Treatment for Younger Siblings of Participants in a Home-Based Intensive Paediatric Feeding Programme in Australia

2020 ◽  
Vol 37 (4) ◽  
pp. 206-218
Author(s):  
Tessa Taylor ◽  
Alayna Haberlin
Keyword(s):  
Food Groups ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Procedural Integrity ◽  
Critical Areas ◽  
Home Based ◽  
Actual Plate ◽  
Differential Attention ◽  
Reversal Design

AbstractEarly childhood feeding problems can be challenging. Children who limit their food consumption may significantly impact multiple critical areas of development. Effective treatment should be accessed as early as possible but has been limited to a handful of US hospital programmes. Feeding problems affect both children with and without disability, and families may struggle with multiple children having feeding difficulties. We provided short-term (less than 2 weeks), in-home, intensive, behaviour-analytic feeding intervention to two children with typical development who were younger siblings of children already in the programme. We used a withdrawal/reversal design to assess the effects of nonremoval of the spoon, re-presentation, contingent and noncontingent access to tangibles, differential attention, and response cost. This multi-component intervention was effective in increasing the consumption of a wide variety of foods at regular texture and self-feeding for both participants. Variety was increased to over 60 foods from all food groups. Admission goals were met (100%). We trained caregivers to high procedural integrity and generalised the protocol. We provided actual plate picture examples of family meals consumed where the brothers and parents ate the same meal. Caregiver satisfaction and social acceptability were high. Gains were maintained at 3-year follow-up where parents reported problems were fully resolved.

scholarly journals Effect of Frenotomy on Maternal Breastfeeding Symptoms and the Relationship Between Maternal Symptoms and Problematic Infant Feeding

2022 ◽  
Vol 9 ◽  
pp. 2333794X2110728
Author(s):  
Rebecca R. Hill ◽  
Karen S. Lyons ◽  
Susan Kelly-Weeder ◽  
Britt F. Pados
Keyword(s):  
Infant Feeding ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Time Points ◽  
Dental Office ◽  
The Relationship

The relationship between maternal symptoms and problematic infant feeding in the context of tongue-tie is unknown. In a sample of infants with tongue-tie undergoing frenotomy and their mothers, the aims of this study were to: (1) describe changes in maternal symptoms pre- and post-frenotomy, and (2) evaluate the relationships between maternal symptoms and symptoms of problematic feeding pre- and post-frenotomy. Mother-infant dyads were recruited from 1 pediatric dental office between July and November 2020. The sample included 102 mother-infant dyads; 84 completed the follow-up survey. Maternal symptoms of painful and difficult latch, creased/cracked nipples, bleeding, or abraded nipples, chewing of the nipple, and feelings of depression were significantly less common after tongue-tie revision. Poor latch onto the breast was associated with feeding difficulties at both time points. Frenotomy resulted in a decrease of symptoms in breastfeeding mothers. Maternal symptoms and feeding problems persisting post-frenotomy warrant further evaluation.

Innominate Artery Compression of the Trachea in Infants

1994 ◽  
Vol 103 (5) ◽  
pp. 347-350 ◽  
Author(s):  
Dwight T. Jones ◽  
Richard A. Jonas ◽  
Gerald B. Healy
Keyword(s):  
Innominate Artery ◽  
Respiratory Arrest ◽  
Feeding Problems ◽  
Tracheal Compression ◽  
Feeding Difficulties ◽  
The Past ◽  
Proper Patient Selection ◽  
Follow Up Care ◽  
Before And After

Innominate artery compression of the trachea in infants can cause severe biphasic stridor, cyanosis, and respiratory arrest. These episodes are sometimes referred to as “dying spells.” In the past, aortopexy has been used for the treatment of this problem, but since many have questioned its success, its use has not been popularized or generally accepted. Over the past 4 years, 12 children have been successfully treated for innominate artery compression of the trachea with aortopexy. These children all initially presented with significant respiratory and/or feeding difficulties. Preoperative and postoperative videos were obtained to document the degree of tracheal compression and/or lumen size before and after surgery. Since treatment, all patients have been without further feeding problems or cyanosis. When performed in selected patients, aortopexy is successful in relieving tracheal obstruction from innominate artery compression. This article discusses proper patient selection, operative technique, and follow-up care. The management of compression in patients with less severe symptoms will also be addressed.

