Guided Eating/ Feeding:
The study by Qvarfordt, Occupational therapist (2009) ”Guided eating or feeding: three girls with Rett syndrome” shows that guiding during the meal with verbal and tangible support, increased the participation and interest in eating and coordination of mouth and arm/hand movements.
Involuntary stereotypical hand movements can make eating a very difficult self-care task for individuals with RTT. The following are some interventions OT use to address feeding issues.
The study by Qvarfordt, Occupational therapist (2009) ”Guided eating or feeding: three girls with Rett syndrome” shows that guiding during the meal with verbal and tangible support, increased the participation and interest in eating and coordination of mouth and arm/hand movements.
Involuntary stereotypical hand movements can make eating a very difficult self-care task for individuals with RTT. The following are some interventions OT use to address feeding issues.
- Educating and encouraging caregivers to practice guided feeding. Guided feeding involves having the individual with RTT grasp the spoon and having the caregiver's hand over top of the child's in order to guide the movement of the individual to eat. Although they may not become fully independent, this is to encourage involvement of the client in this self care activity (Qvarfordt, 2009). Signals such as opening their mouth in preparation for food, rejecting unwanted foods, and spending an increased amount of time watching their helpers, indicates that guided feeding therapy can increase engagement in eating in some cases. (Rett Syndrome-Occupational Therapy and Speech/Language Therapy, 2014).
- Making hand splints. Research suggests that hand splints place the hand in a more functional position and prevent repetitive motion (Naganuma & Billingsley, 1988), this leads to better finger and spoon-feeding skills. Similar to guided feeding, hand splints allow clients with RTT to become more engaged in eating. Alternatively, active participation can be encouraged through the use of elbow splints, which decrease the repetitive stereotyped arm movements (Aron, 1990). As a result, socialization and interaction with the environment during eating may increase. (Rett Syndrome-Occupational Therapy and Speech/Language Therapy, 2014)
- Other adaptations to eating include altering the pace of feeding and recommending specific food textures that is easier to swallow (Rett Syndrome-Occupational Therapy and Speech/Language Therapy, 2014)
- Adaptive devices such as cuffs and loops (to help the individual hold their utensils), large handled utensils that are easier to grasp, and cups with lids can assist with eating and address proper nutrition. (Rett Syndrome-Occupational Therapy and Speech/Language Therapy, 2014)
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References
Aron, A. (1990). The use and effectiveness of elbow splints in the Rett syndrome. Brain Development, 12, 162-163.
Naganuma, G. M., Billingsley, F. F. (1988). Effects of hand splints on stereotypic hand behavior of three girls with Rett syndrome. Physical Therapy, (68), 5, 664-671.
Qvarfordt, I., Witt Engerstrom, I., Eliasson, A. C. (2009): Guided eating or feeding: three girls with Rett syndrome. Scandinavian Journal of Occupational Therapy, Oct 7, pp1-7.
Rett Syndrome - Occupational Therapy and Speech/Language Therapy. (2014). A Site About Education, Degrees, School, Elementary School, Middle School, Grade School, High School, Home School, College, University & More. Retrieved July 29, 2014, from http://www.sloansemester.org/rett_syndrome/occupational_therapy_and_speechlanguage_therapy
Images from:
http://www.rehabmart.com/category/Eating_Utensils_and_Accessories.htm
http://www.ncbi.nlm.nih.gov/pubmed/18839388
References
Aron, A. (1990). The use and effectiveness of elbow splints in the Rett syndrome. Brain Development, 12, 162-163.
Naganuma, G. M., Billingsley, F. F. (1988). Effects of hand splints on stereotypic hand behavior of three girls with Rett syndrome. Physical Therapy, (68), 5, 664-671.
Qvarfordt, I., Witt Engerstrom, I., Eliasson, A. C. (2009): Guided eating or feeding: three girls with Rett syndrome. Scandinavian Journal of Occupational Therapy, Oct 7, pp1-7.
Rett Syndrome - Occupational Therapy and Speech/Language Therapy. (2014). A Site About Education, Degrees, School, Elementary School, Middle School, Grade School, High School, Home School, College, University & More. Retrieved July 29, 2014, from http://www.sloansemester.org/rett_syndrome/occupational_therapy_and_speechlanguage_therapy
Images from:
http://www.rehabmart.com/category/Eating_Utensils_and_Accessories.htm
http://www.ncbi.nlm.nih.gov/pubmed/18839388