Airway Protective Behaviors and Mealtime Performance in Children With Spastic Cerebral Palsy and Typically Developing Controls

This investigation aimed to objectively measure physiological deficiencies across the continuum of airway protection and clinical feeding and swallowing severity in children with spastic cerebral palsy (SCP), and to make comparisons with a healthy control group. Eleven children with SCP (GMFCS I-V) and 10 controls (mean age: 7+ 2 years) were tested. Results revealed significantly impaired oropharyngeal function and greater clinical feeding and swallowing severity for children with SCP. These children also demonstrated impaired respiratory-swallow coordination evidenced by frequent post-swallow inhalation across all bolus types. Reduced cough volume acceleration was also observed in children with SCP compared to controls. In the SCP group, significant correlations with clinical feeding and swallowing severity were observed with oral praxis and post-swallow inhalation. Additionally, clinical feeding and swallowing severity and peak expiratory flow rate were significantly correlated with gross motor function.

This is the first study to objectively identify the co-occurrence of dysphagia and dystussia in children with SCP, and to quantify factors underlying these deficits. Future research should address functional deficits along the continuum of airway protection in both assessment and treatment paradigms in order to maximize the quality of life for this population.