Evidence to support treatment options for children with swallowing and feeding disorders: A systematic review

Gosa, Memorie M.; Carden, Hillary T.; Jacks, Courtney C.; Threadgill, Amy Y.; Sidlovsky, Tara C.

doi:10.3233/prm-170436

Cited by 26 publications

(12 citation statements)

References 72 publications

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“…As detailed in Table 3, the use of more than one treatment methods was observed in every treatment study. This multi-modal finding is consistent with results of both narrative and systematic reviews identified in our literature search, many of which suggest that sensorimotor interventions for chewing dysfunction most often involve a variety of methods, including oral motor exercises, sensory stimulation, consistency changes, positioning and mealtime modifications to name a few (Arvedson, 1998;Gosa & Dodrill, 2017;Gosa, Carden, Jacks et al, 2017).…”

Section: Naturesupporting

confidence: 85%

Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review

Wilson

Simione

Polley

2021

Intl J Lang & Comm Disor

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Background: Chewing dysfunction can have adverse effects on growth, development and quality of life. There is a lack of evidence-based consensus guidelines for sensorimotor intervention. To address this, we need to understand the current state of the science in clinical sensorimotor interventions for paediatric chewing dysfunction and systematically plan a research agenda and priorities for the field. Aims: The purpose of this scoping review was to examine the extent, range and nature of evidence for oral sensorimotor interventions for paediatric chewing dysfunction. Methods & Procedures: This scoping review entailed five phases that included: identification of the research question; identification of relevant studies; study selection; data charting; and collation, summarization and report of the results.Treatment studies that were peer-reviewed and written in English were included. All studies involved a paediatric population and included an oral sensorimotor and/or chewing intervention. Information regarding study design, population, intervention, comparator, outcome measures and findings were extracted. Main Contribution: Of the 21 studies included in this scoping review, 53% were specific to children with cerebral palsy. All interventions were multi-component in nature and the treatment studies included a range of study designs, but few were controlled trials with comparators. A wide variety of outcomes measures were used within and across studies to determine treatment effectiveness. Conclusions & Implications:The findings suggest that in a small number of studies, sensorimotor interventions provide preliminary evidence for effectiveness in specific populations. These and other treatment protocols must be trialled in additional clinical populations and settings to improve the evidence base for sensorimotor treatment of paediatric chewing dysfunction. This review also serves to help prioritize research agendas and further motivates the need for consensus-based clinical guidelines for paediatric chewing treatment.

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Section: Naturesupporting

confidence: 85%

Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review

Wilson

Simione

Polley

2021

Intl J Lang & Comm Disor

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“…These results complement and add to prior studies in this field. Few studies have evaluated the impact of feeding interventions on improvement in symptoms and outcomes in any type of oropharyngeal dysphagia (25). Jackson showed symptom improvements from feeding interventions in a population of Down syndrome patients with aspiration (30).…”

Section: Discussionmentioning

confidence: 99%

Feeding Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration

Duncan¹,

Larson²,

Davidson

et al. 2019

J. pediatr. gastroenterol. nutr.

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Objectives: To determine if children with laryngeal penetration on videofluoroscopic swallow study (VFSS) who received feeding interventions (thickened liquids, change in liquid flow rate and/or method of liquid delivery) had improved symptoms and decreased hospitalizations compared to those without intervention. Methods: We performed a retrospective cohort study of children under 2 years with laryngeal penetration on VFSS at our institution in 2015 to determine initial and follow-up VFSS findings, symptom improvement at follow-up, and hospitalization risk before and after VFSS. Proportions were compared with Fisher's exact test and hospitalizations with paired t-tests. Results: We evaluated 137 subjects with age 8.93±0.59 months who had laryngeal penetration without aspiration on VFSS. 55% had change in management, with 40% receiving thickening and 15% a change in flow rate. There was significant improvement in symptoms for children that had feeding intervention and this improvement was greatest with thickening (OR 41.8, 95% CI 12.34-141.69, p<0.001). On repeat VFSS, 26% had evidence of aspiration that was not captured on initial VFSS. Subjects had decreased total and pulmonary hospitalizations with feeding intervention and decreased pulmonary nights with thickening (p<0.05). Conclusions: Laryngeal penetration appears to be clinically significant in children with oropharyngeal dysphagia and interventions to decrease its occurrence are associated with improved outcomes including decreased symptoms of concern and hospitalization nights. Thickening or other feeding intervention should be considered for all symptomatic children with laryngeal penetration on swallow study.

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“… 12 Level of evidence was low with only a few large randomized controlled trials published and none of these including adolescents. 12 Another review from 2020 concentrating only on management of ARFID found equally little evidence to support any particular treatment modality. 18 …”

Section: Discussionmentioning

confidence: 99%

“…Evidence on management of non‐organic swallowing difficulties in older children is scarce. A systematic review of articles published before the end 2015 identified 61 studies reporting intervention strategies for pediatric dysphagia covering oral motor, sensory, pharmaceutical and behavioral domains 12 . Level of evidence was low with only a few large randomized controlled trials published and none of these including adolescents 12 .…”

Section: Discussionmentioning

confidence: 99%

“…An intense behavioral treatment program was commenced. There is currently no evidenced‐based treatment for functional dysphagia, 12 but on the basis of previous cases with younger children, the Sequential Oral Sensory (SOS) feeding approach was initiated. 13 After a pre‐treatment session, where the action of eating and swallowing was explained anatomically and physiologically with a model, it was decided that the patient should come to the SLP clinic twice per week for 4 weeks.…”

Section: Case Presentationmentioning

confidence: 99%

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Swallowing difficulties in adolescents: A case report and suggestion of treatment model

Lindh

Selander

Kukka

2022

Clinical Case Reports

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Evidence to support treatment options for children with swallowing and feeding disorders: A systematic review

Cited by 26 publications

References 72 publications

Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review

Paediatric oral sensorimotor interventions for chewing dysfunction: A scoping review

Feeding Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration

Swallowing difficulties in adolescents: A case report and suggestion of treatment model

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