Early Feeding Abilities in Children with Cerebral Palsy: A Parental Report Study

Abstract

PURPOSE: The goals of this study were to 1) describe the feeding skills of young children with cerebral palsy (CP); and 2) elucidate the type and severity of feeding problems for children with and without oral-motor involvement. METHOD: Parents of 37 children (16 females, 21 males) with CP, who ranged in age from 11-58 months (mean age = 41 months), completed questionnaires regarding their child's past and current feeding abilities. Children were also clinically evaluated to determine whether each had evidence of oral-motor involvement. RESULTS: Children with CP and oral-motor involvement had significantly more difficulty with self-feeding, increased frequency of coughing and choking, increased prevalence of swallowing evaluation and feeding therapy, and were introduced to solid food at a later age relative to children with CP who did not have oral-motor involvement. Both groups of children were similar in their history of tube feeding, bottle feeding, difficulty with solid foods, use of adaptive equipment, duration of mealtimes, and presence of choking, coughing, and gagging. CONCLUSIONS: Children with and without oral-motor involvement initially presented with similar feeding difficulties. However, feeding problems appeared to resolve to a greater extent in children without oral-motor involvement. The difficulties identified early in life, for children with oral-motor involvement, appeared to persist with development.

Figure 1

Illustration of previous investigations on feeding abilities in individuals with cerebral palsy. For each investigation (vertical axis) the age range (years) of the participants is depicted along the horizontal axis. Each investigation includes the authors, the number (n) of participants, as well as the mean age of the participants. * Mean age not provided

Figure 2

Distribution of participant characteristics. The vertical axis represents the age distribution (months rounded). The horizontal axis represents the gender distribution. The presence or absence of oral-motor involvement is also reported; a black bar represents the absence of oral-motor involvement and a white bar represent the presence of oral-motor involvement.

Figure 3

The range and average frequency rating of coughing, gagging, and choking for children with oral-motor involvement and children without oral-motor involvement. The vertical axis represents the two oral-motor involvement categories and respective symptoms. The horizontal axis represents the frequency range of symptoms (1 = never, 7 = every meal). The average frequency rating for those children reporting the presence of coughing, gagging, or choking (i.e., frequency rating >1) is depicted by the large ♦ for each symptom across both groups. There was no significant difference in the presence of any symptom between the groups. However, children with oral motor involvement demonstrated significantly greater frequency of both coughing and choking. Note: all participants who demonstrated coughing or choking symptoms had a frequency rating of 2. Therefore the range and average was 2.