Feeding problems are common in children with special healthcare needs, and inquiring about feeding skills should be a routine part of the developmental assessment. Failure to meet normal feeding milestones, the presence of swallowing problems, and the presence or history of placement of a nasogastric or gastrostomy tube are all reasons to refer a child for a feeding evaluation. An interdisciplinary approach that includes the pediatrician along with a feeding team that includes a speech pathologist, occupational therapist, feeding-oriented nutritionist, and often others, should be taken to diagnose and manage feeding disorders in such children as early as possible for the best prognosis. However, caregivers also play a critical role in intervention, and effective management of feeding disorders should always be seen as a partnership between the caregiver and the interdisciplinary team. The additional benefit is the feeling of competence by the caregiver who is properly trained in the feeding of his/her special needs child. Providing caregivers with proper training as well as realistic goals, regular instruction for home practice, and the expectation for periodic setbacks, can help the child and the caregiver reap the most benefit from feeding intervention.
Background & Aims Poor sleep in young children imperils language learning and use. Both sleep and language problems are prevalent in early childhood. Speech-language pathologists are in a unique position to expand surveillance of sleep problems, which in turn may contribute to communication difficulties. We conducted a feasibility study of speech-language pathologist screening for behavioral sleep problems and sleep-disordered breathing symptoms at a multidisciplinary evaluation and treatment center. Methods Speech-language pathologists administered screeners to parents of 2–6-year-olds: the Short Form-Children's Sleep Habits Questionnaire (for behavioral sleep problems) which includes an item asking if the child has a sleep problem (yes/no), and the pediatric sleep questionnaire (for sleep-disordered breathing). Speech-language pathologists participated in pre- and post-screening focus groups. Pre-screening topics included professional preparation and clinical experience regarding pediatric sleep issues. Post-screening, speech-language pathologists provided feedback about the screening experience and feasibility of incorporating such screening into practice. Results Among 51 children, 31% (16/51) screened positive for sleep-disordered breathing, 78% for behavioral sleep problems (40/51), and 43% (12/28) per parent report. Parent-reported problems were associated with sleep-disordered breathing ( p = 0.00) but not behavioral sleep problems ( p = 0.24). During focus groups, speech-language pathologists reported no formal pediatric sleep training, high parent concern about sleep, and agreed that screening fit their professional mandate. Speech-language pathologists affirmed that the ≤15 min screenings integrated seamlessly into practice but that additional training, particularly for sleep-disordered breathing, was needed. Conclusions The prevalence of sleep problems in 2–6-year-olds presenting to speech-language pathologists was higher than in community samples, but consistent with data from young children with developmental disabilities. Speech-language pathologists endorsed the utility and feasibility of sleep problem screening and education in their clinical practice. Implications Integrating sleep problem screening and education into speech-language pathologist practice is feasible and could widen surveillance of both sleep problems and risk factors for developmental language disorders. Further research should include larger samples and other settings, e.g. home or school.
Date Presented 04/01/2022 Therapists explored the perceptions of caregivers of children with developmental disabilities who did, and did not. do telehealth and whether they found it feasible, effective, and supportive. Results show that telehealth can be effective if there is internet access, as well as effective communication between the caregiver and therapist. Our study indicates that therapists should be flexible during telehealth to accommodate for language barriers and children who have difficulty attending to telehealth. Primary Author and Speaker: Daniella Soba Additional Authors and Speakers: Carol Terilli, Sherly Kornhaber, Elizabeth Ridgway, Ida Barresi, Tamelly Jimenez
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