1
|
Puoti MG, Safe M, Thapar N, Di Chio T, Pieri ES, Nikaki K, Lindley K, Rybak A, Borrelli O. The role of high-resolution impedance manometry to identify rumination syndrome in children with unexplained foregut symptoms. J Pediatr Gastroenterol Nutr 2024; 78:1082-1090. [PMID: 38385686 DOI: 10.1002/jpn3.12164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Diagnosis of rumination syndrome (RS) relies on Rome IV criteria. Oesophageal high-resolution impedance manometry (HRIM) can objectively demonstrate the episodes of rumination, but its role in the diagnostic pathway is not yet established. We aimed to demonstrate the clinical contribution of this tool for the timely diagnosis of RS and diagnostic work-up of children with unexplained foregut symptoms deemed to be due to other conditions. METHODS HRIMs performed between 2012 and 2021 were searched to retrieve all diagnoses of RS. Medical records were reviewed for clinical data. RESULTS Out of 461 HRIMs performed, 76 children had manometric diagnosis of RS (35 male, median age: 13 years). Of them, 47% were not clinically suspected as the symptoms did not fulfil clinical criteria for RS. The indications for HRIM in these cases were investigation of unexplained foregut symptoms (37%), suspected refractory gastroesophageal reflux disease (8%) and dysphagia (2%). Among all HRIMs performed for investigations of unexplained foregut symptoms (n = 80), 35% demonstrated rumination episodes. CONCLUSION Identification of characteristic patterns of rumination on HRIM in children with unexplained foregut symptoms enables the immediate diagnosis of RS. Thus, in situations of diagnostic uncertainty, the use of HRIM at early stages of the diagnostic pathway would reduce unnecessary investigations and treatments.
Collapse
Affiliation(s)
- Maria Giovanna Puoti
- Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, UK
- Department of Paediatric Gastroenterology and Hepatology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Mark Safe
- Department of Paediatric Gastroenterology, The Royal Children's Hospital, Melbourne, Australia
| | - Nikhil Thapar
- Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Woolworths Centre for Child Nutrition Research, Quuensland University of Technology, Brisbane, Queensland, Australia
| | - Teresa Di Chio
- Paediatric Unit, Paediatric Institute of Southern Switzerland, Bellinzona, Switzerland
| | | | - Kornilia Nikaki
- Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, UK
| | - Keith Lindley
- Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, UK
| | - Anna Rybak
- Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, UK
| | - Osvaldo Borrelli
- Department of Paediatric Gastroenterology, Division of Neurogastroenterology and Motility, Great Ormond Street Hospital, London, UK
- Stem Cells and Regenerative Medicine, University College London Institute of Child Health, London, UK
| |
Collapse
|
2
|
Irani MZ, Jones MP, Halland M, Herrick L, Choung RS, Loftus YAS, Walker MM, Murray JA, Talley NJ. Prevalence, symptoms and risk factor profile of rumination syndrome and functional dyspepsia: a population-based study. Aliment Pharmacol Ther 2021; 54:1416-1431. [PMID: 34626489 PMCID: PMC10835603 DOI: 10.1111/apt.16630] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rumination syndrome is a functional gastroduodenal disorder characterised by effortless regurgitation of recently ingested food. Emerging evidence reports duodenal eosinophilic inflammation in a subset, suggesting a shared pathophysiology with functional dyspepsia (FD). AIM To assess the clinical features of rumination syndrome and FD in a community-based study. METHODS We mailed a survey assessing gastrointestinal symptoms, diet and psychological symptoms to 9835 residents of Olmsted County, MN, USA in 2017-2018; diagnostic codes were obtained from linked clinical records. The two disorders were assessed as mutually exclusive in 'pure' forms with a separate overlap group, all compared to a control group not meeting criteria for either. Prevalence of associations, and univariate and independent associations with predictors were assessed by logistic regression. RESULTS Prevalence of rumination syndrome and FD were 5.8% and 7.1%, respectively; the overlap was 3.83-times more likely than expected by chance. Independent predictors for rumination (odds ratio (OR), 95% confidence interval (CI)) were female gender (1.79, 1.21-2.63), smoking (1.89, 1.28-2.78), gluten-free diet (1.58, 1.14-2.19), allergic rhinitis (1.45, 1.01-2.08) and depression (1.10, 1.05-1.16). FD was independently associated with female gender, depression, non-coeliac wheat sensitivity, migraine, irritable bowel syndrome and somatic symptoms. A similar reported efficacy (≥54%) of low fat or dairy-free diets was found with both disorders (P = 0.53 and P = 1.00, respectively). The strongest independent associations with overlapping FD and rumination syndrome were a history of rheumatoid arthritis (3.93, 1.28-12.06) and asthma (3.02, 1.44-6.34). CONCLUSION Rumination syndrome overlaps with FD with a shared risk factor profile, suggesting a common pathophysiology.
