Vol 34 No 1 (2015): .
Speech
How to Cite
S, P., P, P. K., N, S., & Srushti Shabnam. (1). Feeding and Oromotor Problems in Children with Cerebral Palsy. Journal of All India Institute of Speech and Hearing, 34(1), 36-47. Retrieved from http://203.129.241.91/jaiish/index.php/aiish/article/view/835
Abstract
The aim of the study was to identify and investigate the feeding and oromotor problems in children with cerebral palsy. Seventy four partici- pants with cerebral palsy and associated problems in the age group of 1.2 years to 9.6 years were screened for feeding and oromotor problems using a questionnaire that was developed. The parents of these children were
asked to respond to the questions in the questionnaire. The responses were documented as 'yes' or 'no' with a score of '1' and '0' respectively. When the frequency of feeding problems were analysed, it was found that overall, 63.51% of children with cerebral palsy exhibited problems in feeding skills like self feeding skills, vegetative skills, eating (semisolid
& solid food items), swallowing skills, preferences towards soft/ warm food items and prolonged meal times. Oral motor skills were aected in 61.70% of children. Further analysis revealed that feeding problems were highly prevalent when cerebral palsy was associated with intellectual decit. There was a correlation observed between oromotor skills and
feeding skills.Children with oro motor decits had greater feeding problems compared to children without oro motor decits. To conclude, children with cerebral palsy presented inadequate feeding and oromotor skills. Hence, it is very important for speech-language pathologists to include in depth assessment and management of feeding skills as a rehabilitative goal along with communication skills.
References
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motor skills in toddlers. The Com DEALL trust. Ban-
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Arvedson, J. C., & Brodsky, L. (2002). Pediatric swallow-
ing and feeding: Assessment and Management. Albany,
NY: Singular Publishing Group.
Aurelio, S. R., Genaro, K. F., & MacedoFilho, E. D. (2002).
Comparative analysis of swallowing patterns between
children with cerebral palsy and normal children. Brazil-
ian Journal of Otolaryngology, 68, 167-173.
Beckung, E., & Hagberg, G. (2002). Neuroimpairments, ac-
tivity limitations, and participation restrictions in chil-
dren with cerebral palsy. Developmental Medicine and
Child Neurology, 44(5), 309-316.
Benfer, K. A., Weir, K. A., Bell, K. L., Ware, R. S., Davies,
P. S.W., & Boyd, R. N. (2013). Oropharyngeal dyspha-
gia and gross motor skills in children with cerebral palsy.
Pediatrics, 131(5), e1553-1562.
Brouwer, B., & Ashby, P. (1991). Altered corticospinal pro-
jections to lower limb motoneurons in subjects with cere-
bral palsy. Brain, 114, 1395-1407.
Calis, E. A., Vengelers, R., Sheppard, J. J, Tibboel, D.,
Evenhuis, H. M., & Penning, C. (2008). Dysphagia in
children with severe generalized cerebral palsy and in-
tellectual disability. Developmental Medicine and Child
Neurology, 50, 625-630.
Clancy, K. J., & Hustad, K. C. (2011). Longitudinal changes
in feeding among children with cerebral palsy between
the ages of 4 and 7 years. Developmental Neurorehabil-
itation, 14, 191-198.
Diwan, S., & Diwan, J. (2013). A study of feeding prob-
lems in children with cerebral palsy. National Journal
of Integrated Research in Medicine, 4, 78-86.
Eicher, P.S. (2007).Feeding.In M.L. Batshaw, L. Pelligrino,
& N.J. Roizen (Eds.), Children with disabilities (pp.479-
498). Baltimore, MD: Paul H. Brookes.
Field, D., Garland, M., & Williams, K. (2003). Correlates
of speci c childhood feeding problems. Journal of Pae-
diatric Child Health, 39, 299-304.
Gangil, A., Patwari, A. K., Aneja, S., Ahuja, B., & Anand,
V. K. (2001). Feeding problems in children with cerebral
palsy. Indian Pediatrics, 38, 839-846.
Gouge, A. L., & Ekvall, S. W. (1975). Diets of handi-
capped children: Physical, psychological, and socioeco-
nomic correlations. American Journal of Mental De -
ciency, 80, 149-157.
