Article

AIM: To determine the texture constitution of children's diets and its
relationship to oropharyngeal dysphagia (OPD), dietary intake, and gross motor
function in young children with cerebral palsy (CP).
METHOD: A cross-sectional,
population-based cohort study comprising 99 young children with CP (65 males, 35
females) aged 18 to 36 months (mean age 27mo; Gross Motor Function Classification
System [GMFCS] level I, n=45; II, n=13; III, n=14; IV, n=10; V, n=17). CP
subtypes were classified as spastic unilateral (n=35), spastic bilateral (n=49),
dyskinetic (n=5), and other
(n=10), in accordance with the criteria of the
Surveillance of Cerebral Palsy in Europe. Habitual dietary intake of food
textures, energy, and water were determined from parent-completed 3-day weighed
food records. Parent-reported feeding ability of food textures was reported on
the Pediatric Evaluation of Disability Inventory and a feeding questionnaire. OPD
was classified based on clinical feeding assessment using the Dysphagia Disorders
Survey (rated by a certified assessor, KAB) and a subjective Swallowing Safety
Recommendation (classified by a paediatric speech pathologist, KAB). RESULTS:
Food/fluid textures were modified for 39% of children. Children with poorer gross
motor function tended to receive a greater proportion of energy from fluids
(GMFCS levels IV-V: beta=0.9, p=0.002) in their diets and fewer chewable foods
(level III: beta=-0.7, p=0.03; levels IV-V: beta=-1.8, p<0.001) compared to level
I to II participants. Fluids represented a texture for which children frequently
had OPD and the texture most frequently identified as unsafe
(or recommended for
instrumental assessment). INTERPRETATION: These findings indicate that swallowing
safety, feeding efficiency, and energy/water intake should be considered when
providing feeding recommendations for children with CP.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS