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Foundations Of Speech Pathology > Chapter 15 > Flashcards

Chapter 15 Flashcards

1
Q

what does the SLP who specializes in feeding and swallowing disorders in children serve as?

A

the feeding specialist and carries the responsibility of strengthening the child’s oral-motor system and building the capacity for safe feeding and swallowing

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2
Q

what does the oral motor system refer to?

A

the physical structures and neuromuscular functions involved with both eating and speaking

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3
Q

what three things does the feeding specialist focus on?

A

improving oral motor functions

oral-motor muscular tone

oral-motor sensation

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4
Q

Definition of feeding disorder

A

a child’s persistent failure to eat adequately for a period of at least 1 month, which results in a significant loss of weight or a failure to gain weight

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5
Q

when do feeding disorders manifest?

A

prior to 6 years of age, and in most cases the onset is in the first year of life

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6
Q

true or false: feeding disorders can occur as a secondary disorder to broader medical or developing condition

A

true

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7
Q

four symptoms associated with feeding disorders

A

unsafe or inefficient swallowing patterns

growth delay affecting height and/or weight lack of

tolerance of food textures and tastes

poor appetite regulation

rigid eating patterns

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8
Q

Definition of swallowing disorder

A

a specific type of feeding disorder in which the child exhibits an unsafe or inefficient swallowing pattern that undermines the feeding process

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9
Q

Definition of deglutition

A

the complex neuromuscular act of moving substances from the oral cavity to the esophagus

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10
Q

Definition of bolus

A

substance being moved from the oral cavity to the esophagus

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11
Q

Definition of penetration

A

food or liquid enters the larynx, which can cause choking or respiratory distress

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12
Q

Definition of aspiration

A

food or liquid passes through the larynx and into the lungs

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13
Q

true or false: not all children with feeding disorders have problems swallowing, but all children with swallowing problems exhibit a feeding disorder

A

true

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14
Q

treatment for swallowing disorder

A

managing the failure to eat adequately

training the child to safely and effectively swallow

providing alternative feeding for the period in which swallowing is unsafe

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15
Q

true or false: mild and transient feeding problems are not common in young children

A

false - they are common

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16
Q

true or false: conditions that cause frailty in infants are increasing in their prevalence

A

true

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17
Q

Definition of nutrition

A

an individual’s intake of calories and nutrients to meet requirements for energy, growth, development, and learning

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18
Q

Definition of undernutrition and malnutrition

A

conditions in which children’s basic nutritional requirements are not being met, most often because of environmental circumstances or developmental disabilities

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19
Q

Definition of growth

A

children’s height/length and weight achievements, as well as the weight­ to-length relationship

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20
Q

what is the greatest detriment to growth?

A

poor nutrition

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21
Q

three categories of growth deficiency

A

the child who is underweight weighs less than expected, based on age

the child who is wasting weighs less than expected, based. on height

the child who is stunting is shorter than expected, based on age

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22
Q

which category of growth deficiency is typically signified long-standing malnutrition or undernutrition?

A

the child who is stunting is shorter than expected, based on age

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23
Q

Definition of catch-up growth

A

an increase in growth velocity as children recover from a period of growth deficiency

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24
Q

feeding and Swallowing Development: birth to 6 months

A

At birth, babies possess an estimated 27 primitive reflexes, of which four greatly facilitate their ability to feed outside the womb

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25
Q

Definition of suckling reflex

A

emerges prenatally and is elicited by stimulating an infant’s lips

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26
Q

Definition of rooting reflex

A

elicited by stimulating the area around the infant’s mouth, causing the infant’s head to turn in the direction of the stimulus

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27
Q

Definition of grasping reflex

A

enabled the infant’s fingers to close around a stimulus to the palm

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28
Q

what happens if the infant-parent attachment is underdeveloped?

A

the infant may act out during feeding, fail to signal hunger, or resist feeding altogether

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29
Q

Definition of gagging reflex

A

a protective reflex present at birth which persist throughout the lifespan

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30
Q

Definition of homeostasis

A

a quiet, alert, and wakeful state

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31
Q

what protects the larynx from foreign entry?