Collapse
Affiliation(s)
- Mudar Zand Irani
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Michael P. Jones
- NHMRC Centre of Research Excellence in Digestive Health
- School of Psychological Sciences, Macquarie University, North Ryde, Australia
| | - Magnus Halland
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Linda Herrick
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Rok Seon Choung
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | | | - Marjorie M. Walker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health
| | - Joseph A. Murray
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Nicholas J. Talley
- Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- NHMRC Centre of Research Excellence in Digestive Health
- Hunter Medical Research Institute, New Lambton Heights, Australia
| |
Collapse
|
3
|
Gal E, Gal-Mishael R, Vissoker RE, Hedley D, Bury SM, Stolar O. Eating Challenges in Children with Autism Spectrum Disorder: Development and Validation of the "Aut-Eat" Questionnaire (AEQ). J Autism Dev Disord 2021; 52:811-822. [PMID: 33792802 DOI: 10.1007/s10803-021-04978-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The Aut-Eat Questionnaire (AEQ) provides a novel and comprehensive assessment of eating problems and patterns in children with ASD. To establish the internal consistency and discriminant validity of the AEQ, parents of children with ASD (n = 105, Mage = 40.85, SD = 15.67 months) or typical development (TD; n = 98, Mage = 50.33, SD = 16.50 months) completed the AEQ. Questionnaire construction, content validity, factor analysis, internal consistency and discriminant validity are reported. The AEQ was reliable with high internal consistency in most domains. Significant differences were found between groups in all domains. The AEQ is a reliable and valid tool and may help to characterize eating difficulties in this population.
Collapse
Affiliation(s)
- Eynat Gal
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel.
| | - Rotem Gal-Mishael
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Roni Enten Vissoker
- Department of Occupational Therapy, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Simon M Bury
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Orit Stolar
- Shamir Medical Center, Department of Pediatrics, Autism Center, Zerifin, Israel
| |
Collapse
|
4
|
Burton Murray H, Juarascio AS, Thomas JJ. Augmenting Diaphragmatic Breathing With Behavioral Exposure: Single-Case Experimental Design for Rumination Disorder. Cognitive and Behavioral Practice 2020; 27:347-56. [DOI: 10.1016/j.cbpra.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
5
|
Migan‐gandonou JA, Leon Y. Empirically derived consequences to treat rumination. Behavioral Interventions 2019; 35:166-77. [DOI: 10.1002/bin.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
6
|
Nall RW, Rung JM, Shahan TA. Resurgence of a target behavior suppressed by a combination of punishment and alternative reinforcement. Behav Processes 2019; 162:177-183. [PMID: 30862521 PMCID: PMC7720655 DOI: 10.1016/j.beproc.2019.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/11/2019] [Accepted: 03/08/2019] [Indexed: 01/03/2023]
Abstract
Differential-reinforcement-based treatments involving extinction of target problem behavior and reinforcement of an alternative behavior are highly effective. However, extinction of problem behavior is sometimes difficult or contraindicated in clinical settings. In such cases, punishment instead of extinction may be used in combination with alternative reinforcement. Although it is well documented that omitting alternative reinforcement can produce recurrence (i.e., resurgence) of behavior previously suppressed by extinction plus alternative reinforcement, it remains unclear if resurgence similarly occurs for behavior previously suppressed by punishment plus alternative reinforcement. The present experiment examined this question with rats. In Phase 1, a target behavior (lever pressing) was reinforced with food pellets. In Phase 2, the target behavior continued to be reinforced, but it also produced mild foot shock and an alternative behavior (nose poking) also produced food. Finally, all consequences were removed and resurgence of target behavior occurred. Resurgence did not occur for another group that similarly received punishment of target behavior in Phase 2 but not alternative reinforcement. These results indicate that resurgence was a product of the history of exposure to and then removal of alternative reinforcement and that the removal of punishment alone did not produce resurgence of target behavior.
Collapse
|
7
|
Abstract
Rumination syndrome (RS) is characterized by the repeated regurgitation of material during or soon after eating with the subsequent rechewing, reswallowing, or spitting out of the regurgitated material. Rumination syndrome is classified as both a "Functional Gastroduodenal Disorder" (by the Rome Foundation's Functional Gastrointestinal Disorders: Disorders of Gut-Brain Interaction, 4th edition) and a "Feeding and Eating Disorder" (by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition). Rumination syndrome is a disorder that is often inaccurately diagnosed or missed, resulting in patients experiencing protracted symptoms and not receiving treatment for long periods. There is a lack of clear consensus for RS diagnosis, mechanisms that maintain RS, and treatment. Guided by existing research and our clinical expertise, we synthesize available evidence and provide recommendations for clinical use. We present a case example and critically summarize the literature to date to (i) increase clinicians' understanding of heterogeneous clinical presentations, (ii) suggest assessment strategies to facilitate accurate diagnosis, and (iii) provide a schematic for intervention options. Overall, we recommend clinicians recognize the heterogeneous features of RS when considering diagnosis, assess for RS symptoms by clinical history, and treat RS with targeted diaphragmatic breathing while using other methods as augmented intervention or alternative treatment.
