Paediatric
Speech,Language and Feeding Therapy
Paediatric
Speech,Language and Feeding Therapy
What to Expect
Assessment and Treatment of Eating and Drinking Difficulties (Dysphagia)
The term 'Dysphagia' describes eating and drinking disorders which may occur in any of the three stages of swallowing. This includes difficulties with the positioning of food in the mouth, the oral movements including sucking, chewing and the process of swallowing. Eating and drinking difficulties can be associated with a number of conditions:
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Prematurity
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Neurological difficulties
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Infectious diseases
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Respiratory difficulties
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Cardiovascular difficulties
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Gastrointestinal difficulties
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Craniofacial conditions
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Congenital syndromes
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Learning difficulties
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Isolated eating and drinking difficulties related to sensory processing difficulties and sensitivities e.g. children with a traumatic feeding history or traumatic medical history
Risk Associated with Feeding Dificulties:
Children who do not receive timely and appropriate management of their feeding difficulties are at an increased risk of:
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Aspiration i.e. food entering the airway.
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Respiratory infection
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Choking
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Poor nutrition and weight loss
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Poor health
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Hospital admission due to respiratory illness
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Anxiety and distress within the family
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Reduced quality of life (RCSLT)
Treatment:
The treatment of feeding difficulties is a complex process and typically involves the implementation of a combination of strategies. These can include: diet modification, development of chewing skills, general feeding behavior modification, management of parental anxiety around meals.
All children are unique and therefore the treatment programme is designed to meet the child and the family’s needs. Reviews can be direct during a clinic visit or indirect via telephone or email, depending on the need of the child. Progress is carefully monitored and the programme adapted to optimize each child’s feeding potential in an efficient and effective manner. All treatment is based on evidence for effectiveness and efficiency.
Assessment:
All children referred for input regarding their feeding difficulties or dysphagia will undergo a detailed clinical feeding assessment by Analou (SLT) and a specialist paediatric dietitian. If your child is already under the care of a dietitian, the assessment will be done by Analou only.
An appointment will be arranged with the parents, which will allow the professionals to observe a meal time. It is important that the team involved is able to observe how your child feeds. For this purpose the assessment needs to happen at the time the child will be willing to feed. You be will asked to bring your child’s drink and/or food along to the appointment to ensure the clinical assessment is true reflection of meal times in the home environment.
The SLT and dietitian will ask you a range of questions regarding your child’s feeding history, nutritional intake, general development, general health and concerns regarding meal times. It is helpful to bring a video clip of a typical meal along to the appointment. This will provide the SLT with additional information regarding your child’s behaviour around meal times at home.
At the time of the assessment your child will be weighed and measured to determine how your child is growing. Please bring your child’s Red Book along to the appointment in order for the SLT and dietitian to get an impression of your child’s growth over time.
Following the assessment, the SLT will discuss her observations and assessment findings with you. She might recommend further objective assessment of swallow function with videofluorosocpy swallow study or perhaps a referral to other specialists for example paediatric psychologist or paediatric gastroenterologist.
Teletherapy: Video Conferencing
via Zoom
The use of technology in speech and language therapy and other health services have expanded exponentially over the last decade. Teletherapy via Zoom allows for easy access to quality speech and language and feeding therapy in cases where regular clinic visits are not an option. Travel time, distance and cost are no longer barriers to intervention. Research has also demonstrated no apparent loss of quality of intervention. All that is required is a good wifi/broadband connection and an adult to act as the therapists ‘hands’ to facilitate presentation and manipulation of therapy materials.
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You can download Teletherapy via Zoom.
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