Additional Information
Book Details
Abstract
Develop the understanding and clinical reasoning skills you’ll need to confidently manage dysphagia in professional practice! This logically organized, evidence-based resource reflects the latest advancements in dysphagia in an approachable, student-friendly manner to help you master the clinical evaluation and diagnostic decision-making processes. Realistic case scenarios, detailed review questions, and up-to-date coverage of current testing procedures and issues in pediatric development prepare you for the conditions you’ll face in the clinical setting and provide an unparalleled foundation for professional success.
- Comprehensive coverage addresses the full spectrum of dysphagia to strengthen your clinical evaluation and diagnostic decision-making skills.
- Logical, user-friendly organization incorporates chapter outlines, learning objectives, case histories, and chapter summaries to reinforce understanding and create a more efficient learning experience.
- Clinically relevant case examples and critical thinking questions throughout the text help you prepare for the clinical setting and strengthen your decision-making skills.
- Companion Evolve Resources website clarifies key diagnostic procedures with detailed video clips.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Half title page | i | ||
| Evolve page | ii | ||
| Dysphagia | iii | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Dedication | vi | ||
| Preface | vii | ||
| Table Of Contents | ix | ||
| I Foundations | 1 | ||
| 1 Dysphagia Unplugged | 1 | ||
| Chapter Outline | 1 | ||
| Objectives | 1 | ||
| What is Dysphagia? | 1 | ||
| Incidence and Prevalence | 3 | ||
| Prevalence by Setting | 3 | ||
| Community | 4 | ||
| Acute and Chronic Geriatric Care | 4 | ||
| Acute General Hospitals | 4 | ||
| Acute Rehabilitation Unit | 4 | ||
| Special Populations | 4 | ||
| Stroke | 4 | ||
| Head and Neck Cancer | 5 | ||
| Head Injury | 5 | ||
| Progressive Neurologic Disease | 6 | ||
| Parkinson’s Disease. | 6 | ||
| Amyotrophic Lateral Sclerosis. | 6 | ||
| Multiple Sclerosis. | 6 | ||
| Myasthenia Gravis. | 6 | ||
| Muscular Dystrophy. | 6 | ||
| Polymyositis and Dermatomyositis. | 6 | ||
| Rheumatoid Arthritis. | 6 | ||
| Scleroderma. | 7 | ||
| Sjögren’s Syndrome. | 7 | ||
| Dementia. | 7 | ||
| Developmental Disability. | 7 | ||
| Mental Illness. | 7 | ||
| Phagophobia. | 7 | ||
| Premature Infants. | 7 | ||
| Spinal Cord Injury. | 8 | ||
| Consequences of Dysphagia | 8 | ||
| Medical Consequences | 8 | ||
| Psychosocial Consequences | 8 | ||
| Clinical Management | 9 | ||
| Clinical Examination | 9 | ||
| Imaging Examination | 9 | ||
| Treatment Options | 9 | ||
| Who Manages Dysphagia? | 10 | ||
| Speech-Language Pathologist | 10 | ||
| Otolaryngologist | 11 | ||
| Gastroenterologist | 11 | ||
| Radiologist | 11 | ||
| Neurologist | 12 | ||
| Dentist | 12 | ||
| Nurse | 12 | ||
| Dietitian | 12 | ||
| Occupational Therapist | 12 | ||
| Neurodevelopmental Specialist | 12 | ||
| Pulmonologist and Respiratory Therapist | 12 | ||
| Levels of Care | 13 | ||
| Acute Care Setting | 13 | ||
| Neonatal Intensive Care Unit | 13 | ||
| Subacute Care Setting | 14 | ||
