Aspiration Precautions

Children and adults with developmental disabilities often face challenges with eating, drinking and swallowing disorders than the general population. It is estimated that adults with intellectual disabilities require support from caregivers during mealtime. It is common among people who have a diagnosis of cerebral palsy, intellectual disability, physical  disability and muscular dystrophy.

Dysphasia is a medical term used to describe any person having difficulty swallowing foods and liquids taking  more energy and time to move food from the mouth to the stomach. Signs of dysphasia may include:

  • Drooling
  • Food or liquid remaining in the oral cavity after swallowing
  • Complaints of pain when swallowing
  • Coughing during or right after eating or drinking
  • Extra time needed to chew or swallow
  • Reflux of food

Dysphasia can lead to aspiration. Aspiration is defined when food, fluid, or other foreign material gets into the trachea or lungs instead of going down the esophagus and into the stomach. when this occurs, the person is able to cough to get the food or fluid out of their lungs, in some cases especially with children and adults with disabilities may not be able to cough. This is known as Silent Aspiration.

A complication of aspiration is Pneumonia which is defined as inhaling food, saliva, and liquids into the lungs

According to the Office of People with Developmental Disabilities Health and safety Alert, factors that place people at risk for aspiration include:

  • Being fed by others
  • Weak or absent coughing, and/or gag reflexes, commonly seen in people with cerebral palsy.
  • food stuffing and rapid eating/drinking
  • Poor chewing or swallowing pills
  • GERD- the return of partially digested food or stomach contents to the esophagus
  • Providing liquids or food consistencies the person is not able to tolerate such as eating whole foods.
  • Seizures that may occur during eating and/or drinking.

How to recognize signs and symptoms of Aspiration:

  • Choking or coughing while eating or just after eating
  • Drooling while eating or just after eating
  • Eyes start to water
  • Shortness of breath
  • Fever 30 minutes after eating
Intervene immediate if there are signs of aspiration:
  • Stop feeding immediately
  • Keep the person in an upright position
  • Call 911 if the person has difficulty or stops breathing and no pulse
  • Start rescue breathing

Minimize aspiration from occurring by serving the appropriate food texture and liquid consistency. If you are not sure of the right consistency, check with your health care provider. The following are pictures of food consistencies.

Courtesy of OPWDD

Courtesy of OPWDD

Whole. Food is served as it is normally prepared; no changes are needed in
preparation or consistency

Courtesy of OPWDD

1 ” Pieces cut to size. Food is served as prepared and cut into 1-inch pieces
(about the width of a fork).

Courtesy of OPWDD

1/4 Pieces Cut to Size. Food is cut with a knife or a pizza cutter or placed in a food
processor and cut into ¼ -inch pieces (about the width of a #2 pencil)

Courtesy of OPWDD

Ground. Food must be prepared using a food processor or comparable equipment
until MOIST, COHESIVE AND NO LARGER THAN A GRAIN OF RICE, or relish
like pieces, similar to pickle relish. Ground food must always be moist. Ground meat
is moistened with a liquid either before or after being prepared in the food processor
and is ALWAYS served with a moistener such as broth, low fat sauce, gravy or
appropriate condiment. Hard, dry ground particles are easy to inhale and must be
avoided.

 

Courtesy of OPWDD

Pureed. Food must be prepared using a food processor or comparable equipment.
All foods are moistened and processed until smooth, achieving an applesauce-like or
pudding consistency. A spoon should NOT stand up in the food, but the consistency
should not be runny. Each food item is to be pureed separately, unless foods are
prepared in a mixture such as a soup, stew, casserole, or salad.

Aspiration Precautions

  • Make sure the person eats slowly and takes small bites of food
  •  Ensure the person takes small sips of liquids
  • Focus on the person’s swallowing
  • Make sure the person remains upright for a minimum of thirty minutes after eating
Advertisements

Developmental Disability Facts and Statistics

Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments before the age of 22. A developmental disability can occur before, during or after birth. Common well-known developmental disabilities include autism, Down syndrome, cerebral palsy and Fragile X syndrome. Here are some facts and statistics on developmental disabilities.

