Search

AIM To describe trends in gastrostomy tube insertion in children with developmental or acquired disorders in Sweden and assess their demographic characteristics. METHOD Children aged 0 to 18 years with gastrostomy tube insertions recorded between 1998 and 2014 were identified in the Swedish National Patient Register. Associations between disorder type and year of surgery, as well as age at surgery, were analysed using linear regression analyses. The association between disorder type and mortality 2 years from gastrostomy tube insertion was also analysed using logistic regression analysis. RESULTS The data for 4112 children (2182 males, 1930 females), with a median age of 2 years (interquartile range=1–8y), were analysed. Children who presented with developmental disorders were the largest group (n=3501, 85%). The most common diagnosis in children with developmental disorders was cerebral palsy (n=165, 4%). In children with acquired disorders, acute lymphoblastic leukaemia (n=117, 3%) was the most common diagnosis. Gastrostomy tube insertions increased from 1998 to 2014, with the greatest increase in children with developmental disorders, who were younger than children with acquired disorders when the gastrostomy tube was first inserted. Age at tube insertion decreased inboth groups during the study period. Mortality was higher in children with acquired disorders, suggesting that gastrostomy tube insertion should be part of a palliative care approach. INTERPRETATION Child characteristics differed depending on whether the underlying disorder was developmental or acquired, suggesting a need for clinical health care guidelines related to the specific goals of gastrostomy tube insertion., Funding sponsor: Region Halland

Objectives: Dysphagia and impaired saliva control are common in children and adolescents with congenital and developmental disabilities. The aim of the present review was to investigate the evidence base for oral sensory-motor interventions in children and adolescents with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities and to make recommendations regarding methods for intervention. Methods: A review of the literature from 2000 to 2016, including oral sensory-motor intervention studies for children and adolescents (3-18 years of age) with dysphagia or impaired saliva control secondary to congenital or early-acquired disabilities, was performed. The literature search included the PubMed, CINAHL, Medline, SpeechBITE, OVID, ERIC, Cochrane, and Google Scholar databases. Primary studies were evaluated on a 4-grade scale using the Grading of Recommendations Assessment, Development and Evaluation. Results: Twenty primary studies of oral sensory-motor interventions for dysphagia and 6 studies for the treatment of impaired saliva control fulfilled the inclusion criteria. Of these, 3 were randomized, controlled trials. Five systematic reviews and 16 narrative reviews were also included. Limited and moderately strong recommendations were made on the basis of the grading results from the primary studies. The studies reported good results, but study design was often insufficient, and the study groups were small. The systematic reviews confirmed the lack of high scientific support for oral sensory-motor interventions in children and adolescents with congenital and developmental disabilities. Conclusions: There is an urgent need for high-quality studies that could serve as the basis for strong recommendations relating to oral sensory-motor interventions for children with dysphagia and impaired saliva control., Evidensbaserad habilitering

Background: Studies on long‐term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding. Methods: This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement. Results: The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to “acquired” (n = 13) or “developmental” (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders. Conclusions: This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating.

CentralAnnals of Otolaryngology and RhinologyCite this article: McAllister A, Brodén M, Gonzalez Lindh M, Krüssenberg C, Ristic I, et al. (2018) Oral Sensory-Motor Intervention for Children and Adoles-cents (3-18 Years) with Developmental or Early Acquired Speech Disorders – A Review of the Literature 2000-2017. Ann Otolaryngol Rhinol 5(5): 1221.*Corresponding authorAnita McAllister, Division of Speech and Language Pathology, CLINTEC, Karolinska Institute, Karolinska University Hospital, 171 77 Stockholm, Sweden, Tel: 46701700880, Email: Submitted: 12 November 2018Accepted: 28 November 2018Published:29 November 2018ISSN: 2379-948XCopyright© 2018 McAllister et al. OPEN ACCESS Keywords• Motor learning• Speech sound disorder• Apraxia• Dysarthria AbstractObjectives: The aim of this study was to investigate the level of scientific evidence for different sensory-motor interventions in children and adolescents with motor speech disorders. A final aim was to identify key motor learning principles in these methods. Methods: A review of the literature published 2000-2017, including sensory-motor intervention for children and adolescents (3-18 years) with congenital, developmental or early acquired disabilities affecting speech, was performed. The literature search included the databases PubMed, CINAHL, Medline, Speech BITE, OVID, ERIC, Cochrane and Google Scholar. Identified primary studies were evaluated using Grading of Recommendations, Assessment, Development and Evaluation. Results: Forty-four studies, reporting results following 16 sensory-motor intervention methods for different motor speech disorders, fulfilled inclusion criteria. Of these, three were randomized controlled trials. Scientific evidence varied between strong and insufficient. Rapid Syllable Transition Treatment was the only method rated as high scientific evidence for children with childhood apraxia of speech. Several methods reached medium high scientific evidence with studies reporting improved speech a, Evidensbaserad habilitering