Use of a Move-on Component to Increase Consumption for a Clinical Paediatric Feeding Case In-Home

2021 ◽  
pp. 1-13
Author(s):  
Tessa Taylor
Keyword(s):  
Single Case ◽  
The United States ◽  
Autism Spectrum ◽  
Food Groups ◽  
Home Setting ◽  
Procedural Integrity ◽  
Potential Component ◽  
Food Variety ◽  
Treatment Package

Abstract Research from specialised hospital feeding programmes in the United States has shown effectiveness of a variety of treatments for packing (not swallowing food or liquid in the mouth) to increase swallowing and consumption. One potential component used in clinical practice has not been evaluated in the literature to our knowledge. This component is move-on and involves moving on to the next bite presentation rather than waiting for swallowing (i.e., clean mouth). A 5-year-old female with autism spectrum disorder and avoidant/restrictive food intake disorder participated in a home setting in Australia. We used a withdrawal/reversal single-case experimental design for a move-on component added to a treatment package. With move-on added, latency to clean mouth decreased and consumption increased to 100%. After the treatment evaluation, additional procedures (interspersal, redistribution) were needed in full plate and portion meals. Food variety was increased to 116 regular texture foods across all food groups. All (100%) of admission goals were met. Parents were trained to high procedural integrity, and the protocol was generalised to the community. Gains maintained to 1-month follow-up.

scholarly journals Redistribution with Regular Texture Food for Clinical Cases In-Home

2020 ◽  
Author(s):  
Tessa Taylor
Keyword(s):  
United States ◽  
Autism Spectrum Disorder ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Food Groups ◽  
Short Term ◽  
Home Based ◽  
Reversal Design ◽  
Regular Texture ◽  
Withdrawal Reversal

Research has shown effectiveness of a redistribution procedure for decreasing packing and increasing swallowing. Redistribution has been done using lower manipulated-texture foods on an infant gum brush in specialised United States hospitals. We extended this by using regular texture bites of food in a short-term (1-2 weeks) home-based programme in Australia, showing decreased then absent use of the procedure, and following up. Two children with autism spectrum disorder participated. We used a withdrawal/reversal design. Latency to swallow decreased. Participants increased variety to 90 and 122 regular texture foods across food groups. All goals were met including increasing independence in self-feeding. Both parents were trained. Gains maintained to 6 months and redistribution was no longer needed.

Efficacy of Feeding Team Recommendations for Infants/Children Presenting With Signs of Milk Allergy

2011 ◽  
Vol 3 (6) ◽  
pp. 365-370
Author(s):  
Janice Baunach ◽  
Jennifer Malpass ◽  
Zeenat Q. Malik ◽  
Greg Cable
Keyword(s):  
Medical Intervention ◽  
Milk Allergy ◽  
Feeding Problems ◽  
Inclusion Criteria ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Study Participants ◽  
Professional Guidance ◽  
Infants And Young Children

Caregivers have reported feeding difficulties in approximately 25% to 40% of infants/toddlers that comprise a variety of signs/symptoms, though many of these are transient and resolve without significant medical intervention. Feeding problems, however, have been reported to persist in 3% to 10% of children, resulting in the caregivers seeking professional guidance. The purpose of this study was to evaluate the effectiveness of feeding team recommendations for infants and young children presenting with signs of milk allergies. Retrospective chart reviews were conducted, with associated follow-up phone surveys. Study participants met criteria based on presenting symptoms of possible milk allergy and received recommendations of milk-free diet and/or allergy testing. A total of 85 medical records were reviewed. Of the 85, 53% (45/85) met inclusion criteria for review; however, only 46% (39/85) were available for follow-up. Of the 39 patients available for follow-up, a milk-free diet was recommended for 67% (26/39), and 69% (18/26) of these families followed through with the recommendations. Of those 18 patients who followed the recommendations, 83% (15/18) reported improvement of symptoms. Our data suggest that recommendations resulting from comprehensive feeding team evaluations of infants and children with suspected milk protein allergies can, when followed, result in improvement of patient symptoms.

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Phoebe Ullrich ◽  
Christian Werner ◽  
Martin Bongartz ◽  
Tobias Eckert ◽  
Bastian Abel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older Persons ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Control Group ◽  
Life Space ◽  
Home Based ◽  
Independent Life

Abstract Background Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Methods Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17–26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. Results One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89–13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00–0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. Conclusions The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

scholarly journals Providing Antismoking Socialization to Children After Quitting Smoking: Does It Help Parents Stay Quit?