Click here to download PDF Format

  • Developmental Disability is a severe, long-term disability that affect cognitive ability, physical functioning or both.
  • 1 in 6 or about 15% of children aged 3 through 17 have one or more developmental disabilities.
  • Between 2014 and 2016 the prevalence of developmental disability among kids ages 3 to 17 increased from 5.76 percent to 6.99 percent.
  • Prevalence of autism increased 289.5%
  • Prevalence of ADHD increased 33.0 %
  • Males have a higher prevalence of ADHD, autism, learning disabilities, stuttering and other developmental disabilities.
  • Children from families with incomes below the federal poverty level had a higher prevalence of developmental disabilities.
  • 10% of Americans have a family member with an intellectual disability.
  • Intellectual disabilities are 25 times more common than blindness.
  • Every year 125,000 children are born with an intellectual disability
  • Approximately 85% of the intellectual disability is in the mild category.
  • About 10% of the intellectual disability is considered moderate
  • About 3-4% of the intellectual disability population is severe.
  • Only 1-2% is classified as profound.

 

Resources

National Institute of Health

25 Resources on 504 Accommodations and Modifications

Section 504 is a federal law designed to protect the rights of individuals with disabilities in programs and activities that receive Federal financial assistance from the U.S. Department of Education (Edefines a physical or mental impairment as any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genito-urinary; hemic and lymphatic; skin; and endocrine; or any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.  

5 important classroom accommodations for children with autism

12 accommodations and modifications for dyslexic children in public school

20 modifications for students with autism

21 school accommodations available for children with special needs

504 accommodation checklist

504 plan: ADHD accommodations to manage ADHD symptoms at school

504 plan templates

A 504 plan for those with dyslexia

A parents guide to section 504

504 Education Plans

504 Plan: What is it?

Accommodations and supports for school-age students with autism

Accommodations for ADHD students K-12 in the classroom

Accommodations for students with learning disabilities

Classroom accommodations for ADHD

Classroom accommodations for dyslexic students

Classroom accommodations for students with epilepsy

Developing 504 Classroom accommodation plans

Dyslexia accommodations: How to know what your child needs

Dyslexia and accommodations- ADA guidelines for school and work

Examples of accommodations and modifications

Modification for students with Down syndrome

Section 504 and Discrimination

Section 504: sample accommodations and modifications

What are school accommodations and modifications for students with Asperger’s?

15 Resources on Cerebral Palsy and Adulthood

Cerebral palsy is a condition caused by damage to the specific areas of the brain. Cerebral palsy refers to the brain and palsy to muscle weakness. Cerebral palsy is a syndrome of motor impairment with posture and movement disorder. It is a non-progressive disorder, however, as a person begins to age, muscle and skeletal problems begin to worsen resulting in more pain, discomfort and limited mobility. Due to muscle flexibility, strength and endurance issues, there is a greater risk of falls and injuries. The following articles includes information on understanding how aging and adulthood affect people with cerebral palsy.

5 common challenges for adults with cerebral palsy- Made For Movement Blog

Adults and cerebral palsy– Cerebral Palsy Organization

Adults with Cerebral Palsy- Cerebral Palsy Foundation

Aging with Cerebral Palsy and Chronic Pain– The Mighty

Care of adults with cerebral palsy-American Academy for Cerebral Palsy and Developmental Medicine

Cerebral Palsy and aging– Developmental Medicine and Child Neurology

Cerebral palsy and transitioning to adulthood-Cerebral Palsy Alliance

Cerebral Palsy effects through lifespan-Physiopedia

Cerebral Palsy in Adulthood– Everyday Health

Cerebral Palsy patients provide rare insight into aging– Cerebral Palsy News Today

Cerebral palsy symptoms in Adulthood- Healthfully

Living as an adult with cerebral palsy– Healthline

Living with cerebral palsy as an adult– WebMD

Progression and Correction of Deformities in Adult with Cerebral Palsy-ACNR

The good, the bad, and the ugly facts about adult cerebral palsy-Karen Pape

Cerebral Palsy and Co-occuring Disorders

Cerebral Palsy is defined as a group of disorders of movement and posture causing limitations due to abnormal development in the brain. According to the Centers for Disease Control and Prevention (CDC), many children and adults with cerebral palsy also had at least one co-occurring condition and in some cases more than one. for example, it is not unusual for and individual to have a diagnoses of cerebral palsy with a co-occurring condition of epilepsy and an intellectual disability and associative  issues with an eating disorder.

