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OTA 140 - Pediatrics > Eating and Feeding > Flashcards

Eating and Feeding Flashcards

1
Q

Mealtime encompasses:

A
  • Eating as an occupation
  • Eating for nourishment
  • Eating for socialization
  • Eating for inclusion
  • Mealtime encompasses the entire OTPF!
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2
Q

Oral Structures

A
  • Oral Cavity
  • Pharynx
  • Larynx
  • Trachea
  • Esophagus
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3
Q

Oral Cavity

A

Hard and soft palette, cheeks, jaw, teeth

• Contains food, initial chewing/mastication

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4
Q

Pharynx

A

Base of tongue, buccinator, oropharynx, tendons and thyroid bone.
• Funnels food into esophagus and allows food and air to share space.

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5
Q

Larynx, Trachea and Esophagus

A

Epiglottis, vocal folds, tube below larynx and cartilaginous rings, thin/muscular esophagus
• Valve to trachea closes during swallowing, allowing air to flow into lungs
• Carries food from pharynx to stomach.

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6
Q

Aspiration

A

Liquid getting into the lungs

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7
Q

Order of Development of Feeding Skills

A
  • Sucking and Drinking (milk/formula)
  • Coordination of Suck-Swallow-Breathe (soft food/oatmeal)
  • Biting and Chewing (easily broken-down food; crackers, soft veggies)
  • Self-Feeding Skills
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8
Q

Sucking and Drinking Phase (Details)

A

First stage of feeding skills development.
• Sucking/rooting reflex develops in utero
• First 8-10 months
• Non-nutritive (making sounds) vs. nutritive sucking patterns; rhythmic, rapid, bursts for breathing
• Breast fed vs. Bottle-fed sucking patterns (Breast feeding is harder for babies)
• Premature babies (prior to 33 weeks) have difficulty with endurance and development of suck/swallow/breath pattern (very unlikely to breastfeed)

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9
Q

Sucking and Drinking Phase Patterns

A

1) Suckling (first 4 mo.)- forward/backward movement of tongue
2) Sucking (after 4 mo)- tongue up and down
3) Mature Sucking (6 mo.)- good lip seal, strong suck pattern, good jaw/oral motor control
4) Drinking from Cup (9 mo.)- will be messy bc using suck patterns at first; tongue may protrude to provide stability (sippy cup might bridge gap to cup by allowing tongue pattern to continue)
5) Mature Drinking (24 mo.)- Child can take liquid from cup; up-down tongue movements and tip elevation with internal jaw stabilization

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10
Q

Suck-Swallow-Breathe Phase (SSB)

A

Second phase of development of feeding skills. CRITICAL to monitor this in infants.

1) 1 mo. – 1 suck to 1 swallow
2) 3-4 mo. – 20+ sucks before pause-swallow every 4-5 sucks
3) 9 mo. – cup drinking has less coordination; 2-3 sucks for a swallow
4) 15-18 mo. – mastery of cup drinking
5) 24 mo. – mature cup drinking (better sucking due to fat pads inside cheeks to decrease size of oral cavity)

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11
Q

Biting and Chewing Phase

A

Third phase of development of feeding skills

1) 4-5 mo. – Aphasic bite release pattern on anything put in mouth. Jaw moves up-down
2) Munching – rhythmic up-down pattern continues with pureed/easily dissolved food
3) 7-8 mo. – some variability in munching pattern; diagonal jaw movement with texture variation; lips become more active
4) 9 mo. – handles pureed/soft food well. Continues munching pattern, including more proficient diagonal pattern (usually no teeth)
5) Lateral Tongue Movements – Occur to move food for mastication
6) 12 mo. – rotary chewing begins; active tongue movements
7) 18 mo. – well coordinated rotary chewing and handles variety of foods (arrival of teeth)
8) 24 mo. – can eat most meats and raw veggies; can handle lip closure during chewing

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12
Q

Self Feeding Phase

A

Last stage of development of feeding skills.
• Most related to cognitive and psychosocial development
1) 6 mo. – may try to hold own bottle; can bring food to mouth; may be interested in holding spoon while eating
2) 8 mo. – finger feeding develops first as infant is introduced to cereal/crackers (big enough pieces to grasp)
3) Finger Feeding – preferred until proficiency with spoon develops (24 mo.)
4) 12 mo. – Starts to show understanding of how spoon works; skills in drinking emerge; sippy cup with handles for control at first, then without
5) 24 mo. – Child able to use small cup with no lid; straw drinking emerges
6) 30-36 mo. – child begins to prefer fork (has coordination for it)

