Friday, May 28, 2010
What is Dysphagia
Dysphagia is the medical term for swallowing difficulty. This includes any difficulty while food passes from the mouth to the stomach. In some cases, children may inhale food or liquid into their lungs provoking aspiration pneumonia. Dysphagia’s effects can be serious, potentially causing weight loss, failure to thrive or pain while eating or drinking. Any condition which weakens the muscles or nerves for safe swallowing can cause dysphagia. In adults common causes of swallowing difficulty are stroke, traumatic brain injury, degenerative diseases and head and neck cancer. In infants and children it is respiratory conditions, prematurity, structural differences (e.g., cleft palate) and developmental delays.
To combat dysphagia speech and occupational therapy use techniques like oral motor strengthening, gross motor development, sensory integration and food modifications to improve the child’s ability to safely swallow the food that they love. Recently, neuromuscular electrical stimulation (NMES) has been added to assist in swallowing therapy.
Currently, VitalStim therapy is the only NMES therapy and equipment FDA approved to treat dysphagia. VitalStim therapy is non-invasive, and when used with traditional dysphagia therapy techniques improves safe swallowing by strengthening muscles in the oral cavity (i.e., mouth) and pharynx (i.e., throat).
Ranken Jordan cares for many children suffering from dysphagia. Through a grant by Variety a Children’s Charity of St. Louis, Ranken Jordan purchased VitalStim equipment to enhance the speech therapy program. Kaci Pate, Speech Language Pathologist, joined Ranken Jordan in January 2009, bringing several years of VitalStim experience. Kaci sees firsthand the progress made when VitalStim therapy is used with traditional dysphagia therapy techniques. Kaci says, “VitalStim therapy allows therapists to target specific muscle groups that were otherwise extremely difficult to target in traditional therapy exercises. With the use of VitalStim therapy, patients have the opportunity to improve oral motor and swallowing skills at a potentially faster rate than before.”
4 Year-Old Deven
4 year-old inpatient Deven has insufficient oral motor skills for eating certain foods. The muscles in his mouth, tongue and jaw are weak causing difficulty when eating foods that are chewy, tough or crunchy. He also has trouble keeping saliva in his mouth. Prior to his VitalStim therapy Deven’s bib to catch his drooling needed 8-10 changes a day. Now, his parents say he needs half as many bib changes and does not lose as much food from his mouth while eating.
16 Year-Old Andrew
Andrew was born with cerebral palsy affecting his ability to control the muscles around his mouth. Subsequently, he eats food that is pureed allowing him to eat larger quantities and reduce the risk of choking on larger pieces of food. However, he tends to lose the pureed food and liquids because the deficient muscle strength to close his lips completely.
After surgery for his dislocated hip Andrew came to Ranken Jordan’s Day Treatment Program for rehab. The program incorporates multiple therapies including speech therapy where his dysphagia was treated. In Andrew’s first week of VitalStim therapy his mother Anna says they started to see results, “He’s not losing as much [food] and his lips keep closed better.” The 16-year-old is now back at home still receiving therapy as an outpatient for his hip and dysphagia a couple times a week.