Children with complex medical needs requiring nutritional support are growing in number. This presentation will add new knowledge regarding gastrostomy in children by reporting primary diagnosis, and indications for the use of gastrostomy. Furthermore, the presentation will discuss and analyse data evolution trends from 2005 to 2015 in Sweden. Methods: The first part of the study used national statistics to provide a broad picture of gastrostomy use in Swedish children. The second part applied a retrospective observational study design, reviewing medical charts in order to obtain an in-depth picture of the children in need for gastrostomy, and its use in a five-year perspective. Results: The number of gastrostomy cases recorded in the national database was 3 946, 53% male, and 47% female. The distribution of age groups was: 0-4 years: 61% , 5-9 years: 17%, 10-14 years: 12%, and 15-19: years 10%. When observing trends on a national level, the number of children receiving gastrostomy increased in average by 13% per year. Changes in the separate age groups were analysed. An increase was noted for children aged 0-4 years and for children aged 5-9 years. In the age groups 10-14 years and 15-19 years, there was no progressive increase. The results from the national statistics database will be discussed in relation to the medical chart-analyses of 75 children receiving gastrostomy in one Swedish administrative region between 2005 and 2015. Conclusions: As in many parts of Europe, the number of children in need for gastrostomy is also growing in Sweden, with the youngest children seeming to be the group increasing most. Clinical implications: Nutritional support in Sweden is publicly financed, therefore these findings may be useful when planning both monetary and human resources in meeting the future challenges of paediatric health care.

Aim: Orofacial function includes a multitude of actions, some of them vital, such as breathing, chewing and swallowing, and also acts as the basis for social interaction in terms of speech, emotional communication, facial expression and appearance. Impaired orofacial function is a common feature in many inherited disorders or may be acquired as a consequence of disease and trauma. The Nordic Orofacial Test–Screening (NOT-S) is a comprehensive method for screening of orofacial function developed by a Scandinavian network of dentists and speech and language pathologists. NOT-S comprises evaluation of twelwe domains of orofacial function. They are assessed from a structured interview and a clinical examination with a picture manual illustrating the different tasks in the examination. A method study of 120 individuals with chronic disease or disability compared to 60 healthy controls showed good intra- and interexaminer agreement. The aim was to present current applications and results from publications on the use of NOT-S. Materials and Methods: Beside the method study published in 2007 to date four studies has been published. One was a study in individuals with Parkinson´s disease (n=15), two were studies in individuals with rare disorders; Ectodermal dysplasia (n=46), and Prader-Willi Syndrome (n=45), and one was a study evaluating surgical treatment in children with tonsillar hyperthophy (n=67). In order o visualize to what degree the domains of orofacial function are affected in different conditions, connected plots were made from the mean NOT-S scores for the twelwe domains of NOT-S, here called dysfunction profiles. Results: The groups with different diagnoses showed specific dysfunction profiles indicating patterns of domains with impaired orofacial function. The use of NOT-S to assess orofacial function before and after surgery in children with tonsillar hypertrophy showed that the method can also be used to evaluate interventions. Conclusions: Screening with N