Assessment of an infant/child for feeding/eating skills Flashcards
global assessment
- looks at feeding situation and environment
- child’s general ability to handle food and liquid successfully
specific assessment
Concentrate on 1 part of the mouth – the tongue or lips or cheeks or jaws. How does that specific part of the mouth work to contain various textures (liquid to hard solids).
systems assessment
Concentrate on a body system, such as the respiratory system, the gastrointestinal system
complete a feeding observation/use feeding checklist
- Have parent bring in foods child typically eats and foods child typically will NOT eat
- Have parent bring in typical utensils the child uses
- Best scenario is feeding evaluation in the home – see a typical environment if possible!
collect histories
birth and feeding
naturalistic and elicited observations
naturalistic: parent/caregiver feed the infant/child FIRST. Observe the parent child interaction.
elicited: Therapist feeds the infant/child. The feeding session is modified to elicit behaviors or to observe feeding skills that have not occurred spontaneously.
oral phase
The food enters the mouth and mastication occurs, the food is formed into a bolus in preparation for swallow. This phase requires biting, sucking, chewing/munching of food. Bilabial seal prevents food from spilling from mouth. Tongue lateralization moves the food over the molars for mastication, then back to the center of the tongue for transit to the posterior oral cavity where the swallow is initiated. Anterior – posterior lingual movement.
pharyngeal phase
The bolus moves from the posterior portion of the tongue through the pharynx to the opening of the esophagus. As the bolus is transferred to the posterior oral cavity, the soft palate elevates to close off the nasopharynx. The larynx elevates and moves anteriorly as the epiglottis covers the opening into the trachea. The UES (upper esophageal sphincter) relaxes and opens to allow bolus into the esophagus.
esophageal phase
This phase begins with the opening of the upper esophageal sphincter. The bolus moves through the muscular esophagus by peristalsis. The swallow itself and the sensation of the bolus triggers peristalsis to begin.
modified barium swallow study (MBS)
purpose
- radiology study
- infant is given barium to swallow while an x-ray is taken
- A record of the how food travels from the oral cavity to the esophagus is taken
- gives detailed information about the oral and pharyngeal phases of the swallow.
The purpose of the study is to document if aspiration is occurring and show reason for the aspiration at the point in which it occurs.
important aspects of MBS
- Infant or child should be seated in the typical eating posture, same as when he/she eats meals at home.
- The food items should be the consistency of typical food items the child eats at home. If a child is eating all textures then the study should involve a liquid, soft texture, and solid texture.
strengths of MBS
- Identifies structural abnormalities
- Permanent real-time record
- Simulates eating experience
- Allows therapist to see swallow of various textures
- Allows therapist to try different treatment techniques to improve swallow
limitations of MBS
- Does not identify gastroesophageal reflux
2. a “snap-shot” of feeding, a small sample of feeding questions of generalizability
upper gastrointestinal study (UGI)
- radiographic study typically completed in supine
- evaluates structures and function of the esophagus or upper GI tract (detects narrow or inflamed areas of intestines)
- Can show any structural abnormalities, reflux, slow motility from stomach to small intestine.
strengths of UGI
- Identifies structural abnormalities of the esophagus, stomach, and intestines
- Evaluates height of reflux in the esophagus