Indian Academy of Cerebral Palsy (2001). Incidence of Cere-
bral Palsy in India. In Srushti, S., & Swapna, N. (2014).
Development and validation of feeding handicap index
for children. An Unpublished Master's Dissertation sub-
mitted to University of Mysore, Mysore.
Kirby, M., & Noel, R. J. (2007). Nutrition and gastroin-
testinal tract assessment and management of children
with dysphagia. Seminars in Speech Language, 28, 180-
189.
Matson, J. L., Gardner, W. I., Coe, D. A. & Sovner, R.
(1991). A scale for evaluating emotional disorders in
severely and profoundly mentally retarded persons: De-
velopment of the Diagnostic Assessment for the Severely
Handicapped (DASH) scale. British Journal of Psychi-
atry, 159, 81-89.
Morgan, A., & Reilly, A. (2006). Clinical signs, aetiologies
and characteristics of paediatric dysphagia. In: Cichero,
J., Murdoch, B. E, eds. Dysphagia: foundation, theory
and practice. Chichester, England: John Wiley & Sons.
391-465.
NINDS. Cerebral Palsy: Hope through Research. 2006.
Retrieved 08/26, 2015, from http://www.ninds.nih.gov/
disorders/cerebral palsy/detail cerebral palsy.htm.
Odding, E., Roebroeck, M. E., & Stam, H. J. (2006). The
epidemiology of cerebral palsy: incidence, impairments
and risk factors. Disability Rehabilitation, 28(4), 214-
223.
Ottenbacher, K., Bundy A., & Short M. A. (1983). The de-
velopment and treatment of oral sensorimotor dysfunc-
tion: A review of clinical research. Physical & occupa-
tional therapy in Paediatrics, 3, 1-13.
Palmer, S., Thompson, R.J., & Linscheid, T.R. (1975). Ap-
plied behavior analysis in the treatment of childhood
feeding problems. Developmental Medicine and Child
Neurology, 17, 333-339.
Parkes, J., Hill, N., Platt, M. J., & Donnelly, C. (2010).
Oromotor dysfunction and communication impairments
in children with cerebral palsy: a register study. De-
velopmental Medicine and Child Neurology, 52, 1113-
1119.
Pelligrino, L. (2007). Cerebral palsy. In M.L. Batshaw, L.
Pellegrino, & N.J. Roizen (Eds.), Children with disabil-
ities (6th ed., pp. 387-408). Baltimore, MD: Paul H.
Brooks.
Perske, R., Clifton, A., McClean, B. M., & Stein, J. I. (1977).
Mealtimes for severely and profoundly handicapped per-
sons: New concepts and attitudes. Baltimore: Univer-
sity Park Press.
Pohl, J. F., & Cantrell, A. (2006). Gastrointestinal and
nutritional issues in cerebral palsy. Practical Gastroen-
terology, 29(5), 14-23.
Reilly, S., Carr, L., & Wisbeach, A. (2000). Feeding prob-
lems in children: a practical guide. Abingdon: Radcli e
Medical Press.
Reilly, S., Skuse, D., & Poblete, X. (1996). Prevalence of
feeding problems and oral motor dysfunction in children
with cerebral palsy: a community survey. Journal ofPe-
diatrics, 129, 877-882.
Rezaei, M., Rashedi, V., Gharib, M., & Lot , G.
(2011).Prevalence of feeding problems in children with
intellectual disability. Iranian Rehabilitation Journal,
9, 56-59.
Rogers, B., Arvedson, J., Buck, G., Smart, P., & Msall, M.
(1994). Characteristics of dysphagia in children with
cerebral palsy. Dysphagia, 9, 69-73.
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M.,
& Bax, M. (2006). A report: the de nition and clas-
si cation of cerebral palsy April 2006. Developmental
Medicine and Child Neurology, 49, 8-14.
Sjakti, H. A., Syarif, D. R., Wahyuni, L. K., & Chair, I.
(2008). Feeding diculties in children with cerebral
palsy. Paediatrica Indonesiana, 48,224-229.
Sigurdardottir, S., Indredavik, M.S., Eiriksdottir, A., Einar-
dottir, K., Gudmundsson, H.S., & Vik, T. (2010). Be-
havioural and emotional symptoms of preschool children
with cerebral palsy: A population based study. Devel-
opmental Medicine and Child Neurology, 52(11), 1056-
1061.
