Professional Documents
Culture Documents
Objectives
4,000,000 live births each year 250,000 premature (before 37 wks gestation)
GER
FTT
Structural Anomalies
Any anatomical deviation can impact feeding/swallowing process but a different anatomy does not always indicate a feeding/swallowing disorder.
Bottle feeding
Nipples
Stiffness/pliability Size Shape Opening
Lambs Nipple
Mead Johnson
Orthodontic Nipple
Haberman Feeder
Pigeon Nipple
Obturator
Mobius sequence
Freeman-Sheldon syndrome
Pierre-Robin sequence Treacher Collins syndrome Tracheoesophageal Fistula (TEF)
Laryngeal Cleft
Cerebral Palsy
Nonprogressive, motor function or posture disorder Onset in childhood Prenatal (fall, car accident, dietary issues, metabolic disorders, infection or toxins) Perinatal (during delivery, long labor, child stuck in birth canal, hypoxic injury to child, turned the wrong way, umbilical cord wrapped around childs neck, mother pelvic competency)
Post natal (CP vs TBI) Neurological damage Associated factors Mental retardation Hearing or processing Dental Vision Orthopedic Psychological Seizures Fractures and pain management Growth failures: height and weight problems
UCPA Statistics- incidence 1/250 live births
Differential Profiles of CP
Spastic
Most predominant form of CP (50-60% of cases) Frontal damage; premotor & motor cortex Problems with balance within muscle groups (agonist/antagonist) Flexion at wrists, knees, fingers, elbows Shoulders & hips adducted Aquinas- walks on tip toes Postural Tx: position at 90o angles to break tone Medical tx: medications, surgery
Profiles of CP (contd)
Flaccid
10% of CP cases rag doll/noodle; frog legs when supine Tx: seating system tilted back, but still at 90o; adductor bars/support for knees
Athetoid
20% of CP cases Dyskinesia present because of extrapyramidal involvement, but calm when sleeping Fluctuating tone; often co-occurs with intellectual impairment Tx: very difficult
Profiles of CP (contd)
Ataxic
~10% of CP cases Decreased proprioception Wide-based gait; rigid movements Decreased integration of motor programs Usually a fair to even good prognosis
Mixed
10-15% of CP cases Used when child has CP, but does not fit nicely into any other category
Drooling
AKA
Hypersalivation
Sialorrhea
Ptyalism Posterior drooling
Drooling Sequelae
Drooling Management
Pharmacology (e.g., antihistamines) Surgery (e.g., salivary gland resection) Dental visits
Other Considerations
The End