|
Section 3: Influence of Special Health Care Needs
Many problems associated with specific conditions can contribute to problems
with eating. This section reviews some of these issues and describes potential
feeding problems that can result. When these feeding problems are suspected,
a feeding evaluation by a therapist is indicated.
This page describes the following problems:
Hypertonia
Hypertonia, common among children with neuromuscular disorders, can cause
a number of problems related to feeding and eating:
- Lip retraction –lips are pulled away from the midline in a tight
“smile,” often as an object nears the face
- Tongue thrust –the tongue is forcefully extended, often in response
to an oral stimulus
- Jaw thrust –the lower jaw opens forcefully
- Tonic bite reflex –the mouth clenches involuntarily with oral
stimulation (especially touch to the teeth and gums); it can be difficult
for the child to release
- Problems with positioning
Hypotonia
Hypotonia, or low muscle tone, can lead to feeding-related problems:
- Poor jaw and lip closure, interfering with chewing and swallowing
- Problems with positioning
- Drooling
Hypersensitivity
Hypersensitivity, or sensory defensiveness, can interfere with eating
and feeding:
- Exaggerated bite reflex
- Hyperactive gag
reflex
- Aversions to different textures
Developmental immaturity
Developmental immaturity may be accompanied by retention of reflexes
including tongue
thrust, bite reflex, and rooting
reflex. In addition, the gag
reflex may be immature, preventing a child from consuming solid foods.
Gastroesophageal reflux
Gastroesophageal reflux (GER) is the regurgitation of stomach contents
into the esophagus, often resulting from a weak esophageal sphincter.
GER can be common among children with neuromuscular disorders. GER can
lead to problems with feeding:
- Aspiration
can result, making oral intake unsafe
- Feeding aversions can result because of the pain and discomfort associated
with being fed
Other oral-motor problems
Other oral-motor problems include:
- Tongue retraction –tongue is pulled back in mouth and may obstruct
the airway
- Jaw retraction –lower jaw is pulled back involuntarily
- Jaw clenching - jaw is tightly closed, involuntarily
- Nasal regurgitation –food or liquid moves into the lower sinus
and nose during swallowing and may come out of the nose
|
