pediatrics

Question 1

aversion (to what?)

Answer 1

touch, taste, temp, textures, smell, sight

Question 2

aversion (where?)

Answer 2

localized to mouth/face OR global sensory problem

Question 3

aversion responses

Answer 3

cry, grimace, wiggle, arch away, shutting down/sleeping

Question 4

diagnoses at risk for oral motor feeding problems

Answer 4

broncho-pulmonary disease (poor SSB)
cardiac disorders (rapid fatigue)
drug/alcohol exposure 
genetic disorders
GI issues (reflux)
neurological impairment (TBI)

Question 5

SSB synchrony: when are structures present?

Answer 5

3.5 weeks gestation

Question 6

SSB synchrony: when does swallow first occur?

Answer 6

14-17 weeks gestation

Question 7

SSB synchrony: When does SSB emerge?

Answer 7

31-33 weeks

Question 8

SSB synchrony: When does SSB mature?

Answer 8

37-38 weeks

Question 9

stress cues (behavioral)

Answer 9

shut down/sleep
decreased interest/distraction while feeding
stop sign hand/finger display
push bottle away
tongue on roof of mouth

Question 10

stress cues (non-behavioral)

Answer 10

facial changes
fatigue
changes in tone and respiratory rate

Question 11

0-3 months

Answer 11

chin to rib cage
jaw, tongue, cheeks, lips work as 1 unit
tongue: large, fills oral cavity
reflexes: gag, rooting, phasic bite (down), suck-swallow
sucking pads

Question 12

sucking pads

Answer 12

develop last 2 weeks in utero
fatty tissue pads surrounded by inactive cheek muscles
provide stability/support to help tongue compress nipple

Question 13

3-6 months

Answer 13

problems because changing anatomically (more airflow)
head control increasing
muscles around face/cheeks develop
sucking pads gone (6 months)
everything elongates: neck, larynx lower in throat

Question 14

6-9 months

Answer 14

NECK/SHOULDERS more stable
strong active SUCK (no longer reflexive)
graded JAW movement (open half way)

Question 15

12-18 months

Answer 15

refining movements
rotary CHEW begins
active LIPS clean spoon and lower lip

Question 16

24 months

Answer 16

TONGUE becomes major cleaner inside/outside mouth (before: cloth)
easy LIP closure with no liquid loss from cup
controlled BITE

Question 17

4-5 years

Answer 17

oral motor feeding skills/coordination fully established

Question 18

GER signs in peds

Answer 18

coughing/choking during feeding
re-swallows/dry swallows
arch back
irritable, cranky, moody
eats small amounts (limits self)
wet burps
turns head to left during/after feeding (pathway of esophagus around aortic arch)
ear infections

Question 19

non-nutritive suck rate

Answer 19

~2 sucks/second

Question 20

non-nutritive suck at 27-28 weeks

Answer 20

weak single suck with long pauses

Question 21

non-nutritive suck at 30-33 weeks

Answer 21

short sucking bursts with long irregular pauses

Question 22

nutritive suck rate

Answer 22

~1 suck/second

Question 23

4 components of a nutritive suck

Answer 23

expression
suction
cheeks/lips not active but help with stability
tongue/palate “seal” drives swallow

Question 24

rate of sucks/burst at 38 weeks

Answer 24

12-18 sucks/burst

Question 25

fully mature pattern of SSB

Answer 25

20-30 sucks/burst

Question 26

44 weeks gestation (4-6 weeks past full term) that brain receptors fully mature and send message to brain to do what?

Answer 26

breathe