A

gagging reflex

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32
Q

feeding and Swallowing Development: six months to 12 months

A

parents often begin offering solid foods

oral motor patterns begin to transition from mainly anterior-to-posterior movement to a more up-and-down munching pattern

babies are very curious and oral and this stage and increasingly prefer self-feeding

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33
Q

feeding and Swallowing Development: twelve months and beyond

A

babies are continually delighted by new tastes and textures

by 18 months most toddlers are effective, efficient eaters, although total mastery of all foods is not expected until closer to 24 months

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34
Q

Definition of Oral Preparatory Phase

A

this step to prepare the substance to be swallowed for swallowing

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35
Q

Definition mastication

A

grind the food into a manageable texture to swallow

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36
Q

true or false: only without liquids does a bolus is formed

A

false - even WITH fluids, a bolus forms to assists in controlling the flow of the liquid

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37
Q

true or false: throughout the oral preparatory phase, respiration continues with inhalation and exhalation through the nose

A

true

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38
Q

Definition of oral phase

A

this step moves the bolus to the rear of the oral cavity and prepares it for propulsion down the throat

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39
Q

true or false: the individual still maintains a normal respiratory pattern during the oral phase

A

true

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40
Q

Definition of pharyngeal phase

A

this step propels the bolus downward through the throat to the entrance of the esophagus

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41
Q

when does the pharyngeal phase begin?

A

when the bolus reaches the posterior portion of the oral cavity

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42
Q

why is the pharyngeal phase so important?

A

because the bolus can potentially enter the laryngeal pathway to the lungs or the nasal cavity, prohibiting breathing

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43
Q

what happens if material does go down the wrong way?,

A

a reflexive cough occurs to propel the material back out

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44
Q

Definition of reflexive cough

A

a protective reflex in which exhaled air is forced upward through the vocal folds to expel any foreign matter

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45
Q

Definition of apneic moment

A

when respiration experiences a brief halt that further minimizes the risk of material entering the airway

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46
Q

Definition of esophageal phase

A

this step moves the bolus through the esophagus into the stomach by an involuntary wave, or contraction

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47
Q

Definition of Dysphagia

A

a condition in which an individual exhibits difficulty in at least one of the phases of the swallow, causing swallowing to be inefficient or unsafe

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48
Q

what happens when swallowing is inefficient?

A

it does not provide adequate nutrition

49
Q

what happens when swallowing is unsafe?

A

individuals are at risk of penetration or aspiration because of poor coordination or management of the bolus as it moves through the swallowing phases

50
Q

why is silent aspiration occurs a particular concern?

A

because there is no sign - such as choking, coughing, or speaking with a wet or gurgly voice -to suggest that aspiration is occurring

51
Q

what can penetration result in?

A

choking, causing a loss of oxygen to the brain and leading to brain damage or death

52
Q

what can aspiration result in?

A

pneumonia and pulmonary damage

53
Q

true or false: dysphagia is a disease

A

false: it is a symptom that results from an underlying etiology, or cause

54
Q

three ways pediatric feeding and swallowing disorders are classified

A

descriptive features

casual classifications

Biopsychosocial Perspective

55
Q

Definition of descriptive features

A

Classification of disorders based on descriptive features focuses on the clinical presentation, or observable symptoms, of the disorder

56
Q

Definition of transient feeding and swallowing problem

A

a short-lived or readily correctable disorder

e.g., baby with an unoperated cleft lip

57
Q

Definition of episodic feeding or swallowing disorder

A

a disorder that occurs periodically. (e.g., during cancer treatment)

58
Q

Definition of chronic feeding or swallowing problem

A

a disorder that is ongoing over months or years and cannot be resolved easily

59
Q

Definition of hyperphagia

A

excessive overconsumption of food

60
Q

Definition of pica

A

consuming inappropriate nonnutritive substances like pebbles, glass, etc.)

61
Q

Definition of causal Classifications

A

Classification of disorders based on etiology focuses on known or suspected causes of the disorder.

