Caregiver Adherence to Speech and Language Therapists’ Advice on Management of Dysphagia in Children with Neuro-disabilities

Abstract

Majority of children with Cerebral Palsy (CP) have feeding difficulties that affects not only their quality of life but also their caregivers and family. As caregivers carry out most feeding interventions, it is important to design an intervention that caregivers find it possible to integrate in to their daily life. The study aimed to determine the care-giver adherence to speech and language therapists’ advice on six selected strategies, in the management of dysphagia in children with neuro-disabilities. Fifteen caregivers of 1 to 10 year old children with moderate to severe CP and feeding difficulties, and whose current feeding methods required interventions were selected as participants. Caregivers were video-recorded while feeding their child pre-intervention and then introduced and demonstrated the six management strategies i.e., head position, trunk position, utensils, food consistency, bolus size, and pacing. They were video-recorded after 4-6 weeks post-intervention. A score was given for the six selected strategies both pre- and post-intervention. Results showed a significant difference between pre- and post-intervention for all six strategies (p<0.005). All care-givers were able to adhere to all six strategies post-intervention. However, some strategies were adhered to better than others; utensils, food consistency, and bolus size. Least adherence was seen for head position. Thus, the current study is expected to help speech and language therapists prioritize their goals in the management of pediatric dysphagia in children with neuro-disabilities.