Srushti, S., & Swapna, N. (2014). Development and valida-
tion of feeding handicap index for children. An Unpub-
lished Master's Dissertation submitted to University of
Mysore, Mysore.
Sullivan, P. B., Lambert, B., Rose, M., Ford-Adams, M.,
Johnson, A., & Griths, P. (2000). Prevalence and
severity of feeding and nutritional problems in children
with neurological impairment: Oxford Feeding Study.
Developmental Medicine & Child Neurology, 42, 674-
680.
Waterman, E. T., Koltai, P. J., Downey, J. C., & Cacace, A.
T. (1992).Swallowing disorders in a population of chil-
dren with cerebral palsy. International Journal of Pedi-
atric Otorhinolaryngology, 24, 63-71.
motor skills in toddlers. The Com DEALL trust. Ban-
galore.
Arvedson, J. C., & Brodsky, L. (2002). Pediatric swallow-
ing and feeding: Assessment and Management. Albany,
NY: Singular Publishing Group.
Aurelio, S. R., Genaro, K. F., & MacedoFilho, E. D. (2002).
Comparative analysis of swallowing patterns between
children with cerebral palsy and normal children. Brazil-
ian Journal of Otolaryngology, 68, 167-173.
Beckung, E., & Hagberg, G. (2002). Neuroimpairments, ac-
tivity limitations, and participation restrictions in chil-
dren with cerebral palsy. Developmental Medicine and
Child Neurology, 44(5), 309-316.
Benfer, K. A., Weir, K. A., Bell, K. L., Ware, R. S., Davies,
P. S.W., & Boyd, R. N. (2013). Oropharyngeal dyspha-
gia and gross motor skills in children with cerebral palsy.
Pediatrics, 131(5), e1553-1562.
Brouwer, B., & Ashby, P. (1991). Altered corticospinal pro-
jections to lower limb motoneurons in subjects with cere-
bral palsy. Brain, 114, 1395-1407.
Calis, E. A., Vengelers, R., Sheppard, J. J, Tibboel, D.,
Evenhuis, H. M., & Penning, C. (2008). Dysphagia in
children with severe generalized cerebral palsy and in-
tellectual disability. Developmental Medicine and Child
Neurology, 50, 625-630.
Clancy, K. J., & Hustad, K. C. (2011). Longitudinal changes
in feeding among children with cerebral palsy between
the ages of 4 and 7 years. Developmental Neurorehabil-
itation, 14, 191-198.
Diwan, S., & Diwan, J. (2013). A study of feeding prob-
lems in children with cerebral palsy. National Journal
of Integrated Research in Medicine, 4, 78-86.
Eicher, P.S. (2007).Feeding.In M.L. Batshaw, L. Pelligrino,
& N.J. Roizen (Eds.), Children with disabilities (pp.479-
498). Baltimore, MD: Paul H. Brookes.
Field, D., Garland, M., & Williams, K. (2003). Correlates
of speci c childhood feeding problems. Journal of Pae-
diatric Child Health, 39, 299-304.
Gangil, A., Patwari, A. K., Aneja, S., Ahuja, B., & Anand,
V. K. (2001). Feeding problems in children with cerebral
palsy. Indian Pediatrics, 38, 839-846.
Gouge, A. L., & Ekvall, S. W. (1975). Diets of handi-
capped children: Physical, psychological, and socioeco-
nomic correlations. American Journal of Mental De -
ciency, 80, 149-157.
Indian Academy of Cerebral Palsy (2001). Incidence of Cere-
bral Palsy in India. In Srushti, S., & Swapna, N. (2014).
Development and validation of feeding handicap index
for children. An Unpublished Master's Dissertation sub-
mitted to University of Mysore, Mysore.
Kirby, M., & Noel, R. J. (2007). Nutrition and gastroin-
testinal tract assessment and management of children
with dysphagia. Seminars in Speech Language, 28, 180-
189.
Matson, J. L., Gardner, W. I., Coe, D. A. & Sovner, R.
(1991). A scale for evaluating emotional disorders in
severely and profoundly mentally retarded persons: De-
velopment of the Diagnostic Assessment for the Severely
Handicapped (DASH) scale. British Journal of Psychi-
atry, 159, 81-89.
