Complex Feeding & Swallowing Problems in Children… – Angela Mansolillo

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Developing a Menu for SuccessDeveloping a Menu for Success

The causes of feeding and swallowing difficulties in children are always multifaceted, sometimes misdiagnosed, and often difficult to assess and treat appropriately.The causes of feeding and swallowing difficulties in children are always multifaceted, sometimes misdiagnosed, and often difficult to assess and treat appropriately.

Respiratory difficulties, gastrointestinal function, oral-motor skills, and behavioral issues are just a few of the elements that can influence feeding and swallowing, limit response to treatment, and result in significant health issues.Respiratory difficulties, gastrointestinal function, oral-motor skills, and behavioral issues are just a few of the elements that can influence feeding and swallowing, limit response to treatment, and result in significant health issues.

To maximize effectiveness, clinicians must resist the temptation to assess and treat feeding and swallowing disorders in isolation; instead, they must develop management plans that take into account interactions between and among oral-motor, gastrointestinal, and respiratory systems.To maximize effectiveness, clinicians must resist the temptation to assess and treat feeding and swallowing disorders in isolation; instead, they must develop management plans that take into account interactions between and among oral-motor, gastrointestinal, and respiratory systems.

This essential course recording describes complex feeding and swallowing disorders as they manifest themselves in children who have a variety of diagnoses.This essential course recording describes complex feeding and swallowing disorders as they manifest themselves in children who have a variety of diagnoses.

Attendees gain successful strategies for identification of the underlying etiology of the dysphagia. The evidence base for specific therapies, including oral-motor techniques, behavioral interventions, nutritional interventions, and strategies for respiratory control, are evaluated.Attendees gain successful strategies for identification of the underlying etiology of the dysphagia. The evidence base for specific therapies, including oral-motor techniques, behavioral interventions, nutritional interventions, and strategies for respiratory control, are evaluated.

Arm yourself with practical suggestions and tactics for improving function in these challenging children, as well as strong evidence to support those strategies!Arm yourself with practical suggestions and tactics for improving function in these challenging children, as well as strong evidence to support those strategies!

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1. Examine the interplay between oral-motor, gastrointestinal, and respiratory systems and their impact on food refusal in children in order to expand volume and variety of intake.Examine the interplay between oral-motor, gastrointestinal, and respiratory systems and their impact on food refusal in children in order to expand volume and variety of intake.
2. Identify the signs and symptoms of pharyngeal dysphagia in children to prevent aspiration associated illnesses.Identify the signs and symptoms of pharyngeal dysphagia in children to prevent aspiration associated illnesses.
3. Pinpoint advantages and challenges associated with dietary modifications and use of thickened liquids with a goal of increasing safe oral intake.Pinpoint advantages and challenges associated with dietary modifications and use of thickened liquids with a goal of increasing safe oral intake.
4. Discuss the rationale for various dietary recommendations currently being implemented with children in order to separate fact from fiction about special diets.Discuss the rationale for various dietary recommendations currently being implemented with children in order to separate fact from fiction about special diets.
5. Determine the pros and cons of various oral-motor & sensory treatment approaches to maximize safe, pleasurable eating and drinking in children.Determine the pros and cons of various oral-motor & sensory treatment approaches to maximize safe, pleasurable eating and drinking in children.
6. Develop a behavioral treatment plan to address problem feeding behaviors including food refusal, limited food repertoire, low volume of intake, and rigidity around foods and utensils.Develop a behavioral treatment plan to address problem feeding behaviors including food refusal, limited food repertoire, low volume of intake, and rigidity around foods and utensils.

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RESPIRATORY SYSTEM DEVELOPMENT AND FUNCTIONSRESPIRATORY SYSTEM DEVELOPMENT AND FUNCTIONS

• You Can’t Eat If You Can’t BreatheYou Can’t Eat If You Can’t Breathe
• Breathing/Swallowing Coordination and DiscoordinationBreathing/Swallowing Coordination and Discoordination
• Role of pulmonary clearanceRole of pulmonary clearance
• Aspiration and aspiration pneumoniaAspiration and aspiration pneumonia
• Incorporate respiratory indicators in evaluationIncorporate respiratory indicators in evaluation
• Exercise Interventions for breathing/ swallow discoordination and respiratory insufficienciesExercise Interventions for breathing/ swallow discoordination and respiratory insufficiencies

PHARYNGEAL DYSPHAGIAPHARYNGEAL DYSPHAGIA

• Clinical assessment matters!Clinical assessment matters!
• Instrumental assessment optionsInstrumental assessment options
• Improving pharyngeal swallow functionImproving pharyngeal swallow function
• Interventions to decrease aspiration riskInterventions to decrease aspiration risk
• Dietary modifications – texture modifications and thick liquids pros and consDietary modifications – texture modifications and thick liquids pros and cons
• Oral hygieneOral hygiene
• Interactive case review – What your client’s gut is telling youInteractive case review – What your client’s gut is telling you

GI SYSTEM DEVELOPMENTGI SYSTEM DEVELOPMENT

• GI system and respiration connectionGI system and respiration connection
• Reflux and Reflux DiseaseReflux and Reflux Disease
• ConstipationConstipation
• AllergiesAllergies
• Dietary and lifestyle interventionsDietary and lifestyle interventions
• Food allergies and the gutFood allergies and the gut
• Positioning and sleepPositioning and sleep

ORAL MOTOR FUNCTIONORAL MOTOR FUNCTION

• Postural stability mattersPostural stability matters
• Oral muscles are not skeletal musclesOral muscles are not skeletal muscles
• Exercise Interventions – are they right for your clientExercise Interventions – are they right for your client

SENSORY PROCESSING AND EATING – CAN’T HAVE ONE WITHOUT THE OTHERSENSORY PROCESSING AND EATING – CAN’T HAVE ONE WITHOUT THE OTHER

• Food as therapyFood as therapy
• The role of taste and smellThe role of taste and smell
• Strategies – how to expand food repertoireStrategies – how to expand food repertoire

WHEN IT REALLY IS BEHAVIORWHEN IT REALLY IS BEHAVIOR

• What’s the behavior’s form AND functionWhat’s the behavior’s form AND function
• Examining the feeding environmentExamining the feeding environment
• Finding the right reinforcement strategyFinding the right reinforcement strategy
• Behavioral intervention in 5 steps:Behavioral intervention in 5 steps:
• Environment, hunger, reinforcement, shaping and parent trainingEnvironment, hunger, reinforcement, shaping and parent training
• Interactive case review – when it’s behavior…but not just behaviorInteractive case review – when it’s behavior…but not just behavior

WEANING FROM TUBE FEEDINGWEANING FROM TUBE FEEDING

• Priming the GutPriming the Gut
• Rapid vs. Gradual weansRapid vs. Gradual weans
• Blended dietsBlended diets
• Strategies for Tube Feed WeaningStrategies for Tube Feed Weaning
• Blended diets – when and whoBlended diets – when and who

MORE NUTRITIONAL INTERVENTIONS for Pharyngeal Dysphagia, GI Development, Oral Motor Function, Sensory Processing, Behavior and Tube FeedingMORE NUTRITIONAL INTERVENTIONS for Pharyngeal Dysphagia, GI Development, Oral Motor Function, Sensory Processing, Behavior and Tube Feeding

• Nutrition and immune system functionNutrition and immune system function
• SupplementsSupplements
• Which special diets are really specialWhich special diets are really special
• Techniques to improve nutrition Techniques to improve nutrition 

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