Pediatrics: Feeding, Eating, & Swallowing Flashcards
1
Q
Which phase of swallowing is under voluntary control?
A) Oral phase
B) Pharyngeal phase
C) Esophageal phase
D) Digestive phase
A
A
2
Q
At what age does a mature pattern with spoon feeding typically develop?
A) 6 months
B) 12 months
C) 18 months
D) 24 months
A
D
3
Q
Non-nutritive sucking is primarily for:
A) Nutrition
B) Soothing and regulation
C) Communication
D) Digestion
A
B
4
Q
Which feeding milestone is generally introduced around 8 months?
A) Cup drinking
B) Spoon feeding
C) Chewing solids
D) Using utensils
A
A
5
Q
What is a common intervention for children with sensory processing disorders affecting feeding?
A) Medication
B) Family therapy
C) Sensory play
D) Surgical intervention
A
C
6
Q
The suck-swallow-breath sequence is developed by:
A) 32-34 weeks gestation
B) 1 month
C) 6 months
D) 12 months
A
A
7
Q
Which term describes the repetitive up-and-down biting that occurs when gums are touched?
A) Phasic bite
B) Rotary chew
C) Reflexive chew
D) Soft chew
A
A
8
Q
Early gag reflex in infants typically subsides by:
A) 3 months
B) 6-9 months
C) 12 months
D) 18 months
A
B
9
Q
At what age are soft table foods typically introduced?
A) 6 months
B) 9-10 months
C) 13-14 months
D) 18 months
A
C
10
Q
Attachment and bonding are most influenced by:
A) Feeding frequency
B) Physical and emotional proximity
C) Parental income level
D) Presence of siblings
A
B
11
Q
When assessing oral motor skills, symmetry is most relevant to:
A) Jaw strength
B) Lip closure
C) Tongue movement
D) All of the above
A
D
12
Q
A child avoiding food after a few bites may indicate:
A) Taste preference
B) Early satiety
C) Texture aversion
D) Nutritional deficiency
A
C
13
Q
What intervention is recommended for jaw stability during feeding?
A) Straws only
B) Lateral placement of food
C) No intervention needed
D) Feeding therapy only
A
B
14
Q
A multidisciplinary approach is best for treating:
A) Pediatric dysphagia
B) Simple feeding issues
C) Routine health check-ups
D) Social skills development
A
A
15
Q
What is considered a “red flag” in feeding concerns?
A) Only drinking from a bottle after age 3
B) Eating a varied diet
C) Preferring vegetables over fruit
D) Drinking water frequently
A
A
16
Q
Silent aspiration may be indicated by:
A) Coughing after eating
B) Frequent respiratory infections
C) Eating only soft foods
D) Enjoying drinking from a straw
A
B
17
Q
Sensory play can be beneficial for children who are:
A) Avoidant of food textures
B) Eating a balanced diet
C) Exhibiting no feeding issues
D) Undergoing medical procedures
A
A
18
Q
What is an example of an early feeding skill?
A) Sipping from a cup
B) Spoon feeding with minimal loss
C) Bottle or breast feeding
D) Using a fork
A
C
19
Q
When introducing new foods to children with feeding issues, it is important to:
A) Use only the new food at mealtime
B) Introduce it slowly and repeatedly
C) Avoid their preferred foods
D) Serve in large portions
A
B
20
Q
“Family-style” meals can help improve:
A) Parent-child interaction
B) Texture aversion
C) Weight gain
D) Oral motor skills
A
A
21
Q
“Food chaining” involves:
A) Presenting only preferred foods
B) Gradually introducing new foods similar to preferred ones
C) Restricting certain food groups
D) Rewarding with food
A
B
22
Q
Excessive drooling during feeding may suggest:
A) Poor lip closure
B) Gag reflex
C) Proper motor control
D) Adequate hydration
A
A
23
Q
Sucking on a pacifier is considered:
A) Non-nutritive sucking
B) An ineffective method for feeding
C) Oral aversion
D) A gag reflex response
A
A
24
Q
Children typically begin to self-feed using a spoon at:
A) 3 months
B) 6 months
C) 12 months
D) 18 months
A
C
25
Which is a recommended positioning guideline during feeding?