Understanding both co-occurring conditions and associative disorders is essential in order to develop an effective teaching strategy.

associative issues include aspiration, dysphagia, digestive issues, seizures, intellectual disability, sleep disorder, and speech impairments.

The following links and articles includes information that contain research studies, articles and practical information.

 

Cerebral Palsy and Epilepsy– Cerebral Palsy Guidance

Cerebral Palsy and Seizures– Cerebral Palsy Guidance

Cerebral Palsy and Speech Therapy– Cerebral Palsy Group

Children with spastic cerebral palsy experience lower leg fatigue when walking study shows- Cerebral Palsy News Today

Common health problems associated with cerebral palsy- My Child Without Limits

Communication and swallowing issues for adults with cerebral palsy-EPI

Difficulties in swallowing and coughing in spastic cerebral palsy focus of study– Cerebral Palsy News Today

Digestive health tips for kids with cerebral palsy-Sarah Halstead

Gastrointestinal and nutritional issues in cerebral palsy-practicalgastro.ocom

How does cerebral palsy affect people?-Cerebral Palsy Alliance

Prevalence of cerebral palsy and intellectual disability among children- NCBI

Sleep disorders in kids with cerebral palsy often remain untreated study suggest– Cerebral Palsy News today

Sleep issues among children with cerebral palsy-CP-NET

Seizures in children with cerebral palsy and white matter injuries-Pediatrics

Understanding more about cerebral palsy and seizures– Murdoch Children’s Research Institute

Resources

Centers for Disease Control and Prevention

National Institute of Neurological Disorders and Stroke

Emergency Plans Need to Be in Effect for Students with Disabilities

Published by: Cerebral Palsy News Today

Written by: Jessica Grono

School violence, unfortunately, is on the minds of thousands of people. Protection of our children is extremely important, and it is imperative to find the right plan to keep everyone safe. As more schools implement drills and plans to protect children and staff, children with disabilities aren’t included in the planning. How can we, as a nation, fix this huge safety dilemma for students with disabilities? Click here to read the rest of the story

25 Facts About Cerebral Palsy That You Did Not Know

Click here to download the article

How much do you really know about cerebral palsy? Here are 25 interesting facts about cerebral palsy:

Is a group of neurological disorders that affects body movement and muscle coordination.

Is caused by damage to the brain which controls movement and balance

Affects the motor area of the brain that directs muscle movement.

The symptoms of cerebral palsy differ in type and severity in each person.

Is the leading cause of childhood disabilities.

Cerebral Palsy is not progressive meaning it does not get worse overtime.

Cerebral Palsy prevalence is 3.3 children per 1000.

There is no cure for cerebral palsy

Cerebral Palsy is not contagious

Risk factors for cerebral palsy include pre-mature birth, infections during pregnancy, exposure to toxic substances and mothers with excess protein in the urine or a history of having seizures.

Cerebral Palsy can also be caused by complicated labor and delivery due to disruption of blood and oxygen to the brain(hypoxia) and babies in a breech position (feet first).Spastic cerebral palsy is the most common type affecting 80% of people with cerebral palsy.

Ataxic cerebral palsy affects balance and depth perception

There are more boys born with cerebral palsy than girls.

Stroke in a baby or child less than the age of 3 results in cerebral palsy.

One in nine with cerebral palsy have features of autism

One in three children with cerebral palsy cannot walk

One in four children with cerebral palsy cannot feed themselves

There are 17 million people with cerebral palsy worldwide.

58.2% of children with cerebral palsy can walk independently, 11.3 walk using a hand-held mobility device and 30.6% have limited or no walking ability

Speech and language disorders are common in people with cerebral palsy

Pain is common among children with cerebral palsy

Harry Jennings, an engineer built the first modern folding wheelchair

Sir William Osler write the first book on cerebral palsy

Dr. Sigmund Freud was the first to state that cerebral palsy might be caused by abnormal development before birth.

