The aim of this study was to describe the experience of 452 children and adults with a severe developmental disability who presented to a multidisciplinary clinic with swallowing, nutritional, and gastrointestinal problems. Data were obtained by chart review. Two hundred and ninety-four children (age range 7mo-19y, 173 males, 121 females) and 158 adults (age range 18-53y; 90 males, 68 females) were assessed over 5 years. One hundred and eighty-two children and 86 adults had cerebral palsy. Approximately 90% were wheelchair dependent and totally dependent on caregivers for feeding; 60% had epilepsy. Pulmonary aspiration was identified by oesophageal videofluoroscopy in 41% of 174 children and 47% of 34 adults. Chronic oesophagitis and Helicobacter pylori were found in 57% of 182 children and 76% of 66 adults undergoing endoscopy. Chronic suppurative lung disease was identified by computerized axial tomography in 94% of 62 children and all six adults studied. Most patients improved with simple interventions.

BMC Bone mineral content TBP Total body protein SDS Standard deviation score AIM The aim of this study was to investigate the effect of gastrostomy tube feeding on body protein and bone mineralization in malnourished children with cerebral palsy (CP).METHOD Children aged between 4 and 18 years with spastic quadriplegic CP (Gross Motor Function Classification System level V) were recruited from the Children's Hospital at Westmead to participate in this prospective cohort study. The children had measurements of anthropometry (weight, height, and skinfold), bone mineral content (BMC) by dual-energy X-ray absorptiometry, and total body protein (TBP) by neutron activation analysis before and after gastrostomy tube feeding. Comparison data were collected prospectively from age-matched healthy children and extracted from databases for this study.

Serious complications were uncommon in this series of antireflux surgery in neurologically impaired children. Although gagging and retching were common following surgery, a high percentage of caregivers reported improved nutrition, reflux-related symptoms, and high levels of satisfaction.

Body protein in children with SQCP is significantly reduced for age and height. Skinfold anthropometry and DXA show wide variation in estimation of body protein compared with NAA in this group of children.