Problems Encountered When Feeding The Severly Disabled Essay, Research Paper
There are four problems that may occur in individuals with sever disabilities when feeding is taking place. These four problems, chin retraction, tongue retraction, chin thrust, and tongue thrust, all take place in the dental region of the face, and they all involve the muscles of that same region. Each one presents its own difficulties; however, sometimes the may occur simultaneously.
The basis for the inner feeding team is the jaw, or chin. It controls and regulates the movements of the other muscles, (including the lips and tongue). The jaw may have two significant problems that accompany it. The first is known as chin retraction. This condition is found mainly in individuals with neurological impairments. The reasons for this being that these individuals tend to show more neck extension and shoulder retraction. With this poor development, the jaw is pushed forward by the rest of the skeletal structure. The jaw then opens irregularly and with no set pattern. It may even become stuck in an open position. Feeding is difficult because the child has little or no control over his jaw.
Another problem that may occur with the jaw, but is less common, is chin retraction. This movement is a pulling back of the lower jaw, making it difficult for the mouth to open fully. Strain is placed on the mouth and air passage forming a smaller tunnel of flow. This then creates a problem with swallowing. A child with this type of problem must not be given solid, tough, or chewy food that is not already chopped up. Otherwise choking may occur.
In addition to problems with the chin are problems with the tongue. The tongue is one of the major muscles of the mouth. The ability of the tongue to change shape contributes to the efficiency and skill with which food can be organized and controlled in the mouth. If the tongue becomes thin, thick, flat, bunched, pointed, cupped, or humped, then it cannot function properly.
The first problem that can occur with the tongue is called tongue thrust. This is a forceful protrusion of the tongue from the mouth. Movement that is frequently arrhythmic characterizes it. With the tongue pushed forward, it makes it difficult to insert a spoon or nipple. Many times the food is pushed out of the mouth as it is inserted. A minor form of tongue thrust is known as exaggerated tongue protrusion. This is a much milder form of tongue thrust in which the tongue takes the form of full extension and retraction with emphasis on the outward or exterior phase. This is commonly seen in children with Down s syndrome.
The second type of tongue problem is referred to as tongue retraction. This problem is seen as a pulling or falling back of the tongue which makes breathing and sucking difficult. Tongue retraction occurs mainly in individuals with abnormal postural tone. When the neck is hyperextended, the chin tips upward and the tongue retracts. Most individuals compensate for it by pressing the tongue against the middle of the hard pallet. This correction then creates a problem in the airway. Sucking and swallowing are difficult due to the blocked airway and tongue up against pallet.
Although none of these problems can have instantaneous solutions, many can be corrected over time with the proper training. Muscle exercises and toning techniques can be used to help alleviate the problems.