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Dev Med Child Neurol. 2015 Nov;57(11):1056-63. doi: 10.1111/dmcn.12796. Epub 2015 May 15.

Food and fluid texture consumption in a population-based cohort of preschool children with cerebral palsy: relationship to dietary intake.

Author information

1
Queensland Cerebral Palsy and Rehabilitation Research Centre, The School of Medicine, The University of Queensland, Brisbane, Qld, Australia.
2
Speech Pathology Department, Royal Children's Hospital, Brisbane, Qld, Australia.
3
Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.
4
School of Population Health, The University of Queensland, Brisbane, Qld, Australia.
5
Children's Nutrition Research Centre, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Qld, Australia.

Abstract

AIM:

To determine the texture constitution of children's diets and its relationship to oropharyngeal dysphagia (OPD), dietary intake, and gross motor function in young children with cerebral palsy (CP).

METHOD:

A cross-sectional, population-based cohort study comprising 99 young children with CP (65 males, 35 females) aged 18 to 36 months (mean age 27mo; Gross Motor Function Classification System [GMFCS] level I, n=45; II, n=13; III, n=14; IV, n=10; V, n=17). CP subtypes were classified as spastic unilateral (n=35), spastic bilateral (n=49), dyskinetic (n=5), and other (n=10), in accordance with the criteria of the Surveillance of Cerebral Palsy in Europe. Habitual dietary intake of food textures, energy, and water were determined from parent-completed 3-day weighed food records. Parent-reported feeding ability of food textures was reported on the Pediatric Evaluation of Disability Inventory and a feeding questionnaire. OPD was classified based on clinical feeding assessment using the Dysphagia Disorders Survey (rated by a certified assessor, KAB) and a subjective Swallowing Safety Recommendation (classified by a paediatric speech pathologist, KAB).

RESULTS:

Food/fluid textures were modified for 39% of children. Children with poorer gross motor function tended to receive a greater proportion of energy from fluids (GMFCS levels IV-V: β=0.9, p=0.002) in their diets and fewer chewable foods (level III: β=-0.7, p=0.03; levels IV-V: β=-1.8, p<0.001) compared to level I to II participants. Fluids represented a texture for which children frequently had OPD and the texture most frequently identified as unsafe (or recommended for instrumental assessment).

INTERPRETATION:

These findings indicate that swallowing safety, feeding efficiency, and energy/water intake should be considered when providing feeding recommendations for children with CP.

PMID:
25982341
DOI:
10.1111/dmcn.12796
[Indexed for MEDLINE]
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