A) Leaning forward with back unsupported
B) Sitting with hips, knees, and feet at 90-degree angles
C) Reclined at a 45-degree angle
D) Standing upright
B
26
If a parent reports that their child has difficulty transitioning to textured foods, the best recommendation would be to:
A) Introduce all textures at once
B) Use sensory play with different textures before meals
C) Force the child to eat the food
D) Restrict the child’s diet
B
27
A child with limited lip closure often spills food. What intervention is most appropriate?
A) Use smaller utensils
B) Place food at the sides of the mouth
C) Increase jaw strength exercises
D) Restrict the amount of food
B
28
If a child is coughing frequently during meals, which assessment should be considered?
A) Vision screening
B) Videofluoroscopy
C) Psychosocial assessment
D) Literacy assessment
B
29
To help an infant develop a mature suck-swallow-breath pattern, parents should be advised to:
A) Use a bottle only when crying
B) Avoid pacifiers
C) Encourage regular bottle or breast feeding
D) Introduce solids early
C
30
A child refusing to try new foods may benefit from:
A) Extended fasting periods
B) Sensory play with the food
C) Limiting options at meals
D) Offering only pureed foods
B
31
If a child shows frequent signs of aspiration, like coughing and watery eyes during meals, the next step should be to:
A) Ignore the symptoms
B) Recommend high-calorie drinks
C) Refer for a swallow study
D) Encourage more solid foods
C
32
A parent reports that their toddler struggles with spoon feeding and often throws food. Which strategy could help improve this behavior?
A) Only offer finger foods
B) Introduce imaginative play with the spoon
C) Give large portions at each meal
D) Avoid using a spoon until age 3
B
33
When an infant is overly sensitive to different textures, the best approach might be:
A) Enforce strict rules at mealtime
B) Introduce new textures gradually
C) Ignore any feeding difficulties
D) Replace all foods with liquids
34
For a child showing signs of oral aversion, an effective intervention could be:
A) Oral motor exercises with toys that encourage mouth exploration
B) Limiting all food interactions to prevent discomfort
C) Offering only pureed foods indefinitely
D) Avoiding all non-preferred foods
A
35
If a parent has difficulty getting their child to eat enough at meals, which intervention might you suggest?
A) Calorie and hydration tracking over a 7-day period
B) Offering fewer meals per day
C) Completely removing preferred foods
D) Reducing all meal portion sizes
A
36
A child consistently pockets food in their cheeks. Which strategy can help address this behavior?
A) Lateral food placement with verbal reminders to swallow
B) Serving only liquids
C) Decreasing mealtime duration
D) Offering harder foods to chew
A
37
For a toddler struggling with chewing, the recommended developmental approach would be:
A) Moving directly to harder textures
B) Offering foods with a meltable consistency
C) Focusing on liquids only
D) Avoiding food exploration outside of meals
B
38
If a parent notices their child shows a preference for very specific foods, it’s advisable to:
A) Limit preferred foods to prevent dependency
B) Offer small amounts of new foods alongside preferred ones
C) Rotate all foods every day
D) Use only the preferred foods at all meals
B
39
What action is best if a child repeatedly refuses food when offered on a plate with non-preferred foods?
A) Continue to present a small amount of a preferred food with each meal
B) Serve only non-preferred foods until they adjust
C) Avoid serving food on a plate altogether
D) Offer only preferred foods for the next few days
A
40
A child with sensory sensitivities to food textures is likely to benefit from which intervention prior to meals?
A) Avoiding all tactile play
B) Engaging in sensory play activities with dry-to-wet textures
C) Serving all foods pureed
D) Introducing challenging textures immediately
B
41
If a child shows excessive drooling, especially with cup drinking, what oral motor skill should be addressed?
A) Tongue control only
B) Jaw stability
C) Lip closure
D) Only head positioning
C
42
What approach should be used if a child avoids family meals and prefers eating alone?
A) Encourage family-style meals to increase positive social interactions with food
B) Limit the child’s food options further
C) Allow the child to eat in isolation indefinitely
D) Stop serving preferred foods to reduce preference
A
43
Which positioning strategy is beneficial for a child with postural difficulties during feeding?