Collapse
Affiliation(s)
- Helen B. Murray
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Carlo Di Lorenzo
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Douglas A. Drossman
- Center for Education and Practice of Biopsychosocial Care, Drossman Gastroenterology, Chapel Hill, North Carolina, USA
- Center of Functional GI and Motility Disorders, Division of Digestive Diseases and Nutrition, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- Rome Foundation, Chapel Hill, North Carolina, USA
| | - Jennifer J. Thomas
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
8
|
Affiliation(s)
- David A. Wilder
- School of Behavior Analysis; Florida Institute of Technology; Melbourne Florida
| | - Della Neve
- Devereux Florida Intensive Residential Treatment Center; Viera Florida
| |
Collapse
|
9
|
Alioto A, Di Lorenzo C, Montgomery ML, Yacob D. High Cost and Low Yield: The Diagnostic Evaluation of Rumination Syndrome in Pediatrics. J Pediatr 2017; 185:155-9. [PMID: 28256211 DOI: 10.1016/j.jpeds.2017.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/04/2017] [Accepted: 02/03/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To document the use of diagnostic testing in adolescents who ultimately were diagnosed with rumination syndrome, a functional gastrointestinal disorder. We examined the diagnostic yield of each test as well as the associated costs, and we determined if any demographic or illness-related variables impacted the magnitude of the work-up. STUDY DESIGN A retrospective chart review was conducted for 68 patients with rumination syndrome admitted to our inpatient treatment program. The cost and findings of patients' diagnostic investigations were gathered, as well as demographic and illness-related variables to determine factors that may be related to evaluation size. RESULTS The most commonly used tests in the evaluation of rumination syndrome included esophagogastroduodenoscopy, gastric emptying, antroduodenal manometry, upper gastrointestinal series, and abdominal ultrasound scan. Each patient underwent an average of 8.8 tests, with the average cost for each patient's diagnostic work-up being US $19 795. Few tests were found to be beneficial in the diagnosis of rumination syndrome, and few demographic or illness variables were found to be related to the overall extent of the investigation. CONCLUSIONS Extensive testing for rumination syndrome in adolescents is common in clinical practice, and comes at a high financial cost with low yield, likely delaying diagnosis and treatment. Symptom-based criteria should be used to make the diagnosis of rumination syndrome.
Collapse
|
10
|
Wiseman KV, McArdell LE, Bottini SB, Gillis JM. A Meta-Analysis of Safety Skill Interventions for Children, Adolescents, and Young Adults with Autism Spectrum Disorder. Rev J Autism Dev Disord 2016. [DOI: 10.1007/s40489-016-0096-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
11
|
DeRosa NM, Roane HS, Bishop JR, Silkowski EL. The combined effects of noncontingent reinforcement and punishment on the reduction of rumination. J Appl Behav Anal 2016; 49:680-5. [DOI: 10.1002/jaba.304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 11/05/2016] [Indexed: 11/07/2022]
|
12
|
Abstract
Rumination is the effortless regurgitation of food, with subsequent spitting out or rechewing and reswallowing. In developmentally delayed children, rumination is a pleasurable, self-stimulating habit. For 3 years, we evaluated and treated 2 nonambulatory, nonverbal 4-year-old children who ruminated frequently while awake. The social isolation caused by a child covered in regurgitated food prompted caregivers of these children to find a solution. We hypothesized that rumination would cease if the stomach stayed empty of food. We intervened by placing gastrojejunostomy tubes and then initiated continuous drip jejunal tube feedings over 12 waking hours to reduce hunger; the children's oral diet was also stopped. In both cases, these changes reduced episodes of rumination to 3 to 5 times daily. To eliminate rumination, unpleasant tasting substances (N-acetylcysteine or cayenne pepper-based hot sauce) were given through the gastrostomy tube every 4 hours while the children were awake. Within 1 week of adding the unpalatable substances, rumination ceased. After 2 months of no rumination, 1 mother restarted oral feeding. There was no recurrence of rumination, and 3 months after gastrojejunal tube placement, the tube was removed. In 1 year of follow-up, rumination did not recur. The second mother was pleased with the outcome with jejunal feedings and chose not to resume oral feedings. These results showed that jejunal tube feeding in combination with insertion of unpalatable contents into the stomach eliminated rumination in these developmentally delayed children.
