Motor based feeding skills for older children

Question 1

Feeding behaviors of a child are driven by a combination of….. ?

Answer 1

physical responses (i.e., motor & sensory development) & learned behaviors from family/environment

Question 2

normal muscle tone

Answer 2

normal level of tension or slight contraction of a resting muscle; in every resting muscle, there are always some muscle fibers contracting –> muscle tone

Question 3

purpose of muscle tone

Answer 3

Stabilizes the position of our bodies (specifically bones and joints).

Question 4

function of muscle tone

Answer 4

Makes voluntary contraction of a muscle (i.e. to close the jaw) easier and smoother since some of the muscle fibers are already taut.

Question 5

muscle tone is controlled by…

Answer 5

Central nervous system (CNS), cannot be changed by volitional control or improved with exercise

Question 6

How does muscle tone affect feeding?

Answer 6

• Orofacial muscle tone affects all aspects of feeding and swallowing
• Adequate muscle tone allows the oral and pharyngeal structures to function properly and generate sufficient strength and control for synchronous muscle contractions
• Abnormal muscle tone negatively affects feeding and swallowing

Question 7

hypertonia

Answer 7

high or increased muscle tone; muscles appear excessively contracted, held taught, tense

Question 8

common disorders assoc. w/ hypertonia

Answer 8

Cerebral Palsy (caused by bleeding/lesions on brain)
CNS infections (i.e., meningitis)
infantile stroke
anoxic event (at birth, near drowning)

Question 9

hypotonia

Answer 9

low muscle tone; muscle is flaccid and appears weak; muscle fibers are slow to react to stimuli and fatigue or relax before reaching maximal contraction; makes general appearance of body look “droopy”

Question 10

common disorders assoc. w/ hypotonia

Answer 10

Down syndrome, Prader-Willi, Shaken Baby syndrome

Question 11

extrinsic tongue muscles (4)

Answer 11

styloglossus, hyoglossus, genioglossus, palatoglossus

Question 12

function of extrinsic tongue muscles

Answer 12

Stabilize posterior oral tongue and base of tongue in oropharyngeal cavity; “movers” of the tongue

Question 13

Abnormal use of extrinsic tongue muscles:

Answer 13

children with poor trunk control/stability or with respiratory difficulties will often contract these muscles to help stabilize head/neck on trunk –> results in tongue retraction and shortening of tongue musculature –> difficulty using tongue in functional way

Question 14

body support & stability is provided by (4):

Answer 14

core strength
base of support
head and neck control
body positioning

Question 15

core strength

Answer 15

stabilizes body for good trunk support

Question 16

base of support– when hips are in neutral position…

Answer 16

• body structures line up
• back is straighter
• shoulders are up & aligned
• rib cage and respiratory system are open

Question 17

what can result from poor base of support?

Answer 17

base of support helps to stabilize the head and neck position, therefore jaw/tongue may be tense– do not have free movement for oral-motor function

Question 18

head & neck control: when neck is aligned and head is in midline…

Answer 18

• jaw is freer to function independently

- airway is better protected

Question 19

neck muscles are responsible for…

Answer 19

• posture for head
• function for breathing
• function for swallowing

Question 20

what can result from poor head/neck control?

Answer 20

if neck muscles are having to be used to supplement trunk muscles (in order to maintain better trunk control), then their use for swallow function may decrease

Question 21

best positioning for body:

Answer 21

90-90-90
ankles, knees, and hips all flexed at 90
body should have contact w/ surface like chair or adult

Question 22

motor-based feeding skills hierarchy

Answer 22

necessary for tongue control

pelvic stability –> trunk stability –> head/neck control –> jaw stability –> tongue control