Management of Swallowing and Feeding Disorders in Schools examines the most significant issues in swallowing and feeding facing school-based speech-language pathologists (SLPs). Topics addressed are unique to the school setting, ranging from organizing a team procedure in a district to serving children with complex medical issues, behavioral feeding disorders, and neurological feeding disorders. Ethical, legal, and cultural issues are also addressed. Many students in school districts across the country exhibit the signs and symptoms of dysphagia, and children who were originally treated for dysphagia in hospitals and other settings often begin attending public schools at three years old. The difficulty they had with swallowing and feeding frequently follows them to the school setting. Further, there are many students who develop swallowing and feeding disorders as a result of traumatic brain injury, neurological disorders and syndromes, behavioral disorders, and so forth. The range of students needing services for swallowing and feeding disorders in the school setting can be from three to twenty-two years of age and from mild dysphagia to tube feeding. The identification and treatment of swallowing and feeding disorders in schools is relatively new. There are still many districts in the country and internationally that do not address the needs of children with dysphagia. As school-based SLPs take on the challenge of this population there is a need for information that is current, accurate, and thorough. University programs include very little training, if any, at this time in the area of swallowing and feeding in the school setting. This text is appropriate for both a dysphagia course as well as courses that train SLP students to work with school-aged students.

Pediatric Swallowing and Feeding: Assessment and Management, Third Edition provides information to practitioners interested in and involved with children who demonstrate swallowing and feeding disorders. Since the 2002 publication of the second edition, there has been an exponential increase in the number of medically fragile and complex children with swallowing/feeding disorders. A corresponding proliferation in the related basic and clinical research has resulted in the increased appreciation of the complicated inter-relationships between structures and systems that contribute to swallowing/feeding development, function, and disorders. Case studies throughout the book provide examples for decision making and highlight salient points. New to the Third Edition: * Maureen A. Lefton-Greif, PhD, CCC-SLP, BCS-S, is welcomed as co-editor. She brings extensive research expertise and clinical practice in pediatric dysphagia and feeding. * All chapters contain significant updated evidence-based research and clinical information. * New chapters focus on the genetic testing and conditions associated with swallowing and feeding disorders, and the pulmonary manifestations and management of aspiration. * World Health Organization (WHO) description of an International Classification of Functioning, Disability, and Health (ICF) sets the stage for an in-depth discussion of clinical feeding evaluation procedures, interpretation, and management decision making. Pediatric Swallowing and Feeding continues to be the leading text on pediatric dysphagia that provides practical information for clinicians seeing children with swallowing and feeding disorders. The overall importance of an appropriate fund of knowledge and shared experience employing team approaches is emphasized throughout this third edition as in the earlier editions of this book. From the Foreword: "The Editors have recognized the advances and changes in the understanding in the information now available for the care of pediatric swallowing and feeding challenges. They have recruited an outstanding group of contributors for this newest edition. There are numerous critically important updates and additions in the third edition. They have included World Health Organizations International Classification of Functioning, Disability and Health is the functional basis in all areas of the book. This text has its importance as there has been an increased number of children with complex medical and healthcare conditions which are risk for feeding and swallowing disorders. This edition stresses the need for team approaches and also documents the use of “virtual” teams ...Pediatric Swallowing and Feeding: Assessment and Management, Third Edition is the fundamental holistic source for all healthcare providers providing the care for swallowing and feeding in children. This book will be utilized by all caring for children with feeding and swallowing problems throughout the world. The previous editions have been and now this updated third edition continues to be the standard source for the information concerning diagnosis and care of these children." —Robert J. Ruben, MD, FAAP, FACS Distinguished University Professor Departments of Otorhinolaryngology – Head and Neck Surgery and Pediatrics Albert Einstein College of Medicine Montefiore Medical Center Bronx, New York

Keywords: Occupational Therapy, Occupational Therapist, OT

Presents a comprehensive, multidimensional approach to feeding problems. Ms. Wolf and Ms. Glass assist the feeding specialist in acquiring the knowledge and skills to take an active and effective part in the process of assessment and management of infant feeding. James F. Bosma, M.D., says, "This unique book describes the insights and skills in evaluation and care of dysphagic infants that are being demonstrated by a growing number of occupational, physical, and speech therapists and nurses." Book jacket.

