Part 6

Question 1

Feeding problems with utism:

Answer 1

only eat 3 or 4 things, limited diet

Question 2

Feeding problems with CP

Answer 2

posture, reflexes (ATNR, gag, tongue thrust), high arch pallet, grasp, reach, ROM, oral motor/dysphagia

Question 3

Feeding problems with Down Syndrome

Answer 3

mechanics (enlarged tongue & fatter cheek pads), low muscle tone, delayed tooth eruption, low awareness

Question 4

Feeding problems with Respiratory/Cardiac

Answer 4

low endurance and fast metabolism- can’t get enough to eat

Question 5

Posture for feeding

Answer 5

■ Sitting: trunk control @ midline, head/neck forward, chin tuck, head in midline, arm/foot supported- no dangling, 90-90-90
■ Sidelying: reduce effects of gravity, help swallow/breathing
■ Supine: not a good idea- aspiration/choking; go to sleep with bottle  ear infection and tooth decay

Question 6

Picky eaters (takes __ times to know if you like something)

Answer 6

10

Question 7

○ Temperature of foods for serving
■ Hot:___-105 degrees is ideal
■ Cold: 36- __is degrees is ideal

Answer 7

100

59

Question 8

Prevention and gagging

Answer 8

■ Prevention
● Bite size: double check skills and size
● Speed: make sure they have time to swallow
● Alignment: promote oral structures
● Placement of food: don’t scrap food on teeth and make sure they can control it
● Level of arousal/readiness: if they’re crying, fighting, sleepy
■ Gagging: 10-14 months, therapist stays calm, move to their side, bring forward and keep chin/head in midline

Question 9

Technique for bite presentation

Answer 9

Bite presentation
■ Position yourself where your underarm is just over child’s shoulder, crook of elbow is at child’s occiput, open hand is in front of child’s other shoulder (basic head support position)
■ Tap on lower lip or gently press down until lower teeth show to promote mouth opening
■ Place spoon in mouth over center of tongue, wait for close (should be just over bowl of spoon)
■ Bring spoon straight out – DO NOT scrape on upper teeth
■ Wait for swallow and breath
■ Provide additional pressure on center of tongue to inhibit tongue thrust

Question 10

Side and front eating technique

Answer 10

■ Position yourself where your underarm is just over child’s shoulder
■ Crook of elbow should be behind child’s head
■ Place closed hand along child’s jawline, pinkie along jawbone, avoiding the neck area
■ Move with child’s jaw movements
■ Maintain support during swallow
○ **Child must have head support for b. and c.

Question 11

Technique for L-shaped feeding

Answer 11

■ Position yourself in front of child at eye level
■ Put fingers in “gun” position
■ Put thumb under jaw bone, index finger along cheekbone, other fingers curled under chin
■ DO NOT dig fingers in
■ Move with child’s movements
■ Maintain support during swallow

Question 12

Picky eater characteristics

Answer 12

○ Decreased range in foods, usually at least 30 foods
○ Occasionally burn out on food – after 2 weeks may come back
○ Manipulated/bribed new foods
○ Eat at least 1 food from different texture groups
○ Will add new food in 15-20 steps

Question 13

Problem feeder characteristics

Answer 13

Restricted range usually <20
○ Typically don’t come back from burn out foods
○ If not persistent and consistent will burn out
○ No more often than every other day
○ End the day if non preferred food is present
○ Can’t even sit at the table
○ Only eat 1 food type, shut out entire categories
○ Need more than 25 steps