Pediatric Dysphagia: Etiologies, Diagnosis, and Management

First Edition

Jay Paul Willging, Claire Kane Miller, Aliza P. Cohen

Details: 590 pages, Full Color, Softcover, 7" x 10"

ISBN13: 978-1-59756-864-7

© 2020

Release Date: 12/16/2019

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Pediatric Dysphagia: Etiologies, Diagnosis, and Management is a comprehensive professional reference on the topic of pediatric feeding and swallowing disorders. Given that these disorders derive from abnormalities in the function and/or structure of the airway and digestive systems, multiple clinical specialists may be involved in the evaluation and management of affected children at any given point in time. This text therefore includes significant contributions from a wide range of experts in pediatric dysphagia, including all members of the Interdisciplinary Feeding Team at Cincinnati Children’s Medical Center. These experts present an in-depth description of their roles in the diagnosis and management of dysphagic children, providing the reader with an understanding of why a multidisciplinary model of care is key to the optimization of outcomes.

Pediatric Dysphagia is divided into five parts. In Part I, readers are provided with an overview of the embryologic development of aerodigestive structures that relate to swallowing, an introduction to neural organization related to swallowing function and physiologic aspects of swallowing, a synopsis of oral motor development, a discussion of the various etiologic categories of feeding and swallowing disorders, and an overview of genetic disorders associated with feeding and swallowing issues. Part II covers the clinical and instrumental assessment of patients, including the interdisciplinary feeding team infrastructure and function, the roles of individual members of the feeding team, the specific diagnostic tests commonly used in the assessment of feeding and swallowing issues, the classification of neonatal intensive care units, and the assessment and management of feeding and swallowing issues encountered in the neonatal intensive care unit. Part III focuses on the management of pediatric dysphagia, covering a wide range of treatment strategies and interventions for children with various categories of feeding disorders. Part IV includes an introduction to the concept of evidence-based practice and the application of evidence-based strategies in the management of dysphagia. Part V presents a brief overview of the role of ethics in healthcare and ethical considerations in the treatment of dysphagic children.

In summary, the overall aim of this comprehensive text is to provide all pediatric professionals involved in the care of dysphagic patients with a basic understanding of the complexity of this disorder, the anatomic, neurologic, and physiologic components involved in this disorder, an overview of the diverse population of children who suffer with this disorder, and with a wide range of management approaches based on patient needs and capabilities. The authors also address clinical problem solving and decision making, inspiring readers to develop multidisciplinary models of care at their own institutions.

Foreword by Robin T. Cotton

Preface

Acknowledgments

Contributors

 

Part I. Foundations

 

Section 1. Embryology

Chapter 1. Embryologic Development of Aerodigestive Structures that Relate to Swallowing

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 2. Neural Control of Swallowing

Chapter 2. Neural Organization Related to Swallowing

Claire Kane Miller, Lisa N. Kelchner, and Jay Paul Willging

Chapter 3. Cranial Nerves Associated with Swallowing 

Claire Kane Miller, Lisa N. Kelchner, and Jay Paul Willging

Chapter 4. Three Phases of Swallowing

Claire Kane Miller, Lisa N. Kelchner, and Jay Paul Willging

Chapter 5. Respiration, Swallowing, and Protective Reflexes

Claire Kane Miller, Lisa N. Kelchner, and Jay Paul Willging

 

Section 3. Oral Motor Development

Chapter 6. Oral Motor Development

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 4. Etiologies

Chapter 7. Syndromes, Sequences, and Associations

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 8. Neurologic Etiologies

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 9. Structural Etiologies

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 10. Respiratory Conditions

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 11. Cardiac Conditions

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 12. Functional Disorders of the Esophagus

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 13. Functional Disorders of the Gastrointestinal Tract

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 14. Sensory Processing Disorders

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 15. Metabolic Disorders

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 16. Psychosocial and Behavioral Disorders

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 5. Genetics

Chapter 17. Genetic Syndromes and Disorders and Their Associated Feeding Issues

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Part II. Clinical and Instrumental Assessment

 

Section 6. Interdisciplinary Feeding Team

Chapter 18. Team Infrastructure and Function

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 19. Role of the Pediatric Otolaryngologist

Jay Paul Willging

Chapter 20. Role of the Pulmonologist

Dan T. Benscoter

Chapter 21. Role of the Pediatric Gastroenterologist

Vincent Mukkada, Aliza P. Cohen, and Jay Paul Willging

Chapter 22. Role of the Registered Nurse

Candace J. Hochstrasser

Chapter 23. Role of the Nurse Practitioner

Candace J. Hochstrasser

Chapter 24. Role of the Registered Dietician

Amy E. Reed

Chapter 25. Role of the Pediatric Speech-Language Pathologist

Claire Kane Miller

Chapter 26. Role of the Occupational Therapist

Elizabeth J. Kirby

Chapter 27. Role of the Social Worker

Sarah M. Weller

Chapter 28. Case Study Reflecting Interdisciplinary Feeding Team Approach

Claire Kane Miller

 

Section 7. Oral Motor Feeding Assessment

Chapter 29. Clinical Oral Motor Feeding Assessment

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 8. Instrumental Assessment

Chapter 30. The Videofluoroscopic Swallowing Study

Claire Kane Miller, Steven J. Kraus, Aliza P. Cohen, and Jay Paul Willging

Chapter 31. Fiberoptic Evaluation of Swallowing

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 32. Adjunctive Diagnostic Testing in the Evaluation of Pediatric Dysphagia