| Rehabilitation Setting | 14 | ||
| Skilled Nursing Facility | 14 | ||
| Home Health | 15 | ||
| Take Home Notes | 15 | ||
| References | 16 | ||
| II Dysphagia in Adults | 19 | ||
| 2 Normal Swallowing in Adults | 19 | ||
| Chapter Outline | 19 | ||
| Objectives | 19 | ||
| Normal Anatomy | 20 | ||
| Oral Preparatory Stage | 21 | ||
| Oral/Pharyngeal Stage | 22 | ||
| Esophageal Stage | 24 | ||
| Normal Physiology | 24 | ||
| Oral Preparation | 26 | ||
| Oral Stage | 27 | ||
| Respiration and Swallow | 27 | ||
| Pharyngeal Stage | 27 | ||
| Esophageal Stage | 29 | ||
| Bolus and Delivery Variation | 30 | ||
| Volume and Biomechanics | 31 | ||
| Viscosity | 31 | ||
| Swallow and Normal Aging | 32 | ||
| Oral Stage and Aging | 32 | ||
| Pharyngeal Stage and Aging | 33 | ||
| Esophagus and Aging | 33 | ||
| Neurologic Controls of Swallowing | 34 | ||
| Peripheral and Medullary Controls | 34 | ||
| Supranuclear Swallowing Controls | 38 | ||
| Take Home Notes | 38 | ||
| References | 38 | ||
| 1 Causes and Characteristics of Dysphagia | 41 | ||
| 3 Adult Neurologic Disorders | 41 | ||
| Chapter Outline | 41 | ||
| Objectives | 41 | ||
| Preliminary Considerations: Swallowing Symptoms and Neurologic Deficits | 41 | ||
| Brief Overview of Functional Neuroanatomy Relative to Swallowing Functions | 42 | ||
| Cortical Functions | 42 | ||
| Cortical Functions and Swallowing Impairment | 43 | ||
| Issues of Unilateral versus Bilateral Hemispheric Lesions | 43 | ||
| Swallowing Deficits in Hemispheric Stroke Syndromes | 44 | ||
| Treatment Considerations | 46 | ||
| Swallowing Deficits in Dementia | 49 | ||
| Treatment Considerations | 51 | ||
| Swallowing Deficits in Traumatic Brain Injury | 52 | ||
| Treatment Considerations | 52 | ||
| Subcortical Functions | 52 | ||
| Subcortical Functions and Swallowing Impairment: Parkinson’s Disease | 53 | ||
| Treatment Considerations | 54 | ||
| Brainstem Functions | 56 | ||
| Brainstem Functions and Swallowing Impairment | 56 | ||
| Treatment Considerations | 56 | ||
| The Role of the Cerebellum in Swallowing | 57 | ||
| Lower Motor Neuron and Muscle Disease | 57 | ||
| Lower Motor Neuron Functions and Swallowing Impairment | 57 | ||
| Muscle Diseases and Swallowing Impairment | 59 | ||
| Polyneuropathy | 59 | ||
| Myasthenia Gravis | 60 | ||
| Polymyositis, Scleroderma, and Systemic Lupus Erythematosus | 61 | ||
| Muscular Dystrophy | 61 | ||
| Treatment Considerations | 61 | ||
| Idiopathic or Iatrogenic Disorders of Swallowing that Resemble Neurogenic Dysphagia | 61 | ||
| Take Home Notes | 62 | ||
| References | 63 | ||
| 4 Dysphagia and Head and Neck Cancer | 69 | ||
| Chapter Outline | 69 | ||
| Objectives | 69 | ||
| Cancer as a Disease | 69 | ||
| What Is Cancer? | 69 | ||
| Diagnosis of Cancer | 71 | ||
| Staging | 71 | ||
| Treatments for Head and Neck Cancers | 72 | ||
| Surgery | 72 | ||
| Radiation Therapy | 73 | ||
| Chemotherapy | 74 | ||
| Dysphagia in Patients with Head and Neck Cancer | 75 | ||
| Dysphagia from Surgical Intervention | 75 | ||
| Surgery for Oral Cancers | 76 | ||
| Surgery for Oropharyngeal Cancers | 77 | ||
| Surgery for Hypopharyngeal Cancers | 77 | ||
| Surgery for Laryngeal Cancers | 77 | ||
| Dysphagia from Radiation Therapy | 78 | ||
| Dysphagia Characteristics after Radiation Therapy | 79 | ||
| Assessment Strategies for Dysphagia in Head and Neck Cancer | 82 | ||
| Timing of Swallow Evaluations | 82 | ||
| Assessing Impact Factors | 83 | ||
| Therapy Strategies for Dysphagia in Head and Neck Cancer | 85 | ||
| Timing of Swallowing Therapy | 85 | ||
| Therapy for Bolus Transport Problems | 86 | ||
| Therapy for Airway Protection Problems | 87 | ||
| Therapy for Mucosal and Muscle Changes Resulting from Radiation Therapy | 88 | ||
| Take Home Notes | 91 | ||
| References | 91 | ||
| 5 Esophageal Disorders | 97 | ||
| Chapter Outline | 97 | ||
| Objectives | 97 | ||
| Role of the Speech-Language Pathologist | 97 | ||
| Structural Disorders | 98 | ||
| Esophageal Stenosis | 98 | ||
| Rings and Webs | 98 | ||
| Benign Stricture | 99 | ||
| Malignant Stricture | 101 | ||
| Luminal Deformities | 102 | ||
| Extrinsic Compression | 102 | ||
| Esophageal Diverticulum | 102 | ||
| Esophageal Motility Disorders | 102 | ||
| Disorders of Peristalsis | 103 | ||
| Diffuse Esophageal Spasm | 103 | ||
| Nutcracker Esophagus | 103 | ||
| Nonspecific Motility Disorders | 104 | ||
| Eosinophilic Esophagitis | 104 | ||
| Treatment of Motility Disorders | 104 | ||
| Lower Esophageal Sphincter Abnormalities | 105 | ||
| Achalasia | 105 | ||
| Isolated Abnormalities of the Lower Esophageal Sphincter | 106 | ||
| Motor Weakness | 106 | ||
| Gastroesophageal Reflux Disease | 106 | ||
| Mechanisms of Reflux | 107 | ||
| Measuring Reflux | 107 | ||
| Treatment of Gastroesophageal Reflux Disease | 108 | ||
| Laryngopharyngeal Reflux | 108 | ||
| Differential Diagnosis | 109 | ||
| Disorders of the Pharyngeal Esophageal Segment | 109 | ||
| Cricopharyngeal Bar | 109 | ||
| Zenker’s Diverticulum | 110 | ||
| Pharyngoesophageal Relations | 112 | ||
| Take Home Notes | 112 | ||
| References | 113 | ||
| 6 Respiratory and Iatrogenic Disorders | 115 | ||
| Chapter Outline | 115 | ||
| Objectives | 115 | ||
| Background | 115 | ||
| Artificial Airways | 115 | ||
| Endotracheal Tubes | 115 | ||
| Tracheotomy Tubes | 116 | ||
| Swallowing and Tracheotomy | 118 | ||
| Laryngeal Excursion | 119 | ||
| Restoring Subglottic Pressure | 119 | ||
| Postsurgical Causes of Dysphagia | 120 | ||
| Thyroidectomy | 120 | ||
| Carotid Endarterectomy | 120 | ||
| Cardiovascular Surgery | 120 | ||
| Cervical Spine Procedures and Conditions | 121 | ||
| Osteophytes | 122 | ||
| Postural Changes | 122 | ||
| Esophagectomy | 122 | ||
| Skull Base/Posterior Fossa | 124 | ||
| Traumatic Injuries | 124 | ||
| Dental Trauma | 124 | ||
| Thermal Burn Trauma | 125 | ||
| Medications | 125 | ||
| Chronic Obstructive Pulmonary Disease | 126 | ||
| Take Home Notes | 128 | ||
| References | 128 | ||
| 2 Evaluation of Swallowing | 131 | ||
| 7 Clinical Evaluation of Adults | 131 | ||
| Chapter Outline | 131 | ||
| Objectives | 131 | ||
| Rationale | 131 | ||
| Symptoms of Dysphagia | 133 | ||
| Patient Description | 133 | ||
| Obstruction | 137 | ||
| Liquids Versus Solids | 137 | ||
| Gastroesophageal Reflux | 137 | ||
| Eating Habits | 138 | ||
| Signs of Dysphagia | 138 | ||
| Medical History | 138 | ||
| Historical Variables | 138 | ||
