Exam 2 Flashcards
Instrumental vs Clinical Assessment
Instrumental is the only way to see the pharyngeal phase and disagnose pharyngeal dysphagia
What percentage of children with disabilities have PFD
80%
Evaluation considerations
-address each area of the PFD framework
-make approriate referrals
-naturalistic observations
-obtain caregiver input
-advocate!
Clinical Assessment Structure
- chart review
- case history and interview
- oral mech
- observation of typical feeding
- challenge foods
- sensory and skills assessment with foods
Food Diary
Have parent write down how much food was offered and how the feeding went
Is silent aspiration common in infants
Yes
Basic Tenants of Feeding Therapy
-PFD interventions should be positive or neutral
-we want them to enjoy eating
-take anxiety and fear away
Should food be play food or edible food?
Edible food! Make it as similar to real mealtime as possible
Social modeling
model what you want the child to do, can even take a bite of the new food to show them that it is not scary
Who should we collaborate with for sensory function?
OT
-design a Systematic sensory diet
Treatment of Oral Sensory Function
- Tolerate seeing it
- tolerate smelling it
- Tolerate touching it
- Finall able to taste it by licking, biting, or swallowing it
Food Chaining
take a food that the child eats and change one property at a time to link it to a new food that they are afraid of
Spoon Feeding considerations
-spoon type
-volume on the spoon
-sideways presentation of the spoon
What skill is needed to be able to transition to solid foods?
Tongue lateralization
Cup drinking considerations
- flow rate of the liquid
-presentation of the cup
-cup type
Skill that should be highlighted with straw drinking
lip rounding
pipette technique
block the opening of the straw to suck up the liquid and then drip it into the child’s mouth to work on lip rounding and bolus control
honey bear cup
squeezable bottle that can eliminate some of the effort needed to suck liquid from a straw
is a shorter or longer straw easier?
Shorter
Baby led weaning
baby is boss, foods are presented in ways that the baby can grasp and explore
Systematic desensitization
gradual exposure to the fear stimulus that is play based and focuses on easing the anxiety associated with the new food
Sequential Oral Sensory Approach (SOS)
moves through the senses to desensitize the child
-start with tolerating, then interacting, and eventually move all the way up to eating
Bite sizes
-mouse bite
-bird bite
-dog bite
-horse bite
-elephant bite
systematic texture manipulation
crumbing or blending a safe food into a new texture for the child to try
Alternatives to thickening liquids
change the nipple flow rate, change cups, pacing