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13
Q

Eating as a Co-Occupation

A
  • Child and caregiver
  • Patient/Nurse
  • Child and elderly parent
  • Parent and adult child with disability
  • Patient/therapist
  • Friends sharing meal
  • Family event/holiday
  • Eating in restaurant/public place

(Think of changes in eating in different contexts/with different people)

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14
Q

Bases of Difficulty in Feeding/Eating

A 
Can be based on:
• Physical (structural deficiency)
• Motor
• Cognition
• Psychosocial
• Sensory
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15
Q

Intervention for Feeding/Eating

A
  • Therapeutic approach (ther. use of self)
  • Positional considerations
  • Handling and oral motor interventions
  • Psychosocial implications (memorable meals)
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16
Q

Positional Considerations in Feeding/Eating

A
  • Body Position
  • Head Position
  • Environmental Consideration
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17
Q

Handling and Oral Motor Interventions for Feeding/Eating

A
  • Handling before feeding (calm is best!)
  • Prep for children with hypotonicity (low tone)
  • Altering texture/sensory quality of foods for skill development
  • Handling during feeding (cheek support? Spoon placement?)
  • Postural preparations/oral tactile preparations
  • Head position
  • Handling (jaw stability; head/cheek support)
  • Texture aversion interventions
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18
Q

Adaptive Equipment for Feeding/Eating

A
  • Task modifications (positioning?)

* Adaptive equipment assistance (Dysum, utensils, built-up plates, etc.)

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19
Q

Evaluation of Feeding Issues Includes:

A

1) Pregnancy, birth and delivery history
2) Child’s birth and medical history
3) Assess oral motor mechanism/facial structures prior to feeding
4) Monitor behavior prior/during/after
5) Note muscle tone/energy level
6) Observe respiration status
7) Gather info from parent/caregiver on feedings

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20
Q

What to consider in assessing child’s birth/medical history

A
  • Neurological
  • Respiratory
  • Cardiac
  • GI
  • Musculoskeletal
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21
Q

What to consider in assessing oral motor/facial mechanisms

A
  • Jaw positioning
  • Cheeks
  • Lips
  • Teeth
  • Tongue
  • Palate (hard/soft)
  • Rooting
  • Sucking/Non-nutritive sucking for infants
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22
Q

What to consider in assessing parent/caregiver info on feedings

A
  • Number of feedings (breast, bottle, G-tube); meals; snacks per day
  • Daily schedule of feedings, meals, snacks (ex: is child a “front-loader”- eats/gets tired early?)
  • Intake per feeding
  • Types of foods offered
  • List of preferred foods
  • Modifications to foods?
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23
Q

What to assess during a feeding

A

1) Environmental observations/factors
2) Infant/Child’s position
3) Now is child being fed? (breast/bottle/spoon/etc.)
4) Who is feeding child (how are they interacting while eating?)
5) How much does child intake
6) Behavior during feeding
7) Does child display sensory concerns?

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24
Q

Swallowing Concerns to Observe

A

• Observe before, during and after child swallows
• Listen to breathing
• Note distress and responses
***DO NOT intervene with swallowing issues unless specifically trained!!

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25
Q

Visual Signs of Swallowing Stress (Choking)

A
  • Color changes (pallor, mottling, cyanosis, duskiness)

* Physiological changes (oxygen desaturation, apnea, bradycardia, change in muscle tone)

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26
Q

Feeding Specific Intake Info (What info to gather)

A

1) Have parent complete 3-5 day diary (food, amount eaten, place, who presented meal, food inventory list)
2) Get clear description of feeding set up (type of chair, where takes place, how long client sits for meal); pictures helpful
3) Questions to ask:
• How long has this been a concern?
• How much of an issue has it caused for the family?
• Where does feeding therapy fall in priority to other goals/concerns?
• Are there any cultural factors that are important for me (OT) to know?