62
Q

Definition of organic disorders

A

result from known organic causes

63
Q

Definition of neuromuscular dysfunction

A

disorders that result from an impairment of the neurological or motoric systems required for safe and efficient feeding and swallowing (e.g., cerebral palsy)

64
Q

Definition of mechanical obstruction

A

disorders resulting from an obstruction in the feeding and swallowing apparatuses (e.g., esophageal atresia)

65
Q

Definition of medical/genetic abnormality

A

disorders resulting from illness, trauma, or disability (e.g., reflux)

66
Q

Definition of nonorganic disorders

A

the cause is not clearly evident or does not stem from a physical impairment

67
Q

physical/emotional causes of a disorder

A

disorders stem from a physical or emotional reaction to the environment (e.g., abuse, or maternal depression)

68
Q

educational causes of a disorder

A

disorders include inadequate caregiver knowledge of feeding, eating, and nutrition

69
Q

environmental causes of a disorder

A

disorders are primarily financial constraints which make food under-available

70
Q

behavioral causes of a disorder

A

disorders result from learned behaviors (e.g., tantrums during eating to control the environment)

71
Q

Definition of Failure to Thrive (ITT)

A

a widely used term to describe children whose weight or height deviates significantly from the norm for their age and gender because of nutritional inadequacy

72
Q

three major reasons ITT occurs?

A

Inadequate access to food

Inadequate intake of food

Inadequate retention or absorption of food

73
Q

true or false: even though the terms feeding disorder and failure to thrive are often used interchangeably, not all children with feeding disorders have ITT and not all children with ITT have feeding disorders

A

true

74
Q

what terms do experts prefer when referring to pediatric feeding disorder and why?

A

pediatric undernutrition and growth deficiency

because emphasizing that few cases of pediatric undernutrition result from a single cause

75
Q

what three things are normal feeding and swallowing?

A

safe, efficient, and organized

76
Q

what three things are feeding and swallowing disorders?

A

unsafe, inadequate, or-inappropriate

77
Q

Definition of dysphagia

A

the dysfunction of or damage to a child’s oral-motor system or an inappropriate eating rate, either too fast or too slow

78
Q

when is feeding and swallowing unsafe ?

A

when they pose a risk of penetration or aspiration of the bolus into the airway

79
Q

Definition of hypotonia

A

low muscle tone

80
Q

what syndromes does dysphagia accompany?

A

those that feature low muscle tone, delayed motor development, and physical deformities affecting the oral-motor area

81
Q

four primary reasons inadequate feeding and swallowing occur

A

inefficiency

overselectivity

refusal

feeding delay due to illness or trauma

82
Q

Definition of inadequate feeding and swallowing: inefficiency

A

hildren are unable to meet their own caloric and nutritional needs because the process of feeding and swallowing is not productive

83
Q

Definition of inadequate feeding and swallowing: overselectivity

A

children with overselective eating patterns are restrictive in the taste, type, texture, and/or volume of food they will eat

84
Q

Definition of inadequate feeding and swallowing: refusal

A

a complete refusal to feed

85
Q

causes of refusal

A

a physical or medical issue that has not been resolved (e.g., constipation)

gastrointestinal distress (e.g., reflux)

conditioned dysphagia

86
Q

Definition of conditioned dysphagi

A

a traumatic experience results in resistance to eating after choking, ingestion of poison, severe allergic reactions, etc

87
Q

five causes and risk factors for inadequate feeding and swallowing

A

Low birth weight

Developmental disabilities (mental retardation, autism, cerebral palsy, etc.)

Prematurity

Prenatal drug exposure

Diet restrictions (e.g.: modified diet for diabetes)

88
Q

two defining Characteristics of inappropriate feeding and swallowing

A

Children demonstrate undesirable and disruptive behaviors during mealtimes

Growth and development may be compromised as successful feeding is disrupted

89
Q

causes and risk factors for inappropriate feeding and swallowing

A

behaviors and attributes of the caregiver and/or the child that become complexly intertwined in the feeding process

90
Q

about ____ of feeding disorders in young children result from nonorganic causes

A

one-third

91
Q

how are pediatric feeding and swallowing disorders identified?

