SPV 327 Speech Pathology Organic Disorders

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SPV 327 Speech Pathology Organic Disorders

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SPV 327 Speech Pathology Organic Disorders

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Course Code: SPV327
University: The City University Of New York

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Country: United States


Evidenced Based Practice is something that we strive for as Speech-Language Pathologists and it is important to get into the habit of utilizing current research to find out appropriate therapeutic techniques, assessment techniques, and to keep up to date on various disorders.

Disorder in Children and Infant
More than often, we find ourselves faced with adverse condition when it comes to feeding and swallowing amongst children. This is a common problem amongst infants known as dysphagia. It is usually caused by many factors. In most cases, swallowing disorder or problem can occur at any stage in the process of eating. In some cases, feeding disorder may appear in kids in that it is difficult to gather food and suck, chew, or swallow (Riesco et al., 2018)
Purpose of study
According to Riesco et al. (2018), increased cases of feeding and swallowing disorder has necessitated this research to be carried out with the aim of developing and finding viable solutions, which can help curb the problem among children that can be dragonized. This paper also aims at finding full information about feeding and swallowing disorder, general signs and symptoms, its causes, how to test for the disorder and treatment of the disorder.
Rationale for the study
It has always been very common for pediatric feeding and swallowing disorder of about 25-35% to be seen in children who are developing normally and almost 55-75% in children who have been born prematurely or those who are experiencing chronic medical conditions (Sysko et al., 2015). Technically, swallowing disorder arises more often due to structural weaknesses or dysfunction that in turn results in difficulty with the actual act of food movement in the digestive system i.e. from the mouth to the stomach. On the other hand, feeding disorder majorly entails the motivation of the range if mannerism (behavioral) that results in the kids refusing to eat mostly known as food aversion. It is common to find this kind of problem among children but in rare cases, it also affects adults.
We as grownups, we all know the process of eating which is always a foreign phenomenon amongst children and infants. To kids, this process starts by sucking which then develops to eating tangible food. In the cause of learning how to feed and swallow food, children end up experiencing a number of obstacles such as pushing food back out or may gag on new food, which is always normal to them (Adamson & Morawska 2017). When it comes to children with feeding disorder, they tend to experience this obstacle for a prolonged period. It may even result to children only eating certain foods rather spends much time eating than the normal children. In addition to this, swallowing problem that is also a problem among the children also known as dysphagia takes place in three. According to research, children may have problems in one of the phases or more than one stage. These stages include:

The oral phase it entails sucking, chewing and movement of food or fluids into the esophagus. In this case, feeding becomes part of this stage.
The pharyngeal phase-the genesis of this stage is swallowing and squeezing of bolus down the throat. At this stage, it becomes a requirement for a child to close of his airway so that it may not be tempered with food or fluids. In case of food going through the windpipe, it may result in chocking or coughing.
The esophageal phase-it involves the opening and closing of the esophagus. The long narrow tube that runs from the mouth to the stomach whose main function is to act as food passage. To some extent, children with disorder may experience food sticking in the esophagus or the infant may end up throwing a lot if he has problem with the esophagus.

In order to come up with concrete evidence on the research, various methods were followed. There were 23 participants. Seven children with feeding and swallowing disorders, seven who had no abnormality, four parents and five professionals. A number of instrument were also used in the process such as endoscopic tools, monitor in addition to modified barium swallows.
Results of the research
In most cases, swallowing disorder can results from continuous decrease in the functioning of the oral, pharyngeal or the structure of the esophagus. The major signs that accompany swallowing disorder include; a child or infant coughing or chocking with food or liquid when eating, the quality of the vocal may be wet (gurgle voice), presence of running nose or watery eyes with meals, the kid may experience prolonged durations of feeding or completely refuse to eat. Respiratory problems such as pneumonia, they may experience low-grade fever following meals in addition to difficulty in chewing or abnormal oral feeding (Adamson et al., 2017).
Feeding disorder on the other hand may slightly differ from swallowing disorder in that they are based on mannerism.it arises because of swallowing disorder. For instance, an infant who has been fed through tube may averse orally thus presenting feeding disorder. This kind of problem is majorly characterized by; aversion of food or refusal to eat, the kid may fail to advance to age i.e. may not eat the appropriate food of his age. Development of negative mannerism of mealtime may experience prolonged vomiting, vomiting and chocking in addition to failing to thrive (Adamson et al., 2017). Other additional signs and symptoms of feeding and swallowing disorder include arches on the back or stiffening when feeding, tendency to fall asleep when in the process of eating. The kid may have difficulty in breathing when drinking or eating. They may also experience drooling a lot or presence of fluid coming from the mouth and nose. It should be noted that not every child suffering from this disorder will experience all the symptoms thy may just have part of them (Wade & O’Shea, 2015).
Discussion of the findings
In case of this sighs, the child may be exposed to the risk being dehydrated or poor nutrition, lungs infections such as pneumonia. To some extent, the child may experience the feeling of embarrassment concerning their eating problem thus refusing to eat around others (Wade et al., 2015).
Causes this disorder
The disorder may be result due to a range of possibilities for instance: when the child has nervous system disorders such as cerebral palsy or meningitis, presence of reflux or other stomach complications.  When the child has been born prematurely or has low birth weight, cases of autism and muscle weakness in the face and neck. This problem may also emerge due to sensory complications.
Testing for the presence of the disorder in kids
The best of all practices is talking to the pediatrician concerning the condition that the child is going through. These diseases can be diagnosed by the doctor through asking questions about the history of the child’s development and the genesis of the problem. Taking keen notice of how the child moves his or her tongue and mouth. Trying to keep watch of how the kid eats so that you can see how the child picks food, chews or even swallows. Special tests can be done by the SLP such as (Wade et al., 2015).