Cerebral palsy doesn’t necessary mean learning difficulties.

References

www.cdc.gov/ncbddd/cp

http://www.cerebralpalsy.org/

https://www.ninds.nih.gov/Disorders/

Cerebral Palsy Organizations You Should Know About

Cerebral Palsy describes a group of permanent disorders of the development of movement and posture. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication and behavior, epilepsy, and by secondary musculoskeletal problems.

According to the Centers for Disease Control and Prevention (CDC), cerebral palsy is the most common motor disability in childhood caused by damage to the developing brain that affects a person’s ability to control his or her muscles. CDC estimates that about 1 in 323 children are diagnosed with cerebral palsy annual.

The following organizations provide resources on their websites including fact sheets, resources and information:

Cerebral Palsy Foundation

Funds cerebral palsy research in the United States, (CPF) promotes the delivery of current research, best practices and technology to people with cerebral palsy and their support system. The mission includes transforming lives through research, innovation and collaboration.

Children’s Hemiplegia and Stroke Association

Helps children who have survived an early brain injury that results in hemiplegia (weakness on one side of the body).

Make LemonAide Foundation

The Make Lemon Aide Foundation is a non-profit organization designed to improve the lives of people with cerebral palsy by raising awareness, funding research and training therapist.

Reaching For The Stars

Founded in 2005, RFTS is the largest pediatric cerebral palsy non-profit foundation in the world led by parents with a focus on the prevention, treatment and cure of cerebral palsy

United Cerebral Palsy

UCP educates, advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities. UCP provides services and support to more than 176,000 children and adults through its 68 affiliates around the country.

CP Daily Living

An educational resource website and Facebook page designed to give families and caregivers a central place for practical information and resources.

Cerebral Palsy Alliance

A non-profit organization based in Australia. Provides services to help children and adults living with neurological and physical disabilities.

National Institute of Neurological Disorders and Stroke

NIDS mission is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disorder. The website provides patient and caregiver education on cerebral palsy including an informational page.

Technology Has Opened Doors For Those With Disabilities

Technology Has Opened Doors for Those with Disabilities
Written by: Jessica Grono
Published By: Cerebral Palsy News Today

No matter what type of cerebral palsy a person has, it limits their independence to a certain extent. Independence is amazing, especially when you have such a limited range of freedom. Technology has improved the quality life of thousands of people who have significant disabilities. I know that each time I can do an action for myself, the feeling is indescribable. This week online, I learned of two children who have experienced the unexpected, thanks to advances in technology. Click here to read the rest of the story

Assistive Technology Switches for Children and Adults With Physical Disabilities

Assistive technology devices are identified in the IDEA 2004 as, any item, piece of equipment or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain or improve the functional capabilities of children with disabilities.

Switches fall under this category which allows people with physical disabilities such as cerebral palsy to manipulate their environment by controlling various types of adaptive and assistive switches used for environmental control and communication devices.

The following are resources for assistive technology switches:

Ablenet- Helps people with disabilities through the creation of assistive technology. Ablenet provides switches for both children and adults.

Adaptive Tech Solutions– A therapist-owned and operated company which provides adaptive equipment for individuals with disabilities

eSpecial Needs– Provides adaptive switches to children and adults with physical disabilities which allows them to manipulate their environment.

Enabling Devices– Creates customized one-of-a-kind assistive technology devices for communication, education and playing.

Rehabmart– sells inclusive learning devices which help children with impairments including augmentative communication and adaptive toys

Assistive Technology Websites

Glenda Assistive Technology Information and More– A website containing information on various types of assistive technology including visual supports, AAC, switches and tablets

Teaching Learners With Multiple Special Needs- Created by Kate Ahern, an assistive technology specialist. This website serves as a resource for teachers or learners with severe, profound, or multiple special needs. There is a great article on 60 things to do with a single switch 

Articles 

Assistiveware- How to Support a Student Who Uses a Switch Device

Breezy Special Ed- How to use your iPAD as a switch device

Perkins School for the Blind: Favorite Cause and Affect Switch Apps

Understood- Checklist: What to consider when looking at assistive technology

For more ideas and resources, visit my Pinterest Site:  Assistive Technology