Collapse
Affiliation(s)
- Amber Severio
- Louisiana State University Health Science Center, New Orleans, Louisiana
| | - Javier Monagas
- Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas; and
| | - R Adam Noel
- Baylor College of Medicine, Children's Hospital of San Antonio, San Antonio, Texas; and
| | - Paul E Hyman
- Louisiana State University Health Science Center, New Orleans, Louisiana; Children's Hospital of New Orleans, New Orleans, Louisiana
| |
Collapse
|
13
|
Robertson J, Hatton C, Baines S, Emerson E. Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base. J Appl Res Intellect Disabil 2015; 28:455-523. [DOI: 10.1111/jar.12149] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Janet Robertson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Chris Hatton
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Susannah Baines
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Eric Emerson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
- Centre for Disability Research and Policy; University of Sydney; Sydney NSW Australia
| |
Collapse
|
14
|
Moskowitz LJ, Jones EA. Uncovering the evidence for behavioral interventions with individuals with fragile X syndrome: a systematic review. Res Dev Disabil 2015; 38:223-241. [PMID: 25575286 DOI: 10.1016/j.ridd.2014.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/09/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
Fragile X syndrome (FXS) is associated with a wide range of cognitive, emotional, and behavioral difficulties. Although there is considerable research on the behavioral phenotype of FXS, few empirical studies of behavioral interventions with this population have been identified. Through a hand search of 34 behavioral journals, we examined the evidence base for behavioral interventions with individuals with FXS and in light of the current state of knowledge regarding the FXS behavioral phenotype. Systematic review procedures were used to identify behavioral intervention studies that included at least one participant with FXS, extract and summarize the data on several relevant dimensions, and rate the methodological quality of the studies. Results revealed 31 intervention studies with a small number of participants with FXS. Overall, results suggest a behavioral approach to intervention with individuals with FXS shows promise. Future research focused on individuals with FXS will be necessary to continue to examine differences in response to intervention and interventions that specifically address phenotypic characteristics.
Collapse
Affiliation(s)
- Lauren J Moskowitz
- Department of Psychology, St John's University, Queens, NY 11439, United States.
| | - Emily A Jones
- Queens College, The Graduate Center of the City University of New York, Queens, NY, United States
| |
Collapse
|
15
|
Abstract
The Diagnostic and Statistical Manual of Mental Disorders now recognizes six primary feeding and eating disorders including pica, rumination disorder, avoidant/restrictive food intake disorder, anorexia nervosa, bulimia nervosa and binge-eating disorder. Guided by research from the past 3 years, the current review outlines diagnostic criteria for each disorder, their clinical correlates and treatment options. Recent modifications to diagnostic criteria will likely help to improve treatment outcomes and prognosis. Nevertheless, several concerns remain regarding the validity of current diagnostic criteria for youth, including the clinical relevance of the size and frequency of binge eating episodes. Additionally, the lack of randomized controlled trials has led to an overreliance on data from quasi-experimental studies, case series and single case studies that impede development of strong clinical recommendations for treating feeding and eating disorders. Recommendations for future research include identifying empirically supported treatments and prevention programs focused on early markers of pediatric feeding and eating concerns.
Collapse
|
16
|
Roche L, Sigafoos J, Lancioni GE, O’Reilly MF, Green VA, Sutherland D, van der Meer L, Schlosser RW, Marschik PB, Edrisinha CD. Tangible Symbols as an AAC Option for Individuals with Developmental Disabilities: A Systematic Review of Intervention Studies. Augment Altern Commun 2014; 30:28-39. [DOI: 10.3109/07434618.2013.878958] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
|
18
|
Abstract
PURPOSE To highlight new knowledge and technologies that support the transfer of skills generally acquired by speech language pathologists (SLPs) in academic training programs and clinical practice to involvement in the evaluation and management of individuals with disorders such as paradoxical vocal fold movement (PVFM), chronic cough, manifestations of extra-esophageal reflux (EER), esophageal dysphagia and rumination disorder. RECENT FINDINGS A range of studies published in the previous year provide data to support SLP involvement in the management of some disorders, including PVFM, chronic cough, and some manifestations of EER, both as providers and as clinical resources for other health professionals. However, little research is available that describes the role of SLPs in management of esophageal dysphagia or rumination disorder. SUMMARY Recent research supports the expanded role of the SLP in the interdisciplinary management of PVFM, chronic cough, manifestations of EER, esophageal dysphagia, and rumination. SLP and other health professionals involved in the care of these patients must find a balance between the practical challenges of treating individuals with increasingly complex medical issues and staying abreast of the latest developments in the diagnosis and treatment of these disorders.
Collapse
|
19
|
Didden R, Sturmey P, Sigafoos J, Lang R, O’Reilly MF, Lancioni GE. Nature, Prevalence, and Characteristics of Challenging Behavior. Functional Assessment for Challenging Behaviors 2012. [DOI: 10.1007/978-1-4614-3037-7_3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|