The use of modified barium swallows – this involves eating of food or drinks, which contain barium. When an x-ray is taken, the barium will show thus the doctor can monitor where the food goes.
Endoscopic assessment- this entails putting a tube with light in the nose of the child. The scope which relays information on the screen or monitor. Those who can be involved in diagnosing the child include an occupational therapist, a physical therapist, a dietitian or nutritionist in addition to a lactation consultant

Clinical implications
From the research carried out, it is quite clear that the swallowing and feeding disorder can result to larger problems thus calls for a need to find ways of curbing the problem. The research can be transferred to clinical work by practically trying to develop treatment for the problem through curbing feeding and swallowing disorder amongst the infants, a number of suggestions may be put forth by the experts, which involves medical treatment such as treatment of reflux issuing medication for the problem, involving the children in feeding therapy, changing the temperature of the food. Adjusting the position of the child when eating food may also help curb the problem. In extreme conditions, it may necessitate the use of tube through the nose to inject nutrients to the child. These treatments may facilitate the muscles of the mouth to be stronger and help the kid to move their tongue when feeding (Bryant-Waugh, Markham, Kreipe, & Walsh et al. 2010). They also tend to facilitate chewing of food. In addition to this, the treatment helps the child with sensory issue such as helping them adjust to the test of food in the mouth.
Limitations of the study
The research was limited to children living in a particular region whom were selected randomly from the population to act as sample. It was also discovered that part from the ones discussed above could also lead to the language disorder such as genetic problems, accidents that were not involved in the discussion. Factors such as change in environment, caregiver, and the teacher of the child in addition to caregiver could largely affect the language of the child.
Conclusion and recommendation
It is important to speak with pediatricians concerning any problem or disorder that may appear in children so that solutions can be developed to help the child.  Finding treatment for such disorders is quite critical so that it may not affect the child in the process of development. It is therefore recommended that during future research, it will be important to consider factors such as the environment of the child, effects of the caretaker on the child’s speech and other factors. 
Adamson, M., & Morawska, A. (2017). Early Feeding, Child Behaviour and Parenting as Correlates of Problem Eating. Journal of Child & Family Studies, 26(11), 3167–3178
Bryant-Waugh, R., Markham, L., Kreipe, R. E., & Walsh, B. T. (2010). Feeding and eating disorders in childhood. International Journal of Eating Disorders, 43(2), 98–111.
Riesco, N., Agüera, Z., Granero, R., Jiménez-Murcia, S., Menchón, J. M., & Fernández-Aranda, F. (2018). Other Specified Feeding or Eating Disorders (OSFED): Clinical heterogeneity and cognitive-behavioral therapy outcome. European Psychiatry, 54, 109–116.
Sysko, R., Glasofer, D. R., Hildebrandt, T., Klimek, P., Mitchell, J. E., Berg, K. C.Walsh, B. T. (2015). The eating disorder assessment for DSM-5 (EDA-5): Development and validation of a structured interview for feeding and eating disorders. International Journal of Eating Disorders, 48(5), 452–463.
Wade, T. D., & O’Shea, A. (2015). DSM-5 unspecified feeding and eating disorders in adolescents: What do they look like and are they clinically significant? International Journal of Eating Disorders, 48(4), 367–374

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