| Congenital Disease | 139 | ||
| Neurologic Disease | 139 | ||
| Surgical Procedures | 139 | ||
| Systemic and Metabolic Disorders | 139 | ||
| Respiratory Impairment | 142 | ||
| Esophageal Disease | 142 | ||
| Previous Test Results | 142 | ||
| Advance Directive | 142 | ||
| Physical Examination | 142 | ||
| Clinical Observations | 142 | ||
| Feeding Tubes | 143 | ||
| Tracheotomy Tubes | 143 | ||
| Respiratory Pattern | 144 | ||
| Mental Status | 144 | ||
| Cranial Nerve Examination | 145 | ||
| Facial Muscles | 145 | ||
| Muscles of Mastication | 145 | ||
| Pathologic Reflexes | 145 | ||
| Tongue Musculature | 146 | ||
| Oral Cavity | 147 | ||
| Oropharynx | 147 | ||
| Pharynx | 147 | ||
| Larynx | 148 | ||
| Test Swallows | 148 | ||
| Feeding Evaluation | 149 | ||
| Environment | 150 | ||
| Feeding | 151 | ||
| Posture | 151 | ||
| Eating | 151 | ||
| Assistance | 151 | ||
| Tests to Detect Aspiration | 151 | ||
| Water Tests | 153 | ||
| Swallow Frequency | 154 | ||
| Oxygen Saturation Tests | 154 | ||
| Modified Evans Blue Dye Test | 154 | ||
| Standardized Tests | 155 | ||
| Supplemental Tests | 155 | ||
| Take Home Notes | 157 | ||
| References | 158 | ||
| 8 Imaging Swallowing Examinations: | 161 | ||
| Chapter Outline | 161 | ||
| Objectives | 161 | ||
| Considerations for an Imaging Swallowing Examination | 161 | ||
| Goals of Imaging Swallowing Evaluations | 161 | ||
| Purposes of Imaging Swallowing Examinations | 162 | ||
| Indications for Imaging Swallowing Examinations | 163 | ||
| Videofluoroscopic Swallowing Examinations | 164 | ||
| What’s in a Name? | 164 | ||
| Objectives of the Videofluoroscopic Swallowing Examination | 164 | ||
| Procedures for the Videofluoroscopic Swallowing Examination | 166 | ||
| Instructions to the Patient | 166 | ||
| Patient Positioning | 166 | ||
| Material Used in the Fluoroscopic Study | 167 | ||
| Sequencing the Events in the Fluoroscopic Study | 168 | ||
| What to Look For | 170 | ||
| Strengths and Weaknesses of the Fluoroscopic Swallowing Study | 173 | ||
| Endoscopic Swallowing Examinations | 174 | ||
| Differences between the Endoscopic Swallowing Examination and the Fluoroscopic Swallowing Examination | 174 | ||
| Similarities | 175 | ||
| Differences | 175 | ||
| Procedures for the Endoscopic Swallowing Study | 176 | ||
| What to Look For | 179 | ||
| Strengths and Weaknesses of the Endoscopic Swallowing Study | 179 | ||
| Direct Comparisons between Fluoroscopic and Endoscopic Swallowing Examinations | 180 | ||
| Take Home Notes | 181 | ||
| References | 183 | ||
| 3 Approaches to Treatment | 187 | ||
| 9 Treatment Considerations, Options, and Decisions | 187 | ||
| Chapter Outline | 187 | ||
| Objectives | 187 | ||
| Evidence-Based Practice | 187 | ||
| Evaluating Evidence | 188 | ||
| General Treatment Considerations | 190 | ||
| Patient-Specific Treatment | 192 | ||
| Approach-Specific Treatment | 193 | ||
| Treatment Choices | 194 | ||
| Overview of Treatment Options | 194 | ||
| Medical Options | 194 | ||
| Surgical Options | 195 | ||
| Improving Glottal Closure | 195 | ||
| Protecting the Airway | 196 | ||
| Improving Pharyngeal Esophageal Segment Opening | 196 | ||
| Behavioral Options | 197 | ||
