Characteristics of dysphagia in children with cerebral palsy

Abstract

Videofluoroscopic modified barium swallow (VMBS) examinations may provide clinically relevant information regarding deglutition in children with cerebral palsy and dysphagia. A retrospective review of clinical evaluations and VMBS studies on 90 consecutive children with cerebral palsy and dysphagia was completed. Most children were referred because of concerns regarding airway protection during oral feedings. Most children had multiple disabilities and 93% were nonambulatory. The majority of children were totally dependent for oral feedings (80%). Oral and pharyngeal phase abnormalities were present in almost all patients. Abnormalities of deglutition were observed only while swallowing specific food textures in the majority of patients. Aspiration of specific food textures was significantly more common than aspiration of all food textures (p < 0.0001). Finally, aspiration was silent in 97% of the patients. VMBS studies can provide clinicians with valuable information regarding the most appropriate food textures and rates of oral feeding for children with cerebral palsy and dysphagia.

Medical, surgical, and health outcomes of gastrostomy feeding

“…Estimates of frequency of aspiration in this population range from 31 to 97% (Gisel and Patrick 1988, Mirrett et al 1994, Rogers et al 1994, Wright et al 1996, whereas gastro-oesophageal reflux is reported in 32 to 75% (Abrahams and Burkitt 1970, Reyes et al 1993, Gustafsson and Tibbling 1994.…”

Restriction of oral intake of water for aspiration lung disease in children

“…Primary aspiration is commonly seen in infants and children with feeding and swallowing problems associated with neurological disease, anatomical anomalies and other aetiologies (Weiss 1988;Arvedson 1994;Colombo 1999). Short term manifestations of pulmonary aspiration are cough, wheeze, increased number and prolonged respiratory infections and atelectasis (Colombo 1999;Loughlin 1994).…”

“…Fluid consistencies are the most commonly aspirated material in people with swallowing dysfunction (Arvedson 1994;Rogers 1994;Taniguchi 1994;Morton 1999;Friedman 2000;Lefton-Greif 2000). In the case of thin fluids, texture restriction may entail eliminating the thin fluids from a person's diet and allowing thickened fluids to be orally consumed (Logemann 1983;Newman 2000).…”

Risk owners and risk managers: Dealing with the complexity of feeding children with neurodevelopmental disability

“…(Reilly, Skuse & Poblette 1996;Reyes et al1993;Gisel & Patrick 1988). In some cases oral feeding is considered unsafe, due to high rates of oral aspiration (ie food and secretions are transported into the airway), with implications for the child's respiratory health, including the risk of chest infections and aspiration pneumonia (Rogers et al 1994).…”