The National Center for Evidence-Based Practice
in Communication Disorders
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Cerebral Palsy
Swallowing/Feeding Assessment

 


 

External Scientific Evidence

  

Evidence-Based Practice Guidelines

American Academy of Neurology - Medical Specialty Society 
 
Practice Parameter: Diagnostic Assessment of the Child with Cerebral Palsy: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society
Ashwal, S., Russman, B. S., et al. (2004).
Neurology, 62(6), 851-63.
Added: July 2011
 
Description
This guideline provides recommendations for the assessment of children with cerebral palsy (CP). The primary audience for this guideline is neurologists. The recommendations are classified A, B, C or U based on the strength and consistency of evidence. Level A recommendations are "established as effective, ineffective or harmful" and based on evidence from consistent high quality randomized controlled trials (RCTs). Level B recommendations are "probably effective, ineffective or harmful" and based on evidence from a high quality RCT or consistent evidence from two or more lower quality RCTs. Level C recommendations are "possibly effective, ineffective or harmful" and based on evidence from at least one low quality RCT or consistent evidence from two or more controlled trials. Level U recommendations indicate that the data is "inadequate or conflicting" and therefore, the treatment is unproven. 
 
Recommendations
"Nutrition, growth, and other aspects of swallowing dysfunction should be monitored. Further specific evaluations are warranted if screening suggests areas of impairment" (p. 860). 
 
 
  
 
 
 
Evidence-Based Systematic Reviews
Digestive Tract Neural Control and Gastrointestinal Disorders in Cerebral Palsy
Araujo, L., Silva, L., et al. (2012).
Jornal de Pediatria, 88(6), 455-64.
Added: April 2013

Description
This is a review of the literature investigating the neural control of the digestive tract and the primary gastrointestinal disorders associated with cerebral palsy.

Conclusions

  • In a clinical evaluation of dysphagia height, weight, and anthropometric measures should be obtained. Additionally, "spontaneous swallowing of saliva and intake of different food consistencies should be carefully observed" (p. 6).

  • Signs of dysphagia can include:

    • cough

    • delayed pharyngeal swallow reflex

    • fatigue during or after feeding

    • apnea or dyspnea during feeding

    • tongue thrust

    • grimacing during feeding

    • stridor during or after feeding

  • Videofluoroscopy may also be conducted if aspiration or silent aspiration is suspected.

» See full summary and quality ratings

 
  

Clinical Expertise/Expert Opinion

 
Consensus Guidelines  
No consensus guidelines were found.
 
 
 

Client/Patient/Caregiver Perspectives

 
No information was found pertaining to client/patient/caregiver perspectives.
 
 
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