| Food Modifications | 197 | ||
| Rheology | 197 | ||
| Volume | 197 | ||
| Temperature | 197 | ||
| Taste and Smell | 198 | ||
| Modify Feeding Activity | 198 | ||
| Patient Modifications | 199 | ||
| Mechanism Modifications | 200 | ||
| Swallow Modifications | 200 | ||
| Making Treatment Decisions | 200 | ||
| Sources of Information | 200 | ||
| Forming Meaningful Questions | 201 | ||
| Planning Individual Therapy | 201 | ||
| Framework for Treatment Planning | 203 | ||
| Take Home Notes | 206 | ||
| References | 206 | ||
| 10 Treatment for Adults | 207 | ||
| Chapter Outline | 207 | ||
| Objectives | 207 | ||
| Which Techniques and What to Consider | 207 | ||
| Managing Dysphagia Symptoms: Compensation, Rehabilitation, and Prevention | 209 | ||
| Body Posture Adjustments | 209 | ||
| Head Posture Adjustments | 210 | ||
| Head Extension | 210 | ||
| Head Flexion–Chin Tuck | 210 | ||
| Head Rotation–Head Turn | 211 | ||
| Thickening Liquids and Modifying Diets | 212 | ||
| Thickened Liquids: Pros and Cons | 212 | ||
| Additional Effects of Thickened Liquids on the Swallow Mechanism | 214 | ||
| Other Liquid Modifications | 214 | ||
| Texture-Modified Diets | 215 | ||
| Changing the Swallow: Rehabilitation Approaches | 217 | ||
| Improving the Mechanism: Oral Motor Exercises | 217 | ||
| Protecting the Airway: Breath Hold and Supraglottic and Super-Supraglottic Swallows | 218 | ||
| Prolonging the Swallow: The Mendelsohn Maneuver | 220 | ||
| Increasing Force: The Effortful Swallow | 222 | ||
| Additional Techniques to Change the Swallow | 224 | ||
| Multiple Swallows as a Therapy Technique | 224 | ||
| The Tongue-Hold Maneuver | 225 | ||
| The Head-Lift Exercise | 226 | ||
| Thermal-Tactile Application | 228 | ||
| New Rehabilitation Directions: Exercise Principles and Modalities | 229 | ||
| Exercise Principles and Dysphagia Therapy | 229 | ||
| What Do Adjunctive Modalities Offer the Patient? | 230 | ||
| Surface Electromyographic and Other Forms of Biofeedback | 230 | ||
| Neuromuscular Electrical Stimulation | 231 | ||
| Prevention in Dysphagia Management | 233 | ||
| Potential Future Directions | 233 | ||
| Final Comments on Using Evidence | 233 | ||
| Take Home Notes | 235 | ||
| References | 235 | ||
| 11 Ethical Considerations | 241 | ||
| Chapter Outline | 241 | ||
| Chapter Objectives | 241 | ||
| Medical Ethics | 241 | ||
| Advance Directives | 242 | ||
| Tube Feeding | 242 | ||
| Enteral Nutrition | 242 | ||
| Nasogastric Tubes | 242 | ||
| Gastrostomy and Jejunostomy Tubes | 243 | ||
| Parenteral Nutrition | 243 | ||
| Reasons for Tube Feeding | 243 | ||
| Weaning From Feeding Tubes | 246 | ||
| Aspiration Pneumonia | 247 | ||
| Risk Factors | 247 | ||
| Nonmedical Risks and Benefits | 248 | ||
| Nonmedical Benefits | 248 | ||
| Nonmedical Risks | 248 | ||
| Ethical Dilemmas | 248 | ||
| Take Home Notes | 251 | ||
| References | 251 | ||
| III Dysphagia in Infants and Children | 253 | ||
| 12 Typical Feeding and Swallowing Development in Infants and Children | 253 | ||
| Chapter Outline | 253 | ||
| Objectives | 253 | ||
| Development of Head and Neck Anatomy | 253 | ||
| Infant Head and Neck Development | 254 | ||
| Branchial Arches | 254 | ||