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27
Q

How Correct Positioning Helps During a Meal

A
  • Increases safety with swallowing
  • Inhibits/decreases extensor patterns
  • Improves ability to self feed
  • Allows client to focus on eating rather than balance/trunk support
28
Q

Tips on Correct Seat for Feeding

A
  • Seat positions body in 90-90-90 angles at hips, knees, ankles
  • Appropriate postural support
  • Has pummel (or option for one) as needed to prevent sliding forward
  • Adjustable footrest (modify if not an option)
  • Has accessible tray table
  • Can be adjusted for client’s growth
29
Q

Possible Preparatory Activities for Feeding

A
  • Heavy work (for calm/focus)
  • Proprioceptive based activities
  • Tactile exploration
  • Oral motor exploration
  • Hand washing
  • Transitional tools (ex: getting to the table)
30
Q

Signs of Sensory Distress in Feeding

A
  • Turning away from food/table
  • Pushing food, spoon, hand away
  • Attempting to elope (leave)
  • Crying
  • Gagging (may even vomit if pushed)
  • Coughing
  • Rapid blinking
  • Yawning
31
Q

Steps to Eating (from SOS Approach to Feeding)

A

(Think of visual of steps going up from):

1) Tolerates (looks at, being at table, etc.)
2) Interacts With (assists in prep, uses utensils)
3) Smells (leans down/picks up to smell, smells odor in room)
4) Touches (from fingertip up to tip of tongue)
5) Tastes (from licks lips to chews independently)
6) Eating!

32
Q

Common Reasons Kids Won’t Eat

A
  • Pain (GI, illness)
  • Malaise/Discomfort (nausea, fatigue, congestion)
  • Immature Motor/Oral-Motor/Swallow Skills
  • Sensory Processing Problems (modulation issues, movement, interoception, discrim.)
  • Learning/Behavioral (impaired learning/development)
  • Nutritional (metabolic/absorption disorder, etc.)
33
Q

Factors Influencing Kids’ Eating

A
  • Child Factors (temperament, anxiety, etc.)
  • Parent Factors (no + reinforcement, no modeling, diet restriction/weight fear, tricking child, inconsistent)
  • Environmental Factors (lack of exposure to foods, grazing all day/no schedule, disorganized household, distractions, poor posture support, lack of food)
34
Q

Presentation Tips for Sensory Based Aversion/Pickiness

A
  • Use plain plates/tools so food more interesting
  • Decrease environmental distractions
  • Present all food groups at least 1-3x/week
  • Change presentation to increase interest
  • Where you place food in mouth affects taste
  • More types of foods eaten = more volume
  • Change up foods to decrease rigidity
  • Everyone eats same thing as child/modeling
  • If child seems overwhelmed, clear table and reintroduce slowly as tolerated
  • Avoid tricks, but acknowledge if a new food gets on their lips (“Cookie crumbs were on your lips and your tongue caught them!”)
  • Pick developmentally appropriate food based on current skill, but use food to develop oral motor skills when comfortable
  • Use different tools to manipulate foods (utensils, peelers, chopper)
  • Present foods of similar qualities (group by color, texture, temp, shape, flavor, etc.)
35
Q

General Tips for Sensory Based Aversion/Pickiness

A
  • Create consistent routine/steps (takes 2 weeks to adopt)
  • Have place specifically for eating
  • Snacks: 15-20 minutes
  • Full meal: 20-30 minutes (over 30 sign of avoidance)- let them “escape”
  • Decide to address sensory concerns OR self feeding skills
  • Educate parents early to avoid forcing
  • Accept food will be wasted
  • Verbal praise/acknowledgment (“Wow, you chomped that carrot like a bunny!”)
  • Assist parent in rebuilding rapport with child
  • Observe how they play and incorporate into meal time
  • Allow messiness! Provide napkin, but don’t clean up til end.
  • Wash hands away from eating (in case aversion to napkin, etc.)
  • Avoid child getting up during meal/use timer
  • Teach child to push food away instead of throwing
  • Allow child to squish, roll, crunch, twist, touch food until comfortable moving to mouth (normalize playing with food!)
36
Q

The Art of Crumbing

A
  • Make crumbs out of foods safe for child
  • Make crumbs in tolerable consistencies (fine to rough, meltable, uneven, etc.)
  • Crush with fingers, use coffee grinder, etc.
  • Let child lead on how much to feed; add tiny bit to normal puree and watch their “notice” of it/responses. Build up as comfortable.
  • Mix into pureed foods to add texture, or sprinkled on top to touch palate.
  • Spoonful of puree can be dipped in crumbs
  • Use different flavors (Cheerios, Fruit Loops, Saltines, etc.)
  • Use crackers/chips of different flavors (plain rice, cheese, ranch, “flaming hot,” etc.)
  • Can use healthier ground dehydrated veggies, nuts, etc.
  • Can use sprinkles or seeds for added interest, texture
  • Allow child to dip spoon of wet food into crumbs independently
  • Use crumbs to color a picture! (“Paint” with a sticky food, then color over it with crumbs)
  • Make “Crumb Kisses”—allow child to help make crumbs, then dip wet finger into crumbs and stick them to lips; make kissy faces in a mirror. Either eat them or wipe off.
37
Q

