Motor based feeding skills for older children Flashcards
Feeding behaviors of a child are driven by a combination of….. ?
physical responses (i.e., motor & sensory development) & learned behaviors from family/environment
normal muscle tone
normal level of tension or slight contraction of a resting muscle; in every resting muscle, there are always some muscle fibers contracting –> muscle tone
purpose of muscle tone
Stabilizes the position of our bodies (specifically bones and joints).
function of muscle tone
Makes voluntary contraction of a muscle (i.e. to close the jaw) easier and smoother since some of the muscle fibers are already taut.
muscle tone is controlled by…
Central nervous system (CNS), cannot be changed by volitional control or improved with exercise
How does muscle tone affect feeding?
- 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
hypertonia
high or increased muscle tone; muscles appear excessively contracted, held taught, tense
common disorders assoc. w/ hypertonia
Cerebral Palsy (caused by bleeding/lesions on brain) CNS infections (i.e., meningitis) infantile stroke anoxic event (at birth, near drowning)
hypotonia
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”
common disorders assoc. w/ hypotonia
Down syndrome, Prader-Willi, Shaken Baby syndrome
extrinsic tongue muscles (4)
styloglossus, hyoglossus, genioglossus, palatoglossus
function of extrinsic tongue muscles
Stabilize posterior oral tongue and base of tongue in oropharyngeal cavity; “movers” of the tongue
Abnormal use of extrinsic tongue muscles:
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
body support & stability is provided by (4):
core strength
base of support
head and neck control
body positioning
core strength
stabilizes body for good trunk support
base of support– when hips are in neutral position…
- body structures line up
- back is straighter
- shoulders are up & aligned
- rib cage and respiratory system are open
what can result from poor base of support?
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
head & neck control: when neck is aligned and head is in midline…
- jaw is freer to function independently
- airway is better protected
neck muscles are responsible for…
- posture for head
- function for breathing
- function for swallowing
what can result from poor head/neck control?
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
best positioning for body:
90-90-90
ankles, knees, and hips all flexed at 90
body should have contact w/ surface like chair or adult
motor-based feeding skills hierarchy
necessary for tongue control
pelvic stability –> trunk stability –> head/neck control –> jaw stability –> tongue control