Diagnosis and Treatment of Pediatric Feeding and Swallowing Disorders

Pediatric feeding and swallowing disorders are common. Given the multiple and overlapping factors playing major roles in the development of normal feeding and swallowing, a multidisciplinary team approach is recommended to provide a comprehensive assessment and directed therapy. Patient care is provided in a coordinated and collaborative fashion, thus providing the most efficient and easiest access to care. In this regard, the quality of care for children with feeding and swallowing problems is improved.

Pain, disability, and symptoms among siblings of children with functional abdominal pain

OBJECTIVE

To examine reports of pain, disability, and somatic and psychological symptoms among siblings of children with functional abdominal pain (FAP) and siblings of "healthy" comparison children.

METHODS

This survey study explored two groups of participants (FAP and healthy) consisting of (1) children with FAP and their siblings and parents and (2) healthy comparison children and their siblings, and parents. Participants included 13 FAP families and 10 healthy comparison families. Siblings and children were between 8 and 14 years of age. Measures included the Behavioral Assessment System for Children, Abdominal Pain Index, Children's Somatization Inventory, Functional Disability Inventory, and Family Inventory of Life Events. Cross-sectional data were analyzed using correlations and analysis of variance techniques.

RESULTS

Siblings of children with FAP reported significantly greater mean levels of emotional/ behavioral symptoms than siblings of healthy comparison children. No significant between-group differences were identified in FAP and healthy comparison parents' reports of siblings' pain or emotional/behavioral symptoms. There were significantly more persons with pain problems living in the homes of FAP families. Among FAP families, a greater number of parent-reported family stressful life events was significantly associated with sibling functional disability and somatic symptoms.

CONCLUSION

This investigation suggests that siblings of children with FAP experience more emotional/behavioral symptoms than peers and that their symptoms are not readily identified by parents. These findings highlight the importance of considering the psychological functioning of "unaffected" siblings and family stressors when children present with recurrent pain complaints.

Latino sibling knowledge and adjustment to chronic disability

Forty matched healthy Latino and non-Latino siblings (ages 8-14 years) of children with developmental and physical disabilities completed interviews and questionnaires assessing sibling knowledge of and adjustment to disability and sibling global psychological functioning. One-way analyses of variance revealed Latino siblings to have significantly less accurate information about the disability and more internalizing problems than non-Latino siblings. Sibling and parent wishes for the healthy sibling reflected cultural values. The results indicate that Latino siblings of children with chronic disabilities may be at risk for internalizing psychological problems. Future research regarding cultural factors affecting sibling adaptation to childhood disability is encouraged.

Brief Report: Family-Based Group Intervention for Young Siblings of Children with Chronic Illness and Developmental Disability

OBJECTIVE

To evaluate the impact of a family-based group intervention for young siblings of children with chronic illness and developmental disability (CI/DD).

METHODS

Forty-three healthy siblings (ages 4-7 years) of children with CI/DD and their parents participated in an intervention designed to address sibling challenges that cut across types of diagnostic conditions. The intervention consisted of six sessions of collateral and integrated sibling-parent groups. Measures of sibling knowledge, sibling sense of connectedness with other children in similar family circumstances, and sibling global functioning were collected before and after intervention. A subsample of 17 families completed a 3-month follow-up.

RESULTS

Siblings' knowledge of the child's disorder and sibling connectedness increased significantly from pre- to posttreatment for both boys and girls, regardless of the nature of the brother or sister's condition. Sibling perceptions of self-competence increased from pre- to posttreatment, whereas parent reports of sibling behavioral functioning remained within the normal range. Improvements in sibling knowledge and connectedness maintained at follow-up. Parent satisfaction with the program was high.

CONCLUSIONS

Results support more controlled evaluations of family-based intervention to improve young sibling adaptation to CI/DD.

Integrated sibling-parent group intervention to improve sibling knowledge and adjustment to chronic illness and disability

OBJECTIVE

To evaluate an integrated group intervention for siblings and parents designed to increase sibling understanding of and adjustment to chronic illness and developmental disability (CI/DD).

METHODS

Fifty-four well siblings (ages 8-13 years) and their parents were recruited through hospital-based and community agencies serving children with CI/DD. Measures of sibling knowledge, sibling adjustment to the disorder, sibling connectedness, and sibling global behavioral functioning were collected before and after the intervention. A subsample of 20 families completed a 3-month follow-up to assess maintenance of results.

RESULTS

Sibling knowledge of the child's disorder and sibling connectedness increased, while sibling reports of negative adjustment to the disorder and parent reports of sibling global behavioral functioning decreased significantly from pre- to posttreatment for both boys and girls, regardless of the type of diagnostic condition. Improvements in sibling knowledge, connectedness, and behavioral problems maintained at 3-month follow-up. Parent satisfaction with the program was high.

CONCLUSIONS

Results support the future conduct of more controlled evaluation of the integrated sibling and parent group intervention model to improve sibling knowledge of and adjustment to CI/DD.

Brothers and sisters of young children with communication disorders

Family-centered approaches have revolutionized the way that clinicians provide services to young children with communication disorders and their families. With greater recognition of the significant impact that siblings have on each other's development and the potential stress and role confusion that siblings may experience when there is childhood disability in the family, it becomes more critical that the needs of siblings are considered and addressed. In this article, a variety of issues are considered relative to siblings' experiences. First, the roles of siblings and their effects on each other's development is reviewed, followed by a historical perspective of the impact of childhood disability on brothers and sisters. Next, sibling roles relative to a brother or sister with a communication disability are considered. Finally, clinical implications are discussed, with specific reference to active inclusion of siblings in family-centered assessment and intervention efforts.