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Feeding and swallowing disorders in children with clefts in orofacial region

Nika Jelenc (2017) Feeding and swallowing disorders in children with clefts in orofacial region. MSc thesis.

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    Abstract

    Children with clefts do not only have problems with speech, but also with feeding and swallowing. In the first part of this master’s thesis theoretical description of anatomical structures and embryological development of oral cavity is given. Furthermore, in order to understand problems with feeding, knowledge about typical development of feeding and swallowing skills in infants and children is necessary. Therefore core features of swallowing phases, structural differences connected with feeding and physiology of sucking, chewing and swallowing are described. Afterwards common characteristics of children born with clefts in orofacial area are introduced. Besides prevalence and comorbidity of other problems, anatomical and functional consequences of clefts were also taken into account. In the last, key part, characteristics of feeding children with clefts are described along with definitions, main manifestations, causes and symptoms of feeding disorders in children with clefts. Treatment of children with clefts in Slovenia and worldwide, available diagnostics and therapeutic options are also introduced. The aim of the practical part was examination of prevalence and type of feeding disorders in children with clefts from ages of five months to six years. After a thorough literature overview and consultation with practitioners, anonymous questionnaire for parents was constructed. It was initially tested in a pilot study conducted during medical routine examinations and during speech therapy sessions. Ninety-three questionnaires were sent to parents of children born between 1st January 2013 and 31st December 2016. Nineteen questionnaires were returned during the pilot study and thirty-nine later on, giving the total number of fifty-eight study participants. Results show that almost three quarters of children that participated in the study had problems with feeding initiation right after birth. Even though that feeding disorder occurrence decreased afterwards, in quarter of cases problems remained until surgical treatment or are still present. The major problem before completion of surgical treatment was nasal regurgitation along with excessive air intake and prolonged feeding time. This survey also confirmed that the type of clef has an important impact on feeding problems. Children with isolated cleft lip had distinctly less feeding disorders compared with children with cleft palate with or without cleft lip. Severe feeding issues significantly correlated with speech problems. Furthermore, in children fed with nasogastric tube difficulties with weight gain and chewing seem to be more frequent. Majority of parents used special feeding bottles for children with clefts. They were generally satisfied with them, although there is a lack of feeding bottle selection in Slovenia, which could be overcome by ordering from abroad. Many parents expressed a lack of instructions and support in relation to feeding from maternity hospitals and more than a half of them claimed that they did not receive enough information about feeding from medical staff.

    Item Type: Thesis (MSc thesis)
    Keywords: Orofacial clefts, feeding and swallowing disorders, questionnaire, risk factors
    Number of Pages: 90
    Language of Content: Slovenian
    Mentor / Comentors:
    Mentor / ComentorsIDFunction
    prof. dr. Irena Hočevar BoltežarMentor
    Link to COBISS: http://www.cobiss.si/scripts/cobiss?command=search&base=50126&select=(ID=11635273)
    Institution: University of Ljubljana
    Department: Faculty of Education
    Item ID: 4552
    Date Deposited: 13 Jul 2017 13:56
    Last Modified: 13 Jul 2017 13:56
    URI: http://pefprints.pef.uni-lj.si/id/eprint/4552

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