| Development of Other Body Systems Involved in Feeding | 254 | ||
| Gut Development | 254 | ||
| Lung Development | 255 | ||
| Neurologic Development | 255 | ||
| Development of Feeding Reflexes | 256 | ||
| Suck-Swallow-Breath Coordination | 257 | ||
| Development of Motor and Cognitive Skills Involved in Early Feeding | 258 | ||
| Breastfeeding | 258 | ||
| Bottle Feeding | 259 | ||
| Introduction of Solids | 260 | ||
| Developmental Milestones for Feeding | 260 | ||
| Transition to Mature Mealtime Behavior | 263 | ||
| Nutrition and Growth Considerations in Infants and Children | 263 | ||
| Current Infant Feeding Guidelines | 265 | ||
| Nutrition Guidelines for Children | 265 | ||
| Energy Requirements | 265 | ||
| Macronutrient, Micronutrient, and Fluid Requirements | 266 | ||
| Food Servings and Serving Size | 266 | ||
| Food Handling and Hygiene | 266 | ||
| Growth Charts | 267 | ||
| Take Home Notes | 268 | ||
| References | 268 | ||
| 13 Disorders Affecting Feeding and Swallowing in Infants and Children | 271 | ||
| Chapter Outline | 271 | ||
| Objectives | 271 | ||
| Swallowing and Dysphagia | 271 | ||
| Airway Protection, Aspiration, and Apnea | 272 | ||
| Mealtime Behavior and Feeding Difficulties | 273 | ||
| Interruptions to Early Feeding Development | 274 | ||
| Respiratory and Cardiac Disorders That May Affect Feeding and Swallowing | 275 | ||
| Heart Defects | 275 | ||
| Gastrointestinal Disorders That May Affect Feeding and Swallowing | 277 | ||
| Neurologic Disorders That May Affect Feeding and Swallowing | 281 | ||
| Congenital Abnormalities That May Affect Feeding and Swallowing | 285 | ||
| Maternal and Perinatal Conditions That May Affect Child Feeding and Swallowing | 287 | ||
| Prematurity | 289 | ||
| Summary of Factors That Can Affect Feeding in Preterm Infants | 290 | ||
| Iatrogenic Complications That May Affect Feeding and Swallowing | 292 | ||
| Tube Feeding | 292 | ||
| Respiratory Support | 293 | ||
| Tracheostomy | 296 | ||
| Ingestional Injuries | 298 | ||
| Other Factors That May Potentially Affect Feeding and Swallowing in Children | 298 | ||
| Tonsillitis and Tongue-Tie | 298 | ||
| Oral Motor Impairments | 299 | ||
| Sensory Processing Disorders | 299 | ||
| Oral Sensitivity | 300 | ||
| Autism Spectrum Disorder | 300 | ||
| Parent-Child Interaction | 301 | ||
| Take Home Notes | 301 | ||
| References | 303 | ||
| 14 Evaluating Feeding and Swallowing in Infants and Children | 305 | ||
| Chapter Overview | 305 | ||
| Objectives | 305 | ||
| Members of the Feeding and Swallowing Team | 305 | ||
| Models of Teamwork | 306 | ||
| Multidisciplinary Team | 306 | ||
| Interdisciplinary Team | 306 | ||
| Transdisciplinary Team | 306 | ||
| International Classification of Functioning, Disability, and Health | 307 | ||
| Case History | 307 | ||
| Clinical Feeding Evaluation | 308 | ||
| Assessing Hospitalized Children with Acute Health Issues | 310 | ||
| Medical Stability | 312 | ||
| Nutritional Stability | 312 | ||
| Limitations Caused by Medical Treatments and the Hospital Environment | 312 | ||
| State Control | 313 | ||
| Stress Cues | 313 | ||
| Physiologic Control | 313 | ||
| Assessment of Feeding Interactions | 314 | ||
