Feeding

Question 1

What are types of enteral feeding support?

Answer 1

nasogastric, gastronomy, or orogastric tubes

Question 2

For children needing sustained enteral nutrition support (longer
than a few weeks), health care providers often recommend a
___ tube, which is considered optimal long-term use.

Answer 2

gastrostomy

Question 3

The anatomic structures of the mouth and throat change significantly during the first ___ of life.

Answer 3

12 months

Question 4

Therapists create opportunities for gradual oral sensory exploration through ___ to reduce oral hypersensitivity.

Answer 4

play and positive experiences

Question 5

Difficulty transitioning from the bottle to the cup can be caused by…

Answer 5

poor jaw stability or delayed lip and tongue control, affecting the child’s ability to manage a liquid bolus.

Question 6

What is needed to assist the child with oral
food control and prevent anterior spillage during feeding?

Answer 6

good lip closure and lip seal

Question 7

What is a cleft lip/palate?

Answer 7

A cleft lip or palate is a separation or hole in the oral structures
usually joined together at midline during the early weeks of fetal
development.
A cleft lip is a separation of the upper lip, which may be seen as a
small indentation, or a larger opening that extends up to the nostril.
A cleft palate is a separation of the anterior hard or posterior soft
palate and may occur with or without a cleft lip.

Question 8

Syndromes such as Pierre-Robin sequence, CHARGE association, Smith-Lemli-Opitz syndrome, and orofaciodigital syndrome are often associated with…

Answer 8

cleft in the lip and palate

Question 9

Because of the lack of closure between the oral and nasal cavities, young infants with cleft lip or palate have difficulty…

Answer 9

creating suction to express liquid during breastfeeding or bottle feeding

Question 10

What structural anomalies affect the feeding process?

Answer 10

Micrognathia is defined as a small recessed jaw.
Macroglossia is a term used when the tongue is disproportionately
large in comparison with the size of the mouth or jaw.

Question 11

Infants with micrognathia may benefit from…

Answer 11

a prone or side- lying position to help draw the tongue into a more forward position,
allowing improved respiration and nipple compression during bottle feeding

Question 12

Infants with macroglossia may require…

Answer 12

adaptations to reduce tongue-thrusting movements and anterior food loss during feeding

Question 13

What are the 4 phases of swallowing?

Answer 13

Oral Preparatory Phase
Oral Phase
Pharyngeal Phase
Esophageal Phase

Question 14

What are common problems in the oral preparatory phase?

Answer 14

drooling, pocketing, difficulty chewing, difficulty positioning bolus

Question 15

What are common problems in the oral phase?

Answer 15

Gagging and difficulty in moving or positioning the bolus
A hyperactive gag is due to the anterior 2/3 of the tongue having increased sensitivity to any object or food, eliciting a gag.
A hypoactive gag is due to lack of gag when posterior 1/3 of tongue is impaired.
Difficulty or inability to move the bolus due to weak intrinsic and extrinsic muscles

Question 16

What are common problems in the pharyngeal phase?

Answer 16

aspiration, choking, gurgling voice, delayed swallow, nasal regurgitation

Question 17

What are common problems in the esophageal phase?

Answer 17

Difficulty with solid foods
Regurgitation in supine

Question 18

A competent therapist who provides services for feeding, eating, and
swallowing has knowledge and skills in the following

Answer 18

1. Anatomy and physiology of oral motor and swallowing functions
2. Growth and development milestones for oral feeding and self-feeding
3. Nutrition and medical conditions that influence the assessment and intervention process
4. Diagnostic tests used with children with feeding and swallowing disorders
5. Social, emotional, and behavioral factors that affect feeding and mealtimes
6. Sensory processing skills that support feeding transitions environments
7. Safety considerations for feeding and swallowing
8. Environmental influences and adaptations
9. Positioning modifications
   10.Adaptive equipment and oral motor techniques used in feeding intervention plans
   11.The assessment and treatment of pediatric feeding disorders often require
   interprofessional collaboration between the speech language pathologist and the
   occupational therapist, and other members of the child’s treatment team.
   12.Inclusion of parents and other primary caregivers in all stages of the assessment and treatment program is mandatory to ensure the child’s ultimate success in eating across environments

Question 19

What is the role of the OT in feeding?

Answer 19

Basic anatomy and physiology
Growth and developmental milestones
Nutrition
Medical conditions and their impact on feeding
Social and emotional factors that can affect
feeding

Question 20

What cranial nerves are involved in feeding?

Answer 20

CN V - trigeminal
CN VII - facial
CN XII - hypoglossal

Question 21

What are intervention strategies for feeding?

Answer 21

environmental and positioning adaptations
adaptive equipment
self-feeding
modifications to food consistencies and liquids
dysphagia
SPD
behavioral
food refusal or selectivity
delayed transition to textured foods or to a cup
neuromuscular
transition from non-oral to oral feedings
cleft lip/palate

Question 22

What diagnostic tests are used with children with feeding and swallowing disorders?

Answer 22

Instrumental evaluation of swallowing
(videofluoroscopic swallow study and fiberoptic
endoscopic evaluation of swallowing)
Upper gastrointestinal series
Upper gastrointestinal endoscopy

Question 23

The major components of a comprehensive
occupational therapy intervention plan to address feeding, eating, or swallowing problems in children include:

Answer 23

Safety considerations for feeding and swallowing.
Environmental influences and adaptations.
Positioning modifications.
Adaptive equipment and oral motor techniques used in feeding intervention plans.
Behavior techniques.
Developmental considerations (cognitive, motor, and sensory).
Interprofessional collaboration between the occupational therapist and other members of the child’s treatment team.
Inclusion of parents and other primary caregivers.

Question 24

Initial early feeding reflexes such as the swallowing reflex have been known to
develop between 10 and 14 weeks of gestational age

Question 25

The swallowing reflex helps regulate amniotic fluid and aids in the maturation of the fetus’ gastrointestinal tract

Question 26

Initial early feeding reflexes such as the swallowing reflex have been known to
develop between ___ weeks of gestational age

Answer 26

10 and 14

Question 27

The ___ reflex helps regulate amniotic fluid and aids in the maturation of the fetus’ gastrointestinal tract

Answer 27

swallowing

Question 28

Around 16-20 weeks gestational age, the fetus…

Answer 28

mouths his or her thumb in early, non-nutritive oral stimulation.

Question 29

As early as 15-18 weeks, sucking is observed; however, not until after birth does the infant learn to coordinate ___

Answer 29

suck, swallow, and breathing patterns for successful feeding

Question 30

What reflexes aid in the infant’s success with initial oral feeding?

Answer 30

rooting, sucking, and synchronized suck-swallow-breathe

Question 31

During the first 3 months of life, infants feed using ___ oral motor sucking movements.

Answer 31

symmetric

Question 32

Examples of sensory experiences that typical infants experience:

Answer 32

Feel input from caregiver’s hands, clothing, and other surfaces
Hear their caregiver’s voices, experience eye contact
Feel rhythmic heartbeats against the caregiver’s chest
Experience a variety of smells