Charles M. Myer IV, Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 9. Assessment and Management of Feeding and Swallowing Issues in the Neonatal Intensive Care Unit

Chapter 33. Classification of Neonatal Intensive Care Units

Claire Kane Miller, Alison S. Riley, Brenda K. Thompson, and Ann Clonan

Chapter 34. Selective Conditions Frequently Seen in the Neonatal Intensive Care Unit

Claire Kane Miller, Alison S. Riley, Brenda K. Thompson, and Ann Clonan

Chapter 35. The Neonate in the Neonatal Intensive Care Unit Environment

Claire Kane Miller, Alison S. Riley, Brenda K. Thompson, and Ann Clonan

Chapter 36. Feeding Assessment of Neonates in the Neonatal Intensive Care Unit

Claire Kane Miller, Alison S. Riley, Brenda K. Thompson, and Ann Clonan

Chapter 37. Therapeutic Interventions in the Neonatal Intensive Care Unit

Claire Kane Miller, Alison S. Riley, Brenda K. Thompson, and Ann Clonan

 

Part III. Management of Pediatric Dysphagia

 

Section 10. Overview of Treatment Strategies

Chapter 38. Overview of Treatment Strategies

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 39. Management of Feeding Issues in Infants and Children with Craniofacial Anomalies

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

Chapter 40. Management of Dysphagia in Children with Underlying Neurogenic Conditions

Claire Kane Miller, Aliza P. Cohen, and Jay Paul Willging

 

Section 11. Sensory Processing Disorders

Chapter 41. Sensory Processing Disorders and Regulatory Issues that Affect Feeding

Claire Kane Miller and Jennifer Maybee

Chapter 42. Interventions for Sensory Processing Disorders

Claire Kane Miller and Jennifer Maybee

 

Section 12. Behavioral Feeding Disorders and Intervention Strategies

Chapter 43. Behavioral Feeding Disorders

Claire Kane Miller and Lori B. Vincent

Chapter 44. Behavioral Assessment

Claire Kane Miller and Lori B. Vincent

Chapter 45. Behavioral Feeding Interventions

Claire Kane Miller and Lori B. Vincent

 

Section 13. Management of Gagging, Retching, and Tube Feeding Issues

Chapter 46. Management of Gagging, Retching, and Tube Feeding Issues

Therese O’Flaherty, Aliza P. Cohen, and Jay Paul Willging

 

Part IV. Evidence-Based Medicine

 

Section 14. Evidence-Based Practice and Assessing Outcomes in Pediatric Dysphasia

Chapter 47. Levels of Evidence

Claire Kane Miller

Chapter 48. Components of Evidence-Based Practice

Claire Kane Miller

Chapter 49. Establishing Care Recommendations, Clinical Pathways, and Treatment Protocols

Claire Kane Miller

Chapter 50. Integrating Functional Outcomes in the Dysphagia Treatment Plan

Claire Kane Miller

 

Part V. Ethics in Pediatric Dysphagia

                                        

Section 15. Ethics in Pediatric Dysphagia

Chapter 51. Ethics in Pediatric Dysphagia

Candace Ganz and Claire Kane Miller

 

Index

Jay Paul Willging

Jay Paul Willging, MD, is a Professor of Otolaryngology–Head and Neck Surgery at the University of Cincinnati College of Medicine. He completed his fellowship in pediatric otolaryngology at Cincinnati Children’s Hospital Medical Center (CCHMC) and has been a member of the Division of Pediatric Otolaryngology–Head and Neck Surgery at CCHMC since 1992. He is the Director of the Pediatric Otolaryngology Fellowship Training Program and also the Director of Clinical Operations for the Otolaryngology Division. He has served as the Director of the Interdisciplinary Feeding Team since 1999, and is also an active participant in numerous other multidisciplinary programs, including the Aerodigestive and Esophageal Center, the Craniofacial Anomaly Team, the Fiberoptic Endoscopic Evaluation of Swallowing Safety Clinic, and the Velopharyngeal Insufficiency Clinic. Dr. Willging has numerous peer-reviewed clinical and research publications and has been a longstanding contributor to textbooks on a wide range of otolaryngology topics, particularly feeding and swallowing disorders.

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Claire Kane Miller

Claire Kane Miller, PhD, MHA, CCC-SLP, is the Program Director of the Aerodigestive and Esophageal Center's Interdisciplinary Feeding Team at Cincinnati Children's Hospital Medical Center, where she also assumes a clinical position in the Division of Speech-Language Pathology. She holds a faculty appointment as a field service Associate Professor in the Department of Otolaryngology-Head and Neck Surgery at the University of Cincinnati College of Medicine, where she is an adjunct Assistant Professor in the Department of Communication Sciences and Disorders. Her research and clinical interests are in the area of pediatric dysphagia, with a focus on instrumental swallowing assessment and the clinical management of medically fragile infants and children with congenital and acquired airway and digestive anomalies. She has authored publications and presented nationally and internationally on aspects of pediatric dysphagia.

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Aliza P. Cohen

Aliza P. Cohen, MA, is a medical and science writer who has spent more than three decades working in academic medicine. During this time, she has worked collaboratively with faculty and fellows in pediatric surgery, pediatric neurology, pediatric pulmonary and sleep medicine, and pediatric otolaryngology. She has coauthored numerous articles and book chapters on a wide array of topics within these disciplines and has dedicated her efforts to mentoring fellows and faculty in the pursuit of excellence in writing.

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ISBN13: 978-1-94488-351-5

© 2020

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