Pediatric Dysphagia: Etiologies, Diagnosis, and Management is a comprehensive professional reference on the topic of pediatric feeding and swallowing disorders. Given that these disorders derive from abnormalities in the function and/or structure of the airway and digestive systems, multiple clinical specialists may be involved in the evaluation and management of affected children at any given point in time. Therefore, this text includes significant contributions from a wide range of experts in pediatric dysphagia, including all members of the Interdisciplinary Feeding Team at Cincinnati Children’s Medical Center. These experts present an in-depth description of their roles in the diagnosis and management of dysphagic children, providing the reader with an understanding of why a multidisciplinary model of care is key to the optimization of outcomes. Pediatric Dysphagia is divided into five parts. In Part I, readers are provided with an overview of the embryologic development of aerodigestive structures that relate to swallowing, an introduction to neural organization related to swallowing function and physiologic aspects of swallowing, a synopsis of oral motor development, a discussion of the various etiologic categories of feeding and swallowing disorders, and an overview of genetic disorders associated with feeding and swallowing issues. Part II covers the clinical and instrumental assessment of patients, including the interdisciplinary feeding team infrastructure and function, the roles of individual members of the feeding team, the specific diagnostic tests commonly used in the assessment of feeding and swallowing issues, the classification of neonatal intensive care units, and the assessment and management of feeding and swallowing issues encountered in the neonatal intensive care unit. Part III focuses on the management of pediatric dysphagia, covering a wide range of treatment strategies and interventions for children with various categories of feeding disorders. Part IV includes an introduction to the concept of evidence-based practice and the application of evidence-based strategies in the management of dysphagia. Part V presents a brief overview of the role of ethics in healthcare and ethical considerations in the treatment of dysphagic children. In summary, the overall aim of this comprehensive text is to provide all pediatric professionals involved in the care of dysphagic patients with a basic understanding of the complexity of this disorder, the anatomic, neurologic, and physiologic components involved in this disorder, an overview of the diverse population of children who suffer with this disorder, and with a wide range of management approaches based on patient needs and capabilities. The authors also address clinical problem solving and decision making, inspiring readers to develop multidisciplinary models of care at their own institutions.

Pediatric dysphagia is a clinical problem that crosses disciplines. Children may be seen by numerous medical specialties including pediatric otolaryngology, gastroenterology, pulmonology, speech pathology, occupational therapy, and lactation consultants. The myriad approaches to the diagnosis and management of dysphagia is confusing for both clinicians and families; resulting in recurrent trips to medical professionals. Feeding is integral to socialization and to bonding between infants and parents. Disruptions in feeding development can be extremely taxing emotionally and economically for families. Children with dysphagia are some of the most challenging patients even for clinicians who specialize in their care. This text provides the reader with a comprehensive understanding of swallowing and presents a practical, evidence-based approach to the diagnosis and management of swallowing difficulties in children. It also highlights particular clinical challenges and controversies in the management of pediatric dysphagia. It is unique in that it incorporates the perspectives of multiple types of clinicians that care for these patients including otolaryngologists, gastroenterologists, pulmonologists, speech pathologists, occupational therapists and lactation consultants. In doing so, this text will encourage cross-specialty pollination of ideas and knowledge as well as stimulate further research in the field. Part 1 of the text begins with an overview of the anatomy and physiology of swallowing with a focus on normal development as we currently understand it. It also discusses new information regarding reflexive interactions between the larynx and esophagus that potentially influence swallowing. It then moves on to a discussion of the advantages and limitations of currently available diagnostic modalities and highlights current controversies regarding frame rate, radiation exposure, breastfeeding infants, and grading of studies. Additionally, it reviews the current literature regarding medical and behavioral-based therapy options, including thickening options, oromotor therapy, and controversies concerning strict NPO. Part 2 addresses specific diagnoses which can cause or be associated with dysphagia such as prematurity, velopharyngeal insufficiency, ankyloglossia, laryngeal clefts, laryngomalacia, vocal fold paralysis, and cricopharyngeal dysfunction. The text goes on to explore the pathophysiology and treatment options for each. Anatomic, inflammatory, and neuromuscular esophageal causes of dysphagia are also evaluated. In addition, it delves into the impact of craniofacial anomalies, sialorrhea and psychological factors on swallowing. Finally, it discusses how a multidisciplinary aerodigestive team can help streamline multidisciplinary care for individual patients. It will incorporate information pertinent to the different roles, tools and views of a multidisciplinary dysphagia team, including how pediatric otolaryngologists, gastroenterologists, pulmonologists, speech language pathologists, occupational therapists, and dieticians can collaborate to provide optimal evaluation and care of these often challenging patients, especially for those who are at high-risk of complications related to aspiration.