2017 ◽  
Vol 32 (5) ◽  
pp. 1257-1263 ◽  
Author(s):  
Kim A. Hayes ◽  
Christine Jackson ◽  
Denise M. Dickinson ◽  
Audra L. Miller
Keyword(s):  
New York ◽  
Controlled Trial ◽  
Preliminary Evidence ◽  
Parenting Program ◽  
Smoking History ◽  
Group Differences ◽  
Quit Smoking ◽  
Home Based ◽  
Quitting Smoking

Purpose: To test whether an antismoking parenting program provided to parents who had quit smoking for ≥24 hours increased parents’ likelihood of remaining abstinent 2 and 3 years postbaseline. Design: Two-group randomized controlled trial with 3-year follow-up. Setting: Eleven states (Colorado, Indiana, Michigan, Minnesota, Montana, New York, Ohio, Pennsylvania, South Dakota, Utah, and Vermont). Participants: Five hundred seventy-seven adults (286 treatment and 291 control) who had smoked ≥10 cigarettes daily at baseline, had quit smoking for ≥24 hours after calling a Quitline, and were parents of an 8- to 10-year-old child; 358 (62%) completed the 2-year follow-up interview, and 304 (53%) completed the 3-year follow-up interview. Intervention: Theory-driven, home-based, self-help parenting program. Measures: Sociodemographic, smoking history, and 30-day point prevalence. Analysis: Multivariable regression analyses tested for group differences in 30-day abstinence. Attriters were coded as having relapsed. Results: Between-group differences in abstinence rates were 5.6% and 5.9% at 2 and 3 years, respectively. Treatment group parents had greater odds of abstinence, an effect that was significant only at the latter time point (odds ratio [OR] = 1.49, P = .075 at 2 years; OR = 1.70, P = .026 at 3 years). Conclusions: This study obtained preliminary evidence that engaging parents who recently quit smoking as agents of antismoking socialization of children has the potential to reduce the long-term odds of relapse.

scholarly journals Impact of a nutrition award scheme on the food and nutrient intakes of 2- to 4-year-olds attending long day care

2015 ◽  
Vol 18 (14) ◽  
pp. 2634-2642 ◽  
Author(s):  
Lucinda K Bell ◽  
Gilly A Hendrie ◽  
Jo Hartley ◽  
Rebecca K Golley
Keyword(s):  
Dietary Intake ◽  
Day Care ◽  
Dietary Habits ◽  
Vegetable Intake ◽  
Critical Time ◽  
Food Groups ◽  
Nutrient Intakes ◽  
Long Day ◽  
Award Scheme

AbstractObjectiveEarly childhood settings are promising avenues to intervene to improve children’s nutrition. Previous research has shown that a nutrition award scheme, Start Right – Eat Right (SRER), improves long day care centre policies, menus and eating environments. Whether this translates into improvements in children’s dietary intake is unknown. The present study aimed to determine whether SRER improves children’s food and nutrient intakes.DesignPre–post cohort study.SettingTwenty long day care centres in metropolitan Adelaide, South Australia, Australia.SubjectsChildren aged 2–4 years (n 236 at baseline, n 232 at follow-up).MethodsDietary intake (morning tea, lunch, afternoon tea) was assessed pre- and post-SRER implementation using the plate wastage method. Centre nutrition policies, menus and environments were evaluated as measures of intervention fidelity. Comparisons between baseline and follow-up were made using t tests.ResultsAt follow-up, 80 % of centres were fully compliant with the SRER award criteria, indicating high scheme implementation and adoption. Intake increased for all core food groups (range: 0·2–0·4 servings/d, P<0·001) except for vegetable intake. Energy intake increased and improvements in intakes of eleven out of the nineteen nutrients evaluated were observed.ConclusionsSRER is effective in improving children’s food and nutrient intakes at a critical time point when dietary habits and preferences are established and can inform future public health nutrition interventions in this setting.

scholarly journals Sex Differences in the Effects of Repeated Taste Exposure to the Mediterranean Diet: A 6-month Follow-up Study

2016 ◽  
Vol 77 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Alexandra Bédard ◽  
Louise Corneau ◽  
Sylvie Dodin ◽  
Simone Lemieux
Keyword(s):  
Body Weight ◽  
Sex Differences ◽  
Weight Management ◽  
Mediterranean Diet ◽  
Food Groups ◽  
Post Intervention ◽  
Time Interaction ◽  
The Mediterranean ◽  
Taste Exposure

Purpose: To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. Methods: Thirty-eight males and 32 premenopausal females (all aged 24–53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. Results: Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. Conclusions: Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.

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