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ECU Dysphagia > 13.2 - Assessment of Pediatric Dysphagia - Balaji > Flashcards

13.2 - Assessment of Pediatric Dysphagia - Balaji Flashcards

1
Q

In what two ways do we classify pediatric dysphagia?

A

By time frame

By characteristics

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2
Q

How do we classify time frames in pediatric dysphagia?

3

A

Transient

Episodic

Chronic

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3
Q

How do we classify characteristics of pediatric dysphagia?

3

A

Unsafe feeding/swallowing

Inadequate feeding/swallowing

Inappropriate feeding/swallowing

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4
Q

What kinds of Unsafe Feeding/Swallowing is seen in pediatric patients?

(2)

A

Laryngeal penetration + aspiration

Impaired physiology

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5
Q

What kinds of Inadequate Feeding/Swallowing is seen in pediatric patients?

(4)

A

Inefficiency

Over-selectivity

Refusal

Delay

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6
Q

What kinds of Inappropriate Feeding/Swallowing is seen in pediatric patients?

(4)

A

Undesirable behaviors

Too fast (increasing risk of aspiration)

Too slow (nutritional deficiencies)

Non-food items (pica)

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7
Q

What four areas are assessed during a pediatric dysphagia exam?

A

Physiologic support systems

Motor system

State system

Attention system

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8
Q

What history questions should we ask during a pediatric clinical dysphagia exam?

(11)

A

Gestational age

Birth complications

APGAR scores

Prenatal issues (maternal health, use of medications etc.)

Child’s development history (cognitive abilities, language abilities, gross/fine motor skills, sensory processing)

Feeding history

Length of meals

Quality of intake

Progression from bottle to solids

History of formulas used

Caregiver interaction and relationship

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9
Q

What are we assessing in the child’s Physiologic System in a pediatric dysphagia exam?

(5)

A

Respiratory patterns

Heart rate

Eye movements

Cries, whimpers, etc.

Bowel movements

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10
Q

What are we assessing in the child’s Motor System in a pediatric dysphagia exam?

(5)

A

Posture

Tone

Strength

Reflexes

Oral movements

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11
Q

What are we assessing in the child’s Attention in a pediatric dysphagia exam?

(2)

A

General alertness

Ability to sustain attention.

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12
Q

What are we assessing in the child’s Transitional State in a pediatric dysphagia exam?

(2)

A

Ability to transition from one state to another.

Typically from sleep to being awake.

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13
Q

What are we assessing in the child’s Sucking Behaviors in a pediatric dysphagia exam?

A

Nutritive and non-nutritive sucking.

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14
Q

What do we look for in trial swallows in pediatric dysphagia assessment?

(9)

A

Look for initiation of feeding toward breast/bottle

Lip closure

Ability to draw in liquid.

Oral control

Speed of drinking

Tolerance to various consistencies

Biting + chewing

Speed

Range of motion of oral structures.

(Trial textures depend on age – food types selected based on needs of nutrition and hydration)

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15
Q

What are some Red Flags when assessing pediatric dysphagia?

5

A

Weak suck

Breathing disruptions, apnea

Suck-swallow incoordination

Excessive gagging

Signs of laryngeal penetration/aspiration

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16
Q

What do we need to consider when performing VFSS on pediatric patients?

(5)

A

Proper positioning (use supportive devices when needed)

Be careful about the viscosity (some infants may not tolerate thicker consistencies)

Flow rates can be controlled using bottles and nipples designed to alter them.

Child may not show overt signs of aspiration – be vigilant!

Can perform an examination of esophagus consonantly (radiologist)

17
Q

What do we need to consider when performing a FEES on pediatric patients?

(2)

A

Proper positioning

Pre-assessment activities should be targeted at pacifying the infant and preparing for the exam.

18
Q

What is a Feeding Disorder?

2

A

Persistent failure to eat adequately” for a period of at least one month

Causes significant loss of weight or failure to gain weight

19
Q

When do Feeding Disorders typically appear?

A

Within the first year of life

20
Q

What may be seen in pediatric Feeding Disorders?

6

A

Unsafe or inefficient swallowing

Growth delay

Lack of tolerance to food textures and tastes

Poor appetite regulation

Rigid eating patterns.

Frequent incidence of laryngeal penetration/aspiration.

ECU Dysphagia (31 decks)

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