Children with Feeding and Swallowing Problems (Pediatric Dysphagia)
Welcome
This blog is dedicated to assisting in the oral feeding of children who have difficulties with feeding and swallowing. As a dentist with over four decades of experience in researching and practicing clinical pediatric dysphagia, I have noticed that the primary healthcare providers in this field are Speech-Language Pathologists (SLP) or Occupational Therapists (OT) worldwide. However, the situation in Japan differs slightly from that of other countries. While Speech Therapists (ST) and OTs have traditionally played a major role in dysphagia treatment in my country, a few dentists have also been involved in this area since the 1980s.
In 1977, Dr. Kaneko Yoshihiro traveled to the United States and Denmark on a fellowship from the World Health Organization. During his visit, he gained valuable insights into feeding issues and subsequently established a feeding clinic for dysphagic children in 1980. He was a professor at Showa University and also served as an advisory board member for "Dysphagia". Dr. Kaneko was a trailblazer in the field of pediatric dysphagia in Japan, introducing unique perspectives that differed from those of SLPs and OTs.
Dentists like myself have distinct viewpoints on pediatric dysphagia compared to SLPs or OTs. While most theories in this field are rooted in neurodevelopment and sensorimotor facilitation techniques, Dr. Kaneko focused on enhancing lip closure function, emphasizing the importance of encouraging children to pull food off the spoon using their lips for efficient feeding.
In 2001, I traveled to Canada and the United States to further my study of pediatric dysphagia through the Shimizu Overseas Study Program. To the best of my knowledge, there is no standardized assessment or management program for this field globally. There are numerous ways to address pediatric feeding and swallowing disorders, which may vary based on cultural differences or food habits between Asian and Western countries. Every nation has created a unique weaning method for children, influenced by its traditional cuisine and approach to childcare.
In Japan, typical infants usually start feeding solid foods when they are around five to six months of age. The process of transitioning to solid foods is divided into three stages: primary, middle, and late. This progression is determined by factors like a infant's ability to close their lips, swallow food, and chew. The treatment for pediatric dysphagia is based on these developmental milestones.
When I began treating pediatric dysphagia in 1983, the majority of patients presented with functional disorders such as Cerebral Palsy and Intellectual Disability. However, there has been a notable increase in psycho-behavioral issues like food refusal, picky eating, food phobia, and tube dependency in Japan in recent years, affecting children with and without disabilities.
Here is an overview of my clinic's layout. I will share one of the approaches based on my clinical experiences in Japan, which is divided into two parts: "Functional Disorders" and "Psycho-Behavioral Problems".
Today, I will be discussing "Functional Disorders" with you, with plans to cover the second part in the future. This blog is a work in progress, and I am currently working on creating educational videos on topics like oral motor skill development during transitional feeding.
● The author has no conflicts of interest directly relevant to the content of this article.
About me
My name is Omoto Kazuhiko(尾本和彦) and I was born in 1953. I am a dentist and live in Saitama prefecture, Japan.
<Education>
1993 Ph.D. Showa University （Otsu No.1404）
Doctorial theses:
Development of Oral Functions in Infant FeedingⅠ:A Longitudinal Observation of Lips, Tongue, and Jaw Movements while Eating.
（The abstract is available in the English）Development of Oral Functions in Infant Feeding II: Electromyographic Features of the Activities of the Muscles Relating to Mastication and Swallowing during Bite Reflex, Suckling and Chewing.
（The abstract is available in the English)
1981 Graduate from Tokyo Dental College
<Professional main works published>
Edited by Omoto K. and Ozawa H.: Practical Support for Children with Feeding and Swallowing Disorders (available in Japanese). Ishiyaku Publishers, Inc. Tokyo Japan. 2019.
Omoto K. and Srinual C.: Basic approach to oromotor dysfunction (available in English). Unseal Pediatric Rehabilitation. Faculty of medicine Siriraj hospital Mahidol university, p241-252, Bangkok, Thailand. 2018.
Edited by Kitazumi E. Omoto K., and Fujishima I.: Children with Feeding and Swallowing Disorders (available in Japanese). Nagai Shoten Co., Ltd. Osaka Japan. 2007.
Edited by Kaneko Y. and Omoto K.: Rehabilitation of Dysphagia and
Respiratory Insufficiency in the Disabled-Principle and Management (available in Japanese). Ishiyaku Publishers, Inc. Tokyo Japan. 2005.
Kaneko Y. Mukai Y., and Omoto K.: Disorder in Eating Function- Its Concept and Application to the Rehabilitation Program- (available in Japanese). Ishiyaku Publishers, Inc. Tokyo Japan. 1987.
<Presentation at the international meeting>
Mukai Y. Omoto K., Shishikura J., Sasa R., and Kaneko Y.: Kinetic analysis of lips of the handicapped using a video-computer system. The 7th Congress of the International Association of Dentistry for the Handicapped. Amsterdam, Netherlands, September 1984.
Omoto K. Mukