Dysphagia: Clinical Management in Adults and Children A 12-month-old-boy was ref
ID: 73619 • Letter: D
Question
Dysphagia: Clinical Management in Adults and Children
A 12-month-old-boy was referred for a clinical feeding evaluation. His medical history includes normal development, including feeding, through 11 months of age. He developed a high fever that led to seizures. These seizures were accompanied by vomiting and difficulty breathing. He was transferred to a medical facility by helicopter while in status epilepticus. The seizures were controllable by medication. He remained in the hospital for 17 days and returned home with a nasogastric feeding tube and developmental skills that had decreased to approximately a 4-month level. The NG tube is causing vomiting and must be replaced several times per week. He has no allergies. He is taking several medications to address the seizures and altered muscle tone. Of significance, the family recently lost another child, age 4 years, to significant medical complications associated with extreme prematurity.
What motor and feeding skills may this child have developed before the onset of his seizures?
Given his described current level of motor functioning, what feeding skills may be expected?
The mom is familiar with SLP therapy from her older child’s experience. She asks what type of dysphagia therapy you are planning to implement. Which pediatric therapy approach seems most appropriate to you and why?
Explanation / Answer
Based on the given data,
A disease that causes difficulty in swallowing due to damage of either esophagus or throat in children and older people (most probably) is called dysphagia. The causes of this condition are ineffective working of Central nervous system (CNS), especially the brain. Due to improper functionality of brain, the muscles of throat or esophagus become in contracted state and cannot allow food and drinks to reach the stomach.
The other diseases that cause dysphagia due to damage of CNS are as follows:
Other mouth diseases that cause dysphagia are as follows:
Form this medical history, he has normal feeding and normal development at 12 months age, but at 11 months he had seizures and he was taken medication and it is controllable. However, his feeding habits drops to back four months.
1)
The motor and feeding skills may this child have developed before the onset of his seizures is as follows (at 10 months):
2)
Feeding skills may be expected at current level (4 months):
3)
Give sturdy food with supervision to mouth and chew but that will not break into chunks (frozen bread, etc.)
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