A) Reclining back at a 45-degree angle
B) 90-90-90 position (hips, knees, and feet at 90 degrees)
C) Sitting cross-legged on the floor
D) Standing on tiptoes
B
44
A parent asks for guidance on using reward systems to encourage trying new foods. A helpful strategy is:
A) Using food rewards to reinforce eating
B) Avoiding any type of reinforcement
C) Using non-food rewards like bubbles or toys to encourage tasting new foods
D) Only rewarding with electronic devices
C
45
If a child has a preference for puree textures and resists progressing to solids, what is the best next step?
A) Continue offering purees indefinitely
B) Gradually introduce solids of similar taste but slightly firmer texture
C) Switch directly to hard, crunchy foods
D) Offer no options until solids are accepted
B
46
What is a key indicator of silent aspiration in children?
A) Refusal to eat vegetables
B) Recurrent upper respiratory infections
C) Preference for crunchy foods
D) Quick eating speed
B
47
The practice of “food chaining” involves:
A) Using one preferred flavor repeatedly
B) Incrementally introducing new foods similar to a child’s preferred items
C) Restricting food choices to build hunger
D) Introducing entirely different textures and flavors at each meal
B
47
A child with reduced jaw stability would benefit most from:
A) Lateral food placement for chewing practice
B) Pureed food only
C) Faster-paced meals
D) Solid foods only
A
48
To assist a child with minimal food acceptance, it can be helpful to:
A) Allow preferred foods on the plate as a “safe” option
B) Present only new foods
C) Eliminate preferred foods
D) Reduce all portion sizes
A
49
If a parent struggles with their child not gaining weight, a useful tool is:
A) Providing fewer, more nutrient-dense foods
B) Calorie and hydration counts over a week to monitor intake
C) Restricting the child’s snacks
D) Increasing portion sizes without tracking
B
50
Describe the three phases of swallowing and identify which is under voluntary control.
1. oral phase (voluntary control)- prepares and moves food to the back of the mouth.
2. pharyngeal phase- initiates the swallow reflex
3. esophageal phase- moves the bolus to the stomach
51
What is the difference between suckling and sucking in infants?
* Suckling is the early feeding pattern involving the jaw and tongue with a good seal around the nipple, typical from birth to around 6 months.
* Sucking, which emerges around 6-9 months, uses more lip and cheek movement with less jaw involvement.
52
At what age does spoon feeding typically begin, and what skills does it require?
**4-6 months **
1. **requires head control**
2. **open mouth for spoon acceptance**
3. **early lip and tongue coordination** to move food to the back of the mouth.
53
List two signs that might indicate a child is aspirating during feeding.
* coughing or choking during meals
* frequent respiratory infections.
54
What are “red flags” in feeding that might require further evaluation by a specialist?
Nuemonic: Franklin Ate Donuts Frequent
* frequent coughing or choking
* aversion to textured foods
* difficulty moving beyond baby foods
* frequent respiratory infections that might indicate aspiration.
55
Why is the 90-90-90 positioning recommended during feeding, and what does it mean?
* provides stability and promotes safe swallowing
* better posture, which supports effective feeding and reduces the risk of aspiration.
55
Explain the concept of “food chaining” and its purpose.
**Food chaining is a technique that introduces new foods **(that are similar in flavor, texture, or appearance) **to a child’s preferred foods, gradually increasing variety while reducing food aversions.**
56
What role does sensory play have in pediatric feeding interventions?
helps children become more comfortable with different textures, smells, and tastes, reducing aversion and promoting a positive experience with food.
57
Why is non-nutritive sucking important for infants?
* important for soothing, regulation, and oral motor development
* helps infants develop a rhythmic suck-swallow-breath pattern.
58
What is silent aspiration, and why can it be dangerous?
* Silent aspiration is when food or liquid enters the airway without coughing or obvious signs.
* It can lead to respiratory infections or pneumonia because the child may not show symptoms immediately.
59
What is the purpose of calorie and hydration counts in pediatric feeding?
* helps track a child’s nutritional intake over time
* ensures they are meeting growth and health goals
* provides data for planning interventions.