| Assessing Children in the Community with Chronic Health Issues or Developmental Delay | 314 | ||
| Developmental Level and Potential | 314 | ||
| Nature of the Condition (Stable, Resolving, Deteriorating, or Progressive) | 314 | ||
| Transition from Acute Care | 315 | ||
| Parent Involvement in Assessment and Treatment Planning | 315 | ||
| Social Aspects of Eating | 315 | ||
| Burden on Family | 315 | ||
| Assessment Considerations for Infants | 315 | ||
| Timing of Assessment | 315 | ||
| Breastfeeding | 316 | ||
| Bottle Feeding | 316 | ||
| Assessment Considerations for Older Children | 316 | ||
| Developmental Level | 317 | ||
| Food Preferences | 317 | ||
| Interest and Motivation | 317 | ||
| Imaging Studies | 317 | ||
| Videofluoroscopic Swallow Study | 317 | ||
| Pediatric-Specific Issues Relating to VFSS Studies | 317 | ||
| Fluid and Food Samples | 317 | ||
| Seating and Feeding Equipment | 318 | ||
| Strategies That May Be Trialed during the Study | 318 | ||
| Breastfeeding Infants | 318 | ||
| Compliance Issues | 318 | ||
| Safety Concerns | 318 | ||
| Facilities and Access to Experienced Staff | 319 | ||
| Penetration-Aspiration (PA) Scale | 319 | ||
| Functional Oral Intake Scale (FOIS) | 319 | ||
| Fiberoptic Endoscopic Examination of Swallowing | 320 | ||
| Pediatric-Specific Issues Relating to FEES Studies | 320 | ||
| Infants | 320 | ||
| Pediatric Anatomy | 320 | ||
| Compliance Issues | 320 | ||
| Safety Concerns | 320 | ||
| Sensory Testing | 321 | ||
| Endoscopies | 321 | ||
| Manometry, Impedance, and pH Testing | 321 | ||
| Cervical Auscultation | 321 | ||
| Take Home Notes | 322 | ||
| References | 322 | ||
| 15 Treatment of Feeding and Swallowing Difficulties in Infants and Children | 325 | ||
| Chapter Overview | 325 | ||
| Objectives | 325 | ||
| Setting Therapy Goals | 325 | ||
| Models of Service Delivery | 326 | ||
| Therapy Focused on Swallowing and Airway Protection | 328 | ||
| Interventions for Swallowing Difficulties | 328 | ||
| Thickened Fluids | 328 | ||
| Use of Thickened Fluid for Dysphagia | 328 | ||
| Use of Thickened Feeds for Regurgitation | 330 | ||
| Thickening Fluids | 330 | ||
| Thickened Infant Feeds | 330 | ||
| Which Thickening Agent to Use? | 331 | ||
| Testing the Thickness of Thickened Fluids | 332 | ||
| Alternatives to Thickening Fluids | 332 | ||
| Positioning | 332 | ||
| Feeding Equipment | 333 | ||
| Pacing | 333 | ||
| Swallowing Maneuvers | 333 | ||
| Modified Foods | 333 | ||
| Therapy Focused on Feeding Difficulties and Mealtime Behavior | 333 | ||
| Oral Sensory-Motor Therapy | 334 | ||
| Feeding Utensils and Equipment | 335 | ||
| Bottle Feeding Equipment | 336 | ||
| Breastfeeding Equipment | 336 | ||
| Mealtime Positioning | 336 | ||
| Behavioral Feeding Therapy | 337 | ||
| Feeding Therapy as Part of Nutritional Supplement Weaning | 340 | ||
| Reason for Commencing Nutritional Supplementation | 340 | ||
| Feeding Difficulties in Children Who Are on Nutritional Supplementation | 341 | ||
| Prerequisites for Regular Oral Feeding | 342 | ||
| Therapy Considerations for Children Who Are Ready to Wean from Nutritional Supplements | 342 | ||
| Therapy Consideration for Infants | 342 | ||
| Breastfeeding | 342 | ||
| Bottle Feeding | 344 | ||
