must achieve proper nutrition to promote healing of and recovery from underlying disease, because some people are still unable to meet their nutritional requirement orally even with the diet modification, and compensatory strategies.

12. Penetration is when the food or liquid enters the larynx (which might) causing choking and respiratory distress

13. Dyshagia, is the inability to swallow (deglutiton), and it is also a feeding disorder which is a type when you are no longer able to eat safely,

13.1. Reasons are developmental, neurological, or structural problems alter normal swallowing process

13.2. Undermines someone's eating and drinking process

14. Oral-motor system is the physical structure and neuromuscular function involved with both eating and speaking

14.1. Oral-motor functions are strength and coordination of articulars

14.2. Oral-motor sensation is the sensitivity to taste, movement, and textures.

15. Individuals with dyshagia are at risk of choking and blocking the airway, aspirating foods into their lungs, and getting pneumonia and possibly ends in death

16. 25 to 35% of parents report that thier children having a feeding disorder

17. With poor management and coordination of swallowing increases a child’s or even an adult’s risk of penetration or aspiration of food/liquid into the laryngeal area

17.1. Aspiration, is when the food or liquid passes through the larynx and into lungs, interfering with the exchange of air in the lungs and cause a pulmonary infections e.i pneumonia

18. Swallow Process 1. Oral Preparatory Phase 2. Oral Phase 3. Pharyngeal Phase 4. Esophageal Phase

19. Unsafe swallowing typically results from the dysfunction of or damage to a child’s motor system or an inappropriate eating rate; it can be fast or slow.

20. Feeding Disorders can demostrate unsafe swallowing patterns, growth delay affecting hieght, and weight, lack of tolerance of food textures and tastes, AND poor appetite regulation