A

early Identification and Referral

comprehensive Assessment

92
Q

true or false: many children do not demonstrate overt feeding disorders immediately

A

true

93
Q

who would a child with an inappropriate feeding or swallowing disorder be referred to?

A

ENT, gastroenterologist or feeding specialist

94
Q

what does a comprehensive assessment for a feeding and swallowing problem entail?

A

case history, a physical feeding/swallowing evaluation, and observation of mealtime interactions

95
Q

Definition of case history

A

gathers information on the child’s and family’s eating and feeding experiences to explore possible problems, study changes in behaviors over time, and document specific manifestations of the disorder

96
Q

Definition of physical feeding and swallowing evaluation

A

a careful evaluation of the structures and functions of the child’s oral-motor mechanism at rest and during feeding as the child eats and drinks

structural examination looks for asymmetry, drooling, and abnormal patterns or reflexes and signs of aspiration

97
Q

Definition of modified barium swallow study

A

uses radiography to follow a substance from the child’s lips through the pharyngeal and esophageal aspects of the swallow top see whether aspiration or penetration is occurring

98
Q

what does a modified barium swallow study determine?

A

pictures of the child are taken during the oral, pharyngeal, and esophageal stages of the swallow to determine whether swallowing and feeding are safe and efficient

99
Q

Definition of observation of mealtime interactions

A

live observation of the child during mealtime interactions with caregiver

100
Q

Definition of multidisciplinary collaboration

A

the current standard of care for treatment of pediatric feeding and swallowing disorders involving the pediatrician, nutritionist, feeding specialist, etc.

101
Q

what do Ineffective treatments for feeding and swallowing disorders result in?

A

severe undernutrition and growth deficiency

102
Q

three roles of the NICU feeding specialist

A

conducts evaluations of feeding and swallowing

provides interventions top enhance their developmental achievements

encouraging communication

stimulating the oral-motor mechanism

designing and monitoring feeding interventions

103
Q

Definition of special clinics

A

inpatient treatment in an intensive, hospital-based program

104
Q

Definition of home visits

A

visits to observe food preparation, discipline feeding relationships, etc.

105
Q

two main treatment goals of feeding and swallowing disorders

A

to ensure that nutritional needs are met

feeding and swallowing do not endanger the child’s life

106
Q

two physiology targets of feeding and swallowing treatment

A

emphasize the organic and neurodevelopmental aspects of eating and drinking

improving the coordination of the swallow to achieve efficiency and safety

107
Q

three psychology targets of feeding and swallowing treatment

A

emphasize the behavioral aspects of eating and drinking

decreasing resistance and fussiness when eating

following a consistent meal schedule

108
Q

what qualifies a child for alternative and Supplemental Feeding?

A

those who cannot meet 80% of their caloric needs orally

who have not gained weight or who have continuously lost weight for 3 months

whose weight and height ratio is below the 5th percentile

whose feeding time is greater than 5 to 6 hours daily

109
Q

Nasogastric tubes are used for ____-term feeding.

A

short

110
Q

Gastrostomy (G) tubes are used for ____-term feeding

A

long

111
Q

how is adult dysphagia identified?

A

bedside swallow examination and, if needed, a modified barium swallow (MBS) study

112
Q

Definition of modified barium swallow (MBS) study

A

uses radiography and should be used only when it is necessary for further diagnosis

113
Q

true or false: most instrumental procedures require a physician’s prescription if they are to be paid for by the insurance company

A

true

114
Q

true or false: SLPs are typically responsible for actually conducting the instrumental dysphagia examination and interpreting the assessment

A

false - yes SLPs conduct the exam, but radiologist interpret the assessment

115
Q

two types of treatment for Dysphagia

A

compensatory and restorative

116
Q

Definition of compensatory treatment techniques

A

strategies that compensate for a specific problem in order to make swallowing safe and efficient

117
Q

Definition of restorative treatment techniques

A

improve or restore swallow function

118
Q

true or false: despite dietary modifications and compensatory strategies, some individuals are unable to meet their nutritional requirements orally

A

true

119
Q

true or false: it is unusual for dysphagia patients to receive both oral intake and tube feedings

A

false - it is not unusual

Foundations Of Speech Pathology (13 decks)

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