| Introduction of Solids | 344 | ||
| Therapy Consideration for Older Children | 345 | ||
| Active Participation in Therapy | 345 | ||
| Motivation | 346 | ||
| Learning Compensation Strategies | 346 | ||
| Working with Hospitalized Children with Acute Health Issues | 346 | ||
| Infection Management | 347 | ||
| Patients Requiring Special Diets | 347 | ||
| Safe Handling of Patients | 347 | ||
| Working with Children Living in the Community | 347 | ||
| Measuring Therapy Outcomes | 347 | ||
| Goal Attainment Scaling | 348 | ||
| Take Home Notes | 348 | ||
| References | 349 | ||
| Appendixes | 351 | ||
| Appendix A Common bottles | 351 | ||
| Straight Bottles | 351 | ||
| Angled Bottles | 351 | ||
| Other Shaped Bottles | 351 | ||
| Haberman (Special Needs Feeder) | 351 | ||
| Dr Brown’s Bottles | 352 | ||
| Bottles with Collapsable Bags | 352 | ||
| Squeeze Bottles | 352 | ||
| Medicine Dispenser Nipples | 352 | ||
| Syringe Nipples | 352 | ||
| Appendix B Cervical auscultation equipment | 353 | ||
| Stethoscope | 353 | ||
| Lapel Microphone | 353 | ||
| Amplifier | 353 | ||
| Adhesive | 353 | ||
| Appendix C Common cups | 354 | ||
| Spout Cups | 354 | ||
| Straw Cups | 354 | ||
| Regular Cups | 355 | ||
| Cut-Out Cups | 355 | ||
| Other Cups | 355 | ||
| Appendix D Common pacifier types | 356 | ||
| Cherry-Shaped Pacifiers | 356 | ||
| Orthodontic Pacifiers | 356 | ||
| Straight Pacifiers | 356 | ||
| Oral Toys | 357 | ||
| Teething Toys | 357 | ||
| Infadent Finger Toothbrushes | 357 | ||
| Nuk Gum Brushes | 357 | ||
| Baby Toothbrushes | 357 | ||
| Therapy Tubing | 358 | ||
| Net Feeders | 358 | ||
| Appendix E Common spoons | 359 | ||
| Metal Spoons | 359 | ||
| Silicone Spoons | 359 | ||
| Maroon Spoons | 359 | ||
| Loop Spoons | 359 | ||
| Beginner Bowls | 360 | ||
| Appendix F Artificial nipples for bottle feeding | 361 | ||
| Slow Flow | 361 | ||
| Medium Flow | 361 | ||
| Fast Flow | 361 | ||
| General Recommendations | 361 | ||
| Variable Flow Nipples | 361 | ||
| Nondrip Nipples | 361 | ||
| Straight Nipples | 362 | ||
| Orthodontic Nipples | 362 | ||
| Wide Neck Nipples | 362 | ||
| Peristaltic Nipples | 362 | ||
| Pigeon and Chu Chu Nipples | 363 | ||
| Haberman (Special Needs) Bottle Nipples | 363 | ||
| Appendix G Common infant feeding positions | 364 | ||
| Side-Lying for Breastfeed | 364 | ||
| Cradle Hold for Bottle Feeding | 364 | ||
| Side-Lying for Bottle Feed | 365 | ||
| Semiupright in Feeder’s Arms (Elevated Cradle Hold) | 365 | ||
| Semiupright in Baby Chair | 365 | ||
| Appendix H Examples of seating options | 366 | ||
| Infant Seat | 366 | ||
| High Chairs | 366 | ||
| Multiage Chairs | 367 | ||
| Tumbleform Seat | 367 | ||
| Tomato Chair | 367 | ||
| Hook on Chair (Sassy Seat) | 368 | ||
| Toddler Table and Chairs | 368 | ||
| Glossary | 369 | ||
| Index | 375 | ||
| A | 375 | ||
| B | 375 | ||
| C | 376 | ||
| D | 377 | ||
| E | 377 | ||
| F | 378 | ||
| G | 379 | ||
| H | 379 | ||
| I | 379 | ||
| J | 380 | ||
| K | 380 | ||
| L | 380 | ||
| M | 380 | ||
| N | 381 | ||
| O | 381 | ||
| P | 382 | ||
| Q | 383 | ||
| R | 383 | ||
| S | 383 | ||
| T | 385 | ||
| U | 385 | ||
| V | 385 | ||
| W | 386 | ||
| X | 386 | ||
| Z | 386 |