Abstract

Background: Eating, drinking and swallowing (EDS) disorders can have serious consequences for children which include dehydration, malnutrition, failure to thrive, aspiration pneumonia, choking and possibly death. Paediatric feeding disorders have been reported in up to 25% of children. This number increases to 80% in developmentally delayed children. Therefore disordered feeding should involve assessment by a multidisciplinary team. The problem is seldom limited to the child alone and non-organic factors must also be addressed. Aims: To audit the first 18 months of practice in a new regional EDS clinic from July 2007-December 2008. Methods: Retrospective chart review of clinic reports was carried out. All patients had formal assessment of EDS by a speech and language (SALT) and occupational therapist (OT), a medical review by a doctor and dietetics consult at each clinic visit. Results: 28 patients received full assessment. Average age of 1st consult was 4.16 years. 27/28 patients had an underling diagnosis, the most common being; genetic disorder(n=7), autism(n=3), cerebral palsy(n=3), Ex-prem(n=3), developmental delay of unknown aetiology(n=3). Diverse reasons for referral included(often > 1); issues with coordination of swallow(n=14), perceived behavioural issues(n=6), chronic reflux(n=5), PEG feeding(n=4), aspiration(n=4). 22/28 patients had an abnormal EDS assessment. The two most common interventions initiated were a sensory feeding programme(n=15) or food desensitisation programme(n=4) by SALT/OT. Conclusion: Our EDS clinic has provided further therapeutic intervention for children already with complex medical needs. In conjunction with medical therapy, behavioural and oromotor strategies can be applied successfully even in feeding disorders with an underlying organic cause.

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