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

Katherine A. Benfer, Kelly A. Weir, Kristie L. Bell, Robert S. Ware, Peter S. Davies, Roslyn N. Boyd

Academic Literature


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: beta = 0.9, p = 0.002) in their diets and fewer chewable foods (level III: beta = -0.7, p = 0.03; levels IV-V: beta = -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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Publication information

Journal/Publication : Developmental Medicine & Child Neurology

Domain/s: Education

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