Tips for Poor Oral Motor Skills

A
  • Determine which food textures client eats safely
  • If frequently coughing, pneumonia, etc., recommend a swallow study
  • Observe to see where/how they bite food, where it goes, type of grasp used, spillage
  • Observe if able to form bolus
  • Use mirrors/modeling to increase awareness and skill
  • Typically like to eat foods easiest to manage
  • Present foods to lateral molar and provide downward pressure to facilitate tonic bite reflex
  • If appropriate, work toward biting with anterior teeth/transferring to molars
  • For tongue thrusters, reduce with use of pureed foods and gentle downward pressure at mid tongue with spoon
  • Can puree most foods by steaming/blending, adding milk/water/juice
38
Q

Progression of Food Textures (Developmental Food Continuum)

A

• Breast/Bottle – 0-13 mo.
• Baby food cereals – 5-6 mo.
• Slightly thicker baby food cereals/thin purees/Stage 1 – 5.5-6.5 mo.
• Thin baby food purees/Stage 1 – 6-7 mo.
• Thicker baby food cereals/thicker smooth purees/Stage 2 – 7-8 mo.
• Soft mashed table food/table food smooth purees – 8-9 mo.
**May then go through phase of hard munchables to meltable hard solids to soft cubes to SINGLE TEXTURE soft mechanicals – 8-11 mo.
-OR-
• Straight to MIXED TEXTURES/soft mechanical/Stage 3 – 12 mo.
• Soft table foods (approp. size) – 13-14 mo.
• Hard mechanicals – 15-18 mo.
• Skills refinement – 18-24 mo.

39
Q

“Hard Munchables”

A

Foods for infants 8-9 mo.
• Goal is oral EXPLORATION; not consumption!
• Raw carrot/celery sticks, dried fruit sticks, frozen melon strips, dutch pretzels, frozen pancakes/waffles
• Can use things like licorice, suckers, beef jerky for kids with feeding delays > 12 mo.

40
Q

“Meltable Hard Solids”

A

Foods for infants 9-9.5 mo.
• Foods which dissolve with spit only; no or minimal pressure needed
• Towne crackers, biter biscuits, grahams, thawing frozen pancakes/waffles, Krinkle stick, Gerber’s cereal squares, Fruit Loops, Baby Mum Mum, baby cookies, Gaathiya, Snap Pea Crisps
• Can use things like Pringles, Cheetos, chocolates, popsicles/frozen fruit bars for kids with feeding delays > 12 mo.

41
Q

Weaning off G-Tube

A
  • Make sure client has been cleared to begin consuming foods by mouth
  • Observe how client’s G-Tube feeding times/volumes impact participation during therapy tx (too much/too soon can limit interest)
  • Work with parents, doc, dietician/nutritionist if there are concerns of poor tolerance
  • Discuss option of reducing feeds to assist client with learning hunger/satiation cycle (do not perform without support of medical team)
  • Have client join family and receive G-Tube feedings at table to increase association with meal time/feeling full
42
Q

Poor Tolerance of Oral Input

A

Clients who demonstrate extreme aversion to tools or foods entering mouth; focus on desensitization and improved tolerance with:
• Oral motor toys (whistles, bubbles, straws)
• Distal to proximal tolerance of water, flavored waters, diluted juices, powdered flavors
• Trial oral motor exploration with different tools, popsicles, lollipops etc.
• Try dipping different liquids from straw or dropper onto lips or tongue

43
Q

Merry Mealtime: Setting/Structure

A
  • Social mealtimes with models (meals/snacks offered with other family members at table; eating same food)
  • Limited/No distractions (no tv, toys, etc at table during meal/snacks; socializing/soft music ok)
  • In chair, at table (well supported in chair, with tray/table at approp height; sitting at table with others for meals/snacks)
  • For meals/snacks only (location should ONLY be used for eating/drinking. No meds or other aversive activities)
  • Consistency (mealtime setting, structure; so child knows what to expect)
  • Allow independence (only help with permission; allow independence then help if needed; read child’s cues for acceptance of support)
44
Q

