Ch10: Assessment and Treatment of Feeding, Eating, and Swallowing

Question 1

Feeding/Self-feeding,

Answer 1

Defined as the process of setting up, arranging, and bringing food from the table, plate, or cup to the mouth.

Question 2

Eating

Answer 2

The ability to keep and manipulate food or fluid in the mouth and swallow it

Question 3

Swallowing

Answer 3

A complex act in which food, fluid, medication, or saliva is moved from the mouth through the pharynx and the esophagus and into the stomach

Question 4

Mealtime

Answer 4

A family time that provides physical, cognitive, and emotional nourishment to members.

• Arrange the day temporally, provide routine and structure, and offer a time for relaxation, communication, and socialization.
• Parents and children communicate symbolically and emotionally while at the same time satisfying basic nourishment needs.

Question 5

Childrens Role during Mealtimes

Answer 5

Child is expected to remain seated, attend to the caregiver, feed himself or herself (when age appropriate), communicate with others at the table, and follow family rules for table manners and routines.

Question 6

Family mealtime roles and participation change as a child moves through the different stages of growth and development, from infancy to adulthood.

Answer 6

• During infancy, parents are responsible for feeding or assisting the child.
• During preschool and school-age years, the parent’s role shifts toward oversight, communication, and discipline.

Question 7

Feeding and swallowing difficulties are relatively common among children. Feeding and swallowing problems are reported in…

Answer 7

• 10% to 25% of all healthy and typically developing children
• 40% to 70% in premature infants
• 70% to 80% in children with developmental delays or cerebral palsy

Question 8

Feeding and swallowing disorders can have significant health implications, including…

Answer 8

Adverse effects on growth, nutrition, overall development, and general well-being.

Question 9

hildren develop difficulties with feeding, eating, and/or swallowing because of…

Answer 9

Medical, oral, sensorimotor, and behavioral factors, either alone or in combination

Question 10

Most common medical diagnoses associated with feeding dysfunction include…

Answer 10

Prematurity, neuromuscular abnormalities, structural malformations (such as cleft lip and/or palate), gastrointestinal conditions, visual impairments, and tracheostomies

Question 11

Most frequent diagnoses accompanying feeding disorders in children under 6 years of age.

Answer 11

Cardiorespiratory disease, neurological disease, and gastrointestinal diseases

Question 12

Gastroesophageal Reflux Disease

Answer 12

Frequent or chronic vomiting after feeding

Question 13

Gastroesophogeal Reflux

Answer 13

• Normal physiological process that is not unusual for babies, and many infants spit up occasionally as their gastrointestinal system matures
• Infant likely will outgrow these symptoms over time as they gain postural control and stability, with maturation of the gastrointestinal system, and with the transition from a liquid diet to a balance of liquids and solids.

Question 14

When does GER become problematic?

Answer 14

Problematic when spitting up and vomiting leads to concerns with the infant or child health (ex. esophagitis), ability to eat successfully (refusal, distress w eating, low vol of intake) which leads to poor growth or inadequate weight gain

Question 15

Most Common Food Allergies

Answer 15

Milk, eggs, soy, wheat, peanuts/tree nuts, and fish/shellfish

Question 16

Food Allergies may cause…

Answer 16

Esophagitis, vomiting, skin rash, itchiness, abdominal pain, breathing difficulties, and/or discomfort during eating.
-May also contribute to child unwillingness to eat and subsequent maladaptive behavior at mealtimes or learning to accept new or alternative food choices

Question 17

Eosinophilic Esophagitis

Answer 17

Chronic allergen–immune mediated disease that commonly causes children to have symptoms including abdominal pain, vomiting, feeding avoidance, and dysphagia

Question 18

Competency in Oral Motor Function for feeding is required for…

Answer 18

Safe and Effective Eating

Question 19

Oral Motor Function Skills

Answer 19

Sucking, Suckling, and Chewing are acquired sequentially in typical development and rely on intact anatomy and physiology

Question 20

Children with medical diagnoses or developmental disabilities may fail to meet basic nutritional needs because of…

Answer 20

Delayed or deficient oral motor and self-feeding skills

Question 21

Oral motor dysfunction causing poor nutrition is strongly associated with…

Answer 21

• Poor growth and adverse health outcomes
• These children may exhibit food refusal or selectivity behaviors, vomiting, swallowing difficulty, prolonged mealtimes, poor weight gain, and failure to thrive.

Question 22

Sensory Issues

Answer 22

Cause children to have challenges with experiencing usual sensory input of mealtimes and may include all channels
-Tactile (touch, texture, temperature)
-Proprioceptive (joint and muscle sensations)
-Vestibular (movement and gravity)
Auditory, taste, and visual systems.

Question 23

Children with what diagnosis have a high prevalence of feeding difficulties due to sensory, motor, or behavioral challenges influencing the child’s food preferences and willingness to eat?

Answer 23

Autism spectrum disorder (ASD)

Question 24

Although food refusal may be a feature of selective eating, it may represent…

Answer 24

Lack of parent persistence in continuing to offer new foods more than the child’s preferred foods.

Question 25

Selective Eating Implications for OT

Answer 25

Must conduct a thorough interdisciplinary evaluation of each child to assess anxiety, sensory reactivity, other potential physiological causes, and nonfood-related challenging and repetitive behaviors.

• Role of oral-motor skills in selective eating should be explored, as children with ASD have motor coordination deficits that may be apparent even from an early age
• Difficulty with eating has been associated with feeding problems in children with anatomical and neurological anomalies.