59
Describe an intervention that can help improve jaw stability in children with feeding difficulties.
**Lateral placement of food or chew tubes **can encourage children to practice chewing, which strengthens jaw stability.
60
Why might a family-centered approach be beneficial in feeding therapy?
* improving carryover at home
* addressing family concerns
* creating a supportive environment for the child
61
How does introducing new textures gradually benefit children with feeding difficulties?
Gradual introduction helps children become accustomed to new sensations
62
What is an oral motor skill that can be assessed to evaluate feeding readiness in infants?
**Lip closure** can be assessed to determine if an infant can effectively manage food and prevent excessive drooling or food loss, indicating feeding readiness.
63
Name 3 options in positionig strategies for motor interventions:
1. Adding towel rolls or foam wedges in the chair
2. Using booster seats in standard chairs
3. Use specialzed chair- Keekaroo highchair
64
What are 4 subtle sensory changes we make for food?
1. Shape
2. color
3. Taste
4. Texture
65
Explain what the Fading technique is
Process to introduce new flavors or similar/same foods by mixing in small amounts over time. Starting with 95% preferred and 5% new.
66
What is the 3-bite rule?
Allows child to get over the fear of the first bite so they can actually state whether they like it or not.
67
This type of video imaging uses ____ to capture the clients swallow with a variety of textures.
Videofluoroscopy (VFSS)
68
This type of video imaging is a nonradioactive alternate test and uses a tiny camera initiated through the nose and down the throat into the stoamch.
Fiberoptic endoscopy (FEES)
69
Name the characteristics of an **OTs role** in Feeding, eating, and swallowing
1. Practice framework defines FES
2. ____
3. Parent eduaction/Intervention
4. Adaptive equipment/ strategies
5. ____
6. ____
* Everday basic ADLs
* Advocacy
* swallowing-comfort level/training
70
Name the chracteristics of an OTs Goals in feeding, eating, and swallowing
1. ____
2. Adavancing from g-tube to oral feeding
3. ____
4. Tone reduction for oral preparation
5. ____
6. ____
7. Family education
* positioning and safety
* increase IND. with sel-feeding
* Increased oral intake
* increased diet selection
71
When should an OT refer to Speech Therapy?
1. second opinion
2. specific swallow tests
3. signs of aspiration
72
Match the medical diagnoses to the correct definition
73
Name the characteristics of the Oral Phase:
74
Name the characteristics of the pharyngeal phase:
75
Name the characteristics of the Esophageal phase?
76
Identify the patterns of spoon feeding:
1. Active upper and lower lips, suck pattern established, tongue moves independent of jaw
2. Suckle pattern & lips not active
3. Mouth opens for food; quiet tongue, Combo suck/suckle, Upper lip movement to remove food
A. Transitional pattern
B. Mature Pattern
C. Early/Immature Pattern
1. Mature Pattern- Active upper and lower lips, suck pattern established, tongue moves independent of jaw.
2. Early/Immature Pattern- Suckle pattern & lips not active.
3. Transitional Pattern- Mouth opens for food; quiet tongue, Combo suck/suckle, Upper lip movement to remove food.
77
Identify the patterns of Cup drinking
78
Identify patterns of biting in oral motor skills:
79
Identify the patterns of chewing in oral motor skills:
80
What Impacts attachment and bonding?
* Child born extremely premature
* Child born with Down syndrome (medical condtion)
* Child born full term with severe reflux
81
How can an OT Re-enforce bonding and attachment?
* Promote emotional/social support
* Promote positive support for mother
* Promote postive communication and trust
82
What type of approach is pediatric FES?
A Holistic Approach
83
# Typical feeding skills
Spoon feeding
84
# Typical feeding skills
At how many months should gag reflex be normal, but should subside?
85
# Typical feeding skills
Cup drinking
86
# Typical Feeding skills
Biting/chewing
87
# Introduction to foods
Match the age with the correct stage at which the baby should be eating
87
# Introduction to foods
Match the age with the correct stage at which the baby should be eating
88
# Intro to food
Match the age with the correct stage at which the baby should be eating
89
# Intro to food
Match the age with the correct stage at which the baby should be eating
90
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