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Front 1

**** What 8 factors would you look at in the nutritive suck swallow breath synchrony when assessing feeding in the NICU?

Back 1

1) efficiency of nutritive suck (energy use versus calories)
2)patterning of SSB
3) poor SSB and/or stress
4)cervical auscultation
5)quantity
6)duration of feeding (10 min normal-less than 30 minutes acceptable)
7)trial therapy
8)emesis (throwing up)

Front 2

3 impressions and recommendations in feeding assessment in NICU?

Back 2

1)include feeding guidlines
2) include prognosis
3)response to techniques
also provide education and training

Front 3

what 7 aspects of the medical history do you look at in OM and Feeding assessment?

Back 3

1)birth/neonatal history and etiology
2)medications
3)surgeries
4)neurological or genetic testing
5)diagnosis
6)physician/other health professionals
7)therapeutic support (PT,OT, Educ. AR,Vision)

Front 4

name 10 aspects of feeding/respiratory history do you look at in OM and feeding assessment?

Back 4

1)tube feeding (presence? why? how long?)
2)prodcedures used to transition from tube (how did they tolerate it?)
3)description of feeding in the past
4)ventilator/respiratory support
5)coughing, choking, gagging during feeding
6)reflux, vomiting, and/or spitting up during, after feeding
7)history of frequent irritibility
8)history of chronic constipation
9)history of pneumonia, bronchitis,or frequent respiratory infections
10)history of persistent ear infections--food could be going up eustachian tube

Front 5

name 5 things would you look at when assessing current feeding/nutrition information

Back 5

1- daily feeding schedule- (if their last meal is the worst, maybe they have emptying problems)
2-intke amounts
3-types of foods/liquids presently receiving
4)food likes/dislikes
5)temperature of foods/liquids

Front 6

name the responses to sensory stimulation that you would look at in assessment

Back 6

1) touch
2)gustatory-does child respond to new tastes (hot/warm/cold/room temp. sweet/sour/salty/spicy)
3)olfactory
4)does child own sensory stim? typically developing provide oral tactile sensory stimulation constantly to their mouth with toys, fingers, toes. If a child is motorically impaired and can't we must provide it for them
5)vestibular-look in relation to balance
6)tooth brushing-reaction
7)oral reflex development-rooting (if still has over 4 months of age) suspect oral hypersensitivty, gag-hyper,hypo,absent-will see many kids with hypersensitive gag response in the NMD population

Front 7

How would you assess communication development in OM and feeding assessment?

Back 7

You would look at communication development; modes of communication, gestures, eye pointing,facial expressions

Front 8

how would you assess phonation

Back 8

evaluate jaw position during phonation-in kids with NMD laryngeal blocking and laryngeal tensionis common. May have difficulty with pitch. Check out 1) quality of speech-breathy, hoarse, nasality,pitch and stress 2)can phonation be sustained, varied? 3)try different positions to see if phonation improves over ball, sidelying, chair, feeding chair

Front 9

When looking at respiration you are interested in the infant's _________ and _______ with _______ activity during ______, _____, and ______.

Back 9

When looking at respiration you are interested in the infant's respiratory function and coordination with oral activity during feeding, general movement and sound production.

Front 10

Be aware of _______ during respiration.

Back 10

breathing pattern

Front 11

concerning respiration, phonation, and rib cage patterns

Back 11

high rib cage with flaring of lower ribs, sternal retraction, deep breathing-may see rectus and poor mobility of rib cage

Front 12

if they have been on a ventilator, respirator what sould you find out

Back 12

how long--you will see a high and rigid shoulder girdle-respirators did not create active trunk musculature

Front 13

why would you work with an OT or PT in respiration?

Back 13

initially want to increase belly breathing-increase RC mobility, activating diaphragm--also wll work with you on position ing to bring the SG down-increasing downward pull or RC by elongating the muscles between the ribs (intercostals)

Front 14

NEVER go right on the _____ during handling, positioning.

Back 14

spine

Front 15

what should you look at during the oral peripheral exam?

Back 15

high vaulted palates-- tubed at birth??? also, lip strength, tongue strength, symmetry, tone, etc. etc.

Front 16

IN your observations of feeding you are looking at _____ OM skills and _____ OM skills which include what 5 structures?

Back 16

Normal OM skills and limiting OM skills which include jaw, cheeks, lips, tongue, and coordination

Front 17

what should you pay attention to in assessing sucking-bottle drinking?

Back 17

1)what type of bottle?
2)what type of nipple?
3)rhythmical suck swallow breathe,
4)transitions
5) strength/coordination
6)pathologies observed

Front 18

***any child over ____ with oral problems shouldn't have the botle****

Back 18

18 months

Front 19

there are many norms on straw drinking, true or false

Back 19

false-no norms

Front 20

if kids have _____ tone, get them on a _____: good for ______, _____, and ______ to help influence tone during function.

Back 20

If kids are low tone, get them on a straw--good for obicularis oris, cheeks, tongue to help influence tone during fucntion

Front 21

is straw drinking good for hypertonic kids as well?

Back 21

might not be the best method to try but if this will allow them to be independent

Front 22

what do you look at in assessing cup driniking

Back 22

types of cups used- tippy with lid, spouted- can evaluate several types of cups during diagnostic

lip closure
excessive drooling
external jaw support
types of liquids that can be handled: thin, thick

Front 23

assessing spoon feeding-- 3 things

Back 23

1) type of spoon used--appropriateness for size of mouth, shape, depth of bowl,
2) lip function-- both upper and lower lip stability and mobility issues
3)variety of textures accepted from spoon

Front 24

assessing biting and chewing- 5 things

Back 24

1) look at various food textures--crunchy, hard-cewy, soft
2)look at both sides of mouth
3)loss of food
4)tongue function to assist with chewing
5)jaw approximation

Front 25

Any medication can be_____. Most often meds will _________ Consult the PDR.

Back 25

Any med can be desensitizing, most often meds will dampen the sensory base.

Front 26

toxicity

Back 26

not due to overdosing but due to decreased movement and smaller amounts of oxygen

Front 27

medications may reduce the amount of _______ we can give--________ may be decreased.

Back 27

Medications may reduce the amount of therapuetic imput we can give- therapeutic expectations may be decreased.

Front 28

If the child is on meds, ask the parents about....

Back 28

1) impact it has on appetite
2)impact on OM functioning (tooth brushing, senstivity issues)
3)hyper/hypo trophy of gums
4)hyper/hypo responsiveness to touch and around mouth
5)time of administration and changes before and after

Front 29

After completing the assessment ___________________.

Back 29

Organize the observations nd ideas to creae an initial feeding plan hat will help the child and family make changes in the eating patterns.

Front 30

Which environments are you considering after completing your assessment

Back 30

1) learning environment
2)communication environment
3)physical environment
4)sensory environment