Background: Some children with early feeding difficulties may require nasogastric, (NG) tube feeding or insertion of a percutaneous endoscopic gastrostomy, (PEG) from a young age. A small cohort of these children can develop severe oral aversions that can delay the re-introduction of oral feeding. Multi-disciplinary approaches that provide an intensive approach are deemed the most effective method of intervention to reduce NG and PEG dependency.

Method: Two children and their parents received an Intensive Approach to reduce PEG feeds, (Child A and Child B), whilst one child and her parents elected to receive a Traditional Feeding Clinic Approach, (Child C). The mean age of the participants was 4 years 4 months.
 
Results: Child A initially took 500 kcal (440% daily nutritional requirement) via her PEG, and 750 kcal (60% daily nutritional requirement) orally one week prior to the intensive programme, and Child B took 1200 kcal (100% daily nutritional requirement) via his PEG and O Kcal orally. Three months post the intervention, Child A took 100%all of her nutritional requirements orally, (1300 kcal/ 100% daily nutritional requirement), and Child B had reduced PEG requirement significantly to 38% oftook 500 kcal ( 50% daily nutritional requirement.) via his PEG, and 500 kcal orally. Child C showed no changes in PEG versus oral intake. 
Children who received the intervention were able to remain focused on mealtimes for longermore, with fewer instances ofand did not leavinge the table. Parents altered their language styles post coaching on the intensive intervention with using fewer reprimands. No changes with these behaviours were noted with Child C.

Conclusions: Although this was a small pilot study, there are some strategies used within an intensive multi-disciplinary context that can enable children to reduce their reliance on PEG feeds significantly.

/pdf/evaluation-of-an-intensive-desensitisation-oral-tolerance-4tblrsa2zy.pdf

Evaluation of an intensive desensitisation, oral tolerance therapy and hunger provocation program for children who have had prolonged periods of tube feeds

Eating and drinking are essential for maintenance of nutrition and hydration, but are also important for pleasure and social interactions. The ability to eat and drink hinges on a complex and coordinated system, resulting in significant potential for things to go wrong. The Royal College of Physicians (RCP) has published updated guidance on how to support people who have eating and drinking difficulties, particularly towards the end of life. Decisions about nutrition and hydration and when to start, continue or stop treatment are some of the most challenging to make in medical practice. The newly updated guidance aims to support healthcare professionals to work together with patients, their families and carers to make decisions around nutrition and hydration that are in the best interests of the patient. It covers the factors affecting our ability to eat and drink, strategies to support oral nutrition and hydration, techniques of clinically-assisted nutrition and hydration, and the legal and ethical framework to guide decisions about giving and withholding treatment, emphasising the two key concepts of capacity and best interests. This article aims to provide an executive summary of the guidance.

Supporting people who have eating and drinking difficulties

Purpose: Children with special health care needs (CSHCN) are most in need of anticipatory guidance and prevention. Achieving and maintaining optimal oral health is challenging, due to the many challenges this group faces both in medical and dental care. The purpose of this pilot project was to identify the educational needs of health professionals on a feeding team to prepare them to provide anticipatory guidance to special needs children, along with preliminary investigation into the role of the dental hygienist in improving the oral health of the CSHCN served by the feeding team. Methods: Small focus groups were used to determine educational needs of the feeding team and provide initial identification of the role of the dental hygienist on the feeding team. Results: The needs assessment indicated interest in an in-service to address connections between oral health and feeding issues, i.e. problems related to tube feeding and oral hypo- and hypersensitivities of the CSHCN. Conclusion: This project suggests there is a role for the dental hygienist on the feeding team to provide preventive dental care and referral as well as education for caregivers and therapists. Future research is needed to further delineate the role of the dental hygienist on the feeding team as well as implementation of a model for integrating them into this multidisciplinary team. This study supports the NDHRA priority area, Health Services Research: Assess the impact of dental hygiene services on the outcomes of care for patients with special health care needs

https://jdh.adha.org/content/jdenthyg/85/2/132.full.pdf

Interface with a Community Feeding Team to Address Oral Health of Special Needs Children: A Pilot Project

..................................................................................................................................... i Co-Authorship Statement.......................................................................................................... ii Acknowledgments.................................................................................................................... iii Table of

/pdf/health-professional-students-understanding-of-oral-health-in-3fzllqsi66.pdf

Health Professional Students' Understanding of Oral Health in Traumatic Brain Injury

Chapter 3 – SPECIFIC PROBLEM AREAS

A 56 year old man who was 10 months post-severe traumatic brain injury was unable to tolerate oral hygiene. He had oro-facial hypersensitivity, oral dyspraxia and limited oral function. Poor oral hygiene with coating of oral structures and infection was present. An intensive systematic desensitization programme over 2 weeks, even at this late stage post-injury, increased oral tolerance and allowed full oral hygiene. Participation in oral hygiene and functional patterns of movement also improved, enabling some oral nutritional intake. This case study provides controlled evidence, very little of which exists in the literature, to demonstrate the effectiveness of these treatment techniques

Treatment of oro-facial hypersensitivity following brain injury.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

R. Gilmore

Author Tools

Chat about Author

Papers

Treatment of oro-facial hypersensitivity following brain injury.