Merry Mealtime: Schedule/Routine

A
  • Pleasant beginning/end routine (handwashing at both ends; same for every meal/snack so predictable)
  • Sensory transitions if needed (prior to meal/snack times if suggested by therapist)
  • Guided by medical/nutritional status (schedule determined by physicians/dietician)
  • Regular intervals (eat at regular intervals throughout day; 2.5-3 hr apart, 5-6x/day)
  • Duration (snacks 10-15 min; meals 15-30; increase time with tolerance)
  • Use a timer (to help teach child expectation of staying at table; “meal over when timer dings.”)
  • Allow extra time (may need more if self-feeding, have difficulties or enjoy socially. Do not let it go longer than 30-35 min!)
  • Expect child to stay at table (not ok to get down/leave/sit on laps; use timer)
  • No grazing (build up hunger for set times; water ok anytime/use when hungry; explain when next snack/meal is coming)
  • Use an All-Done Bowl (put uneaten foods in it when timer goes off; sense of finality; increases interactions with foods they refused to eat; may use creative method, like holding in mouth then dropping in)
45
Q

Merry Mealtime: The Food

A
  • Age/skill appropriate (prepare for independence, etc.)
  • Exposure (variety of tastes/textures/ brands; goal is to learn to accept variety)
  • Offer at least 3 different foods (each time offer 1 protein, 1 carb, 1 fruit/veg; try one familiar food and preferred food for comfort; use “family” food—what everyone is eating)
  • Someone describe food (someone talks to child about the food/what it’s like; not used to pressure them into thinking it’s good)
  • Avoid added salt, sugar, flavors, colors and foods marked “low” in things (bad for children’s brains to process the food)
  • Water (Med team can tell you how much needed; avoid sodas, etc.)
  • Healthy sweeteners (molasses, honey > 1yo, maple syrup)
  • Healthy fats (real butter, olive oil, coconut milk, fish oil, nuts, ground flax or flax oil)
46
Q

Teaching Spoon Technique

A

• Developmental age 7 mo. or greater; Go slower in smaller steps if less than 7 mo.
• Use infant feeding spoon with small bowl, long handle
STEP 1: Adult makes eye contact, model open mouth, says “Ahhhhhh….”
STEP 2: Adult brings spoon straight on toward front of mouth, touches lower lip gently with tip (model smacking lips, using tongue to sweep)
STEP 3: Adult moves spoon SLOWLY into mouth, straight on, STOPS just inside lips, spoon tip at tip of tongue. (Only let child suckle on spoon; Model by saying “Ma!” for suction)
STEP 4: Adult draws spoon straight back out when lips begin to close or tongue starts to suckle WHILE continuing “Ma!” modeling. NO DUMPING/SCRAPING FOOD!
STEP 5: Repeat steps 1-3 twice
STEP 6: Again offer spoon straight into mouth, but insert further onto top of tongue (not past mid-way)
STEP 7: As child’s mouth begins to cup around spoon/lips start to close, draw spoon back out (NO DUMPING/SCRAPING!). Model lip smacking and “Ma!” WHILE drawing out.

  • *DO NOT clean any food off child’s face with the spoon (no take-backs of the food!)
  • *DO NOT clean child up at end of feeding while still in chair. Give them napkin/cloth to “help” you wipe tray, then take them messy out of chair and bring to sink to clean while playing in water.
47
Q

Eating vs. Feeding

A

Eating = child maintaining and manipulating food and fluids placed in mouth and then swallowing.

Feeding = setup of food items, managing food containers, and bringing food/drink to the mouth.

48
Q

When to introduce solid food to infants

A

If baby is growing normally, pediatricians typically recommend pureed solid food about 4-6 months. Begins with infant cereal on spoon, then pureed veggies, then pureed fruits.

49
Q

Purpose of introduction of pureed foods to infants

A

Assists the child in developing lip, tongue, and jaw motor control as well as tolerance of various food tastes.

50
Q

Purpose of increasing texture of foods (moving from puree to mash)

A

Promotes increased oral-motor control for chewing. Begins tolerance of different textures, and early process of up and down chewing.

51
Q

Purpose of introducing soft cookies/crackers

A

After mastering mashed/textured foods, infant can begin front biting using cookies/crackers, around 9 months. Happens in coordinating with development of sitting balance for positioning in high chair.

52
Q

Purpose of introducing ground table foods (ground turkey, rice, soft veggies)

A

After mastering front biting, child can learn to chew larger pieces of food placed on the tongue or teeth, moving it to the side of mouth for chewing. By 1 year, able to move food around in mouth and chew using rotary movement and oral-motor structures. (Creates a bolus, moves to back of throat, and swallows.)

53
Q

Signs of Swallowing Difficulty

A
  • History of aspiration pneumonia/chest infections
  • Grayish color around mouth
  • Frequent undiagnosed fevers
  • Cough/choking during feeding
  • Wet voice/breath during feeding
  • Diagnosed vocal cord palsy
  • Sudden drop in oxygen/heart rate
  • Change in voice quality during feeds (low/wet voice)
  • Poor weight gain despite adequate intake
  • Poor secretion control
  • Increased wheezing during feeds
54
Q

Hinderances to Eating/Swallowing

A
  • Born prior to 28 weeks (lacking primitive reflexes)
  • Structural deformities of mouth/jaw (cleft palate, etc.)
  • Some conditions like Down syndrome, CP, have difficulty pursing lips, manipulating tongue, closing mouth
55
Q

Hypersensitivity and Gag Reflex

A

Hypersensitivity around lips/tongue produces gag reflex and refusal of foods. May require desensitization in therapy, such as massage, stimulation with Nuk brush, or using a pacifier to get child used to items in mouth. Allow child to smell/touch/play with food, and lick off lips at own pace.

56
Q

Biomechanical Alignment for Swallowing

A

Optimize biomechanical alignment to encourage swallowing, which is placing food in midline and slightly lower than chin. Infants in semi-recline also helps; toddlers/teens in upright sit with neck slightly flexed forward.

57
Q

Nasogastric (NG) or Gastric (G) Tube Feeding

A

Children with long-term eating/swallowing issues may be fed through tube inserted into stomach. G-feedings administered with mechanical pump. OTP offers suggestions on optimal seat/bed position to promote midline/upright alignment in head, neck and trunk for best nutritional intake and comfort.

58
Q

Independent Self-Feeding

A

Encouraged about 10 months with finger foods (cheerios, boiled chicken, pasta, beans). Eventually incorporate a spoon, and often use a combination of both methods.

59
Q

Atypical Oral-Motor Function

A
  • Lip retraction
  • Exaggerated tongue protrusion/thrust
  • Jaw thrusting with protrusion/retraction
  • Lip pursing
  • Tongue retraction
  • Tonic bite reflex
  • Poor head/trunk control
60
Q

OT Observations about Feeding

A
  • Child’s body structures and functions to identify factors interfering with performance
  • Child’s positioning during feeding; UEs, head, neck and trunk
  • Child’s ability to open/close containers, find food on plate, bring it to mouth (check for visual motor coord, cognition)
  • Food temp, textures, tastes to determine food/sensory preferences and intake amt.
  • Social, cultural, physical, temporal environment around feeding
61
Q

Best Practice Positioning for Feeding

A
  • Neck with midline
  • Head with midline
  • Shoulders level/forward
  • Trunk with midline
  • Pelvis level (palpate ASIS to check)
  • Hips at 90˚ flex
  • Knees at 90˚ flex
  • Feet neutral/on supported surface
62
Q

Recommended Feeding Schedule for Children

A
  • 6 small meals/day best for digestion, calorie intake, long-term healthy habits
  • Recommend 3 meals and 2 snacks daily
  • High protein (yogurt, beans, tofu), as well as 5 fruits and veggies per day
63
Q

Sensory Diet

A

A program of regular sensory activities prescribed by an OTP. May be scheduled, such as upon awakening in the morning or modulating nervous system after school. Can help regulate a sleep/wake cycle. Can include activities with and/or provided to school or family. Considers child’s sensory needs based on assessment, and encourages participation without being threatening.

64
Q

Modified drinking equipment

A

Nose Cutout Cup: when child cannot extend neck.

Cup with Handles: to help client grasp cup.

Spouted Sippy Cup: to help pace the flow of liquid.

Dysphagia Cup: to help client who must chin-tuck to facilitate swallowing

65
Q

Tongue Presentations that Limit Feeding

A

Tongue Thrust: exaggerated pushing of food/liquid out of mouth

Tongue Protrusion: open mouth with tongue passively hanging out

Tongue Hypotonia: low tone in tongue

Tongue Lateralization: tongue movement to sides of mouth

OTA 140 - Pediatrics (18 decks)

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