Introduction: To date, few research studies have evaluated pediatric feeding and swallowing practices in school systems across the United States. This study aims to i) understand the factors that impact a speech-language pathologists (SLPs) level of comfort in providing these services, ii) to identify barriers to service provision, iii) develop a concrete understanding of a SLPs role in providing feeding and swallowing services in a school setting, and iv) to identify the types of service suggested by school-based SLPs in response to a fictional case study. Methods: School-based SLPs and clinical fellows were invited to participate in a 10-15 minute web-based survey. The survey questions focused on basic demographic information, vocational history, barriers to treatment, and clinician comfort level. In addition, survey respondents were asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were collected and analyzed. Results: Descriptive data, summarizing the demographic and vocational factors of the survey respondents, are provided. In addition, independent Pearson Chi-Square analyses were performed to determine the degree of association between the demographic/vocational factors and the SLPs self-reported comfort level. The results of these correlation analyses are reported and discussed. Barriers to dysphagia management and a summary of the services currently provided in the school setting are discussed from the perspective of professional practice issues. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications and the implementation of safe swallow strategies. Discussion: The survey results indicate a number of factors impact clinician comfort level including geographic region, previous medical experience and current service provision. A number of barriers to practice were identified which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Approximately 26.5% of survey respondents indicated that there were providing feeding and swallowing related services in a school setting with 98.1 % of these clinicians providing collaborative consultation. The case study results highlighted the variability in treatment approaches.

Our understanding of eating disorders has improved markedly over the past 10 years since the publication of the previous edition of this volume. Early intervention is the key, as body dissatisfaction, obsession with thinness, and restrained and binge eating can be found in those as young as ten. Exploring prevention methods and therapeutic options,

A Go-To Resource for Speech-Language Pathologists, Occupational Therapists, Psychologists, Physical Therapists, and Behavioral Therapists The causes of feeding and swallowing difficulties in children are always multifaceted, sometimes misdiagnosed, and often difficult to assess and treat appropriately. In Let's Eat!, Angela Mansolillo - a speech-language pathologist and board-recognized specialist in swallowing disorders - has developed a menu for success in identifying and treating complex feeding and swallowing disorders in kids. In this essential pediatric resource, Mansolillo discusses the evidence for specific therapies, including oral-motor techniques, behavioral interventions, nutritional interventions, and strategies for respiratory control. Filled with a variety of easy-to-use checklists, worksheets, and sample treatment plans, this book provides allied health professionals with the tools they need to: - Establish the underlying etiology of the feeding disorder - Manage aspiration risk - Improve oral motor function - Transition clients to new foods and utensils - Navigate food refusal - Create positive associations around eating - Understand tube feeding, including types, schedules, and challenges

Comprehensive Management of Swallowing Disorders, Second Edition has been revised with new authors and expanded information on the clinical evaluations made by dysphagia specialists and with state-of-the-art medical, behavioral, and surgical treatment options. The editors have selected specialists in every swallowing-related discipline to bring this edition to a true "state-of-the-art" comprehensive text on dysphagia. The text meets the needs of students, scientists, and practitioners who are involved daily with the complex issues of dysphagia. It is divided into seven main parts: Part I. IntroductionPart II. Anatomy and Physiology of SwallowingPart III. Evaluation: A. Clinical EvaluationPart III. Evaluation: B. Functional TestsPart IV. Pathophysiology of Swallowing DisordersPart V. Nonsurgical Treatment of Swallowing DisordersPart VI. Surgical Treatment of Swallowing DisordersPart VII. Swallowing Disorders: Prevalence and Management in Special Populations Each section has been carefully edited with up-to-date references and provides the reader with a host of new material related to diagnosis, testing, and management of swallowing disorders. The authors represent the current core of those involved in multidisciplinary swallowing centers, and each focuses on his or her area of specialization. They bring their own perspective on the issues and challenges they face in managing swallowing disorders, knowing that other specialists are equally involved. This single volume is intended for practicing clinicians, students, and research scientists and represents up-to-date information in each area of specialization. Special Features: Details extensive discussions of normal swallow in pediatric and adult populationsProvides concise outlines of specific clinical examinations by seven clinical specialists: Otolaryngology, Speech Pathology, Rehabilitation Medicine, Neurology, Gastroenterology, Pediatrics, and NutritionDescribes a variety of treatments offered by many different specialties, including prosthodontists, speech-language pathologists, infectious disease specialists, and pediatriciansBrings issues of diet and nutrition up to date within the international dysphagia diet guidelinesFeatures a multidisciplinary team approach blended throughout the text that reflects the needs of the patients with swallowing disorders