OT 6415 Test 1- Feeding

Question 1

Posture control and feeding

Answer 1

Helps provide stability for the oral movements of feeding

-proximal stability leads to distal mobility

Question 2

Proper positioning for baby feeding

Answer 2

Elevated side lying (for one side vocal cord paralysis) or semi-reclined
-head support is important

Question 3

Stages of normal swallowing

Answer 3

• Pre-Oral: move food to mouth
• Oral Preparatory: oral structures for bolus by chewing/manipulation
• Oral: bolus in mouth
• Pharyngeal: begins when bolus enters pharynx and ends when bolus enters esophagus
• Esophageal: begins when bolus enters esophagus and ends when it is in stomach

Question 4

Stages of feeding textures

Answer 4

• Stage 1: Pureed, blended or strained food- should be mastered by 1 year
• Stage 2: Ground, lumpy foods- mastered by 1 and 1/2 years
• Stage 3: cut-up, chunky, diced food- mastered by 2 years
• Stage 4: all textures of food- mastered by 3 years

Question 5

Finger feeding development

Answer 5

• 5-6 months: mouths and gums can take baby crackers/puffs
• 6-7 months: feed self a cracker
• 9 months: independent finger feeding

Question 6

Spoon and fork skill development

Answer 6

• 9 months: will bang a cup
• 9 and 1/2 months: will stir spoon in imitation
• 12-14 months: will bring filled spoon to mouth, but turns it over in route
• 15-18 months: scoops food and will bring spoon/fork to mouth, spilling some
• 24 months: brings food to mouth, palm up
• 4 and 1/2-5 years: uses knife to butter bread of cut food

Question 7

Stages of cup drinking development

Answer 7

• Birth to 4 months: accepts liquid from breast or bottle
• 4-6 months: able to drink from a cup help by a caregiver, most liquid will spill
• 9 months: able to hold and drink from a bottle, able to drink cup with spills
• 18 months: skillfully hold cup with lid with 2 hands
• 24 months: can drink from open cup- min spills
• 4 to 4 and 1/2 years: can pour liquid from carton or pitcher

Question 8

OT evaluation for feeding

Answer 8

Medical history

• head and trunk control, fine and gross motor coordination
• type of sucking: prolonged sucking and short sucking bursts will not lead to adequate nutrition
• signs of coughing, choking, gagging
• refusal to eat, wet-sounding voice, poor weight gain

Question 9

Different nipple types for bottles

Answer 9

• Too fast sucking, not getting nutrition= bigger hole
• Baby taking too much and aspirating= smaller hole
• Cleft palate= Haberman or Dr. Brown feeders can help create positive pressure
• Laryngomalacia= low tone in pressure, need bottle with low pressure

Question 10

Sensory progression for non-oral eater

Answer 10

1. Dry spoon
2. Wet spoon
3. Spoon with water
4. Spoon with flavored water
5. Spoon with thickened water
6. Puree

Question 11

Symptoms of childhood feeding disorders

Answer 11

• Poor weight gain
• Irritability
• Constipation
• Refusal to eat
• Excess crying
• Apathy
• Prolonged or stressful meals
• Restricted acceptance of food or liquid variety
• pocketing food in mouth
• gagging, retching, vomiting

Question 12

Intervention strategies for feeding

Answer 12

• Sensory-based: create treatment plan based on child and family’s needs to make sensory diet. Make feeding play-based and give child choices
• Oral motor: utilizes biomechanical and NDT FOR- ROM lips and cheeks, tongue and jaw strengthening
• Behavioral: focus to change patient’s reactions to certain stimuli by positive or negative reinforcement