Morgan, A., & Reilly, A. (2006). Clinical signs, aetiologies
and characteristics of paediatric dysphagia. In: Cichero,
J., Murdoch, B. E, eds. Dysphagia: foundation, theory
and practice. Chichester, England: John Wiley & Sons.
391-465.
NINDS. Cerebral Palsy: Hope through Research. 2006.
Retrieved 08/26, 2015, from http://www.ninds.nih.gov/
disorders/cerebral palsy/detail cerebral palsy.htm.
Odding, E., Roebroeck, M. E., & Stam, H. J. (2006). The
epidemiology of cerebral palsy: incidence, impairments
and risk factors. Disability Rehabilitation, 28(4), 214-
223.
Ottenbacher, K., Bundy A., & Short M. A. (1983). The de-
velopment and treatment of oral sensorimotor dysfunc-
tion: A review of clinical research. Physical & occupa-
tional therapy in Paediatrics, 3, 1-13.
Palmer, S., Thompson, R.J., & Linscheid, T.R. (1975). Ap-
plied behavior analysis in the treatment of childhood
feeding problems. Developmental Medicine and Child
Neurology, 17, 333-339.
Parkes, J., Hill, N., Platt, M. J., & Donnelly, C. (2010).
Oromotor dysfunction and communication impairments
in children with cerebral palsy: a register study. De-
velopmental Medicine and Child Neurology, 52, 1113-
1119.
Pelligrino, L. (2007). Cerebral palsy. In M.L. Batshaw, L.
Pellegrino, & N.J. Roizen (Eds.), Children with disabil-
ities (6th ed., pp. 387-408). Baltimore, MD: Paul H.
Brooks.
Perske, R., Clifton, A., McClean, B. M., & Stein, J. I. (1977).
Mealtimes for severely and profoundly handicapped per-
sons: New concepts and attitudes. Baltimore: Univer-
sity Park Press.
Pohl, J. F., & Cantrell, A. (2006). Gastrointestinal and
nutritional issues in cerebral palsy. Practical Gastroen-
terology, 29(5), 14-23.
Reilly, S., Carr, L., & Wisbeach, A. (2000). Feeding prob-
lems in children: a practical guide. Abingdon: Radcli e
Medical Press.
Reilly, S., Skuse, D., & Poblete, X. (1996). Prevalence of
feeding problems and oral motor dysfunction in children
with cerebral palsy: a community survey. Journal ofPe-
diatrics, 129, 877-882.
Rezaei, M., Rashedi, V., Gharib, M., & Lot , G.
(2011).Prevalence of feeding problems in children with
intellectual disability. Iranian Rehabilitation Journal,
9, 56-59.
Rogers, B., Arvedson, J., Buck, G., Smart, P., & Msall, M.
(1994). Characteristics of dysphagia in children with
cerebral palsy. Dysphagia, 9, 69-73.
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M.,
& Bax, M. (2006). A report: the de nition and clas-
si cation of cerebral palsy April 2006. Developmental
Medicine and Child Neurology, 49, 8-14.
Sjakti, H. A., Syarif, D. R., Wahyuni, L. K., & Chair, I.
(2008). Feeding diculties in children with cerebral
palsy. Paediatrica Indonesiana, 48,224-229.
Sigurdardottir, S., Indredavik, M.S., Eiriksdottir, A., Einar-
dottir, K., Gudmundsson, H.S., & Vik, T. (2010). Be-
havioural and emotional symptoms of preschool children
with cerebral palsy: A population based study. Devel-
opmental Medicine and Child Neurology, 52(11), 1056-
1061.
Srushti, S., & Swapna, N. (2014). Development and valida-
tion of feeding handicap index for children. An Unpub-
lished Master's Dissertation submitted to University of
Mysore, Mysore.
Sullivan, P. B., Lambert, B., Rose, M., Ford-Adams, M.,
Johnson, A., & Griths, P. (2000). Prevalence and
severity of feeding and nutritional problems in children
with neurological impairment: Oxford Feeding Study.
Developmental Medicine & Child Neurology, 42, 674-
680.
Waterman, E. T., Koltai, P. J., Downey, J. C., & Cacace, A.
T. (1992).Swallowing disorders in a population of chil-
dren with cerebral palsy. International Journal of Pedi-
atric Otorhinolaryngology, 24, 63-71.