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Assessing children's swallowing: Parent and professional perceptions
Purpose-For infants and children who have difficulties with eating, drinking and swallowing (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the instrumental method of assessment used to exclude or confirm aspiration. The purpose of this paper is to investigate parental and referrer perceptions of the reasons for and the outcomes of videofluoroscopy.
Design/methodology/approach-Data were gathered through the use of structured telephone interviews before and after videofluoroscopy.
Findings-Four key themes emerged: first, the importance of identifying specifically the problems with swallowing; second, understanding the rationale for videofluoroscopy; third, preparing a child for videofluoroscopy; and fourth, using videofluoroscopy to inform management. Referrers used videofluoroscopy to confirm their concerns about a child's ability to swallow safely.
Practical implications-Parents understood that the purpose of videofluoroscopy was to identify specific swallowing difficulties. They reported anxieties with managing the child's positioning during the procedure and whether the child would eat. They also had concerns about outcomes from the study. Some of these issues raise questions about the true value and benefits of videofluoroscopy.
Originality/value-This is the first study that considers parent views of an instrumental assessment. For some parents of children with learning disabilities, mealtimes are an important social occasion. Further studies that focus on decision making about children with learning disabilities who find feeding difficult are warranted as parents feel loss and disempowerment when decisions are made about non-oral feeding
Mastication and Oral Motor Function in McArdle Disease: Patient Reported Complaints
Background: Exertional myalgia and cramps of the limb and trunk muscles are typical in McArdle disease, but mastication
and oral motor limitations have not been systematically investigated before.
Objective: Determine the reported prevalence and characteristics of limitations on oral motor activities, mastication, swallowing,
and other oral motor activities in patients with McArdle disease.
Methods: An observational study was carried out in 28 patients using a standardised questionnaire on mastication and oral
motor function.
Results: 57% of the participants reported difficulties with mastication. Muscle cramps during mastication occurred in 57%
of the patients. A feeling that food remains in the throat occurred in 32%. Adaptations during mastication were needed in
42% of the patients. Mastication difficulties, muscle cramps during mastication and mastication adjustments were inversely
correlated with age (r2 = –0.445, p < 0.05; r2 = –0.509, p < 0.01; r2 = –0.456, p < 0.05). Feeling of food remaining in throat,
cramps during mastication and during other oral motor muscle activities, were correlated with disease severity (r2 = 0.476,
p < 0.01; r2 = 0.463, p < 0.01; r2 = 0.461, p < 0.01; r2 = 0.432, p < 0.05).
Conclusions: In short, reported mastication difficulties are prevalent in people with McArdle disease, most frequently in
younger people. Therefore, awareness of mastication and oral motor problems is require
International standardisation of the test of masticating and swallowing solids in children
The Test of Masticating and Swallowing Solids (TOMASS) is a validated assessment tool measuring the efficiency of solid bolus intake by four quantitative parameters: discrete bites, masticatory cycles, swallows and time to ingest a single cracker. A normative database for adults (20-80+ years) has previously been established. The objective of this study was to investigate the applicability and reliability of the TOMASS in children and adolescents (TOMASS-C) and to establish the normative database for this younger population. We collected data from 638 participants (male: 311, female: 327) in five age groups (4-18\ua0years) with five different but very similar test crackers in four countries. Significant effects of bolus type (cracker), age group and gender on the TOMASS parameters were identified, requiring stratification of the TOMASS-C database by these variables. Intra-rater reliability was excellent (ICC\ua0>\ua00.94) for all parameters; inter-rater reliability was moderate for "number of swallows" (ICC\ua0=\ua00.54), good for "bites" (ICC\ua0=\ua00.78) and "time" (ICC\ua0=\ua00.82), and excellent for "masticatory cycles" (ICC\ua0=\ua00.96). The "Test of Masticating and Swallowing Solids in Children (TOMASS-C)" was identified to be a reliable diagnostic tool for the comprehensive measurement of discrete oral stage components of solid bolus ingestion, standardised by a large normative database that covers age groups from preschoolers to young adults. While differences between gender groups were less pronounced than in the adult population, previous results relating to changes in masticatory and swallowing as a function of age are confirmed by our data
Dysphagia in children with neuromuscular disorders
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107646.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 25 april 2013Promotor : Geurts, A.C.H.
Co-promotores : Groot, I.J.M. de, Swart, B.J.M. d
Downsyndroom en slikken. Problemen in de orale, faryngeale en oesofageale fase.
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Motorisch leren in de ontwikkeling van eten en drinken, betekenis voor de logopedische behandeling
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Quantitative Ultrasound of Orofacial Muscles in Infants from 6 Months to 5 Years: Collecting Normal Values
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Logopedische diagnostiek van zuigen en slikken bij jonge kinderen.
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