Intervention For Eating & Swallowing

Question 0

Intrinsic/extrinsic tongue muscle exercise (4)

Answer 0

1. Frozen liquid in thick straw - thermal stimulation, lateral strokes of tongue - facilitate mvmt
2. Quick stretch (flick) - enhance muscle organization, facilitate oral phase, increase efficiency
3. Vibration supra-hyoid muscles (place finger under chin in v, vibrate) - help form solid base (floor of mouth) for tongue - help initiate swallow
4. Elicit swallow w/ “ahhhhhh” & vibration input - increase force of swallow

Question 1

Primary feeding intervention

Answer 1

Positioning

75-80% of intervention is to properly position to reduce risk of aspiration

Question 2

Positioning interventions (4)

Answer 2

1. Supportive chairs
2. Use of jaw control
3. Position 90-90-90 (hips, knees, ankles)
4. Slight chin tuck

Question 3

Inhibit pathological reflexes (4)

Answer 3

1. ATNR - slight trunk rotation (rock out of spasticity)
2. Bite reflex - slight neck rotation
3. Tongue thrust - slight pressure downward on the tongue with spoon and remove spoon to side of mouth
4. Hyperactive gag reflex - tongue walking with spoon

Question 4

Facilitation of normal oral motor control (6)

Answer 4

1. Oral prep - stroke sides of mouth toward tongue with form pressure
2. Swallow - vibrate fingers under tongue, lift up & in at corners of mouth, touch midline of lip
3. Jaw control - provide additional stability (“gun”, “v” on chin thumb on side of jaw, “L” on chin/jaw)
4. Tongue control - spoon for quick stretch, vibrate fingers under chin
5. Chewing - food over molars to facilitate munching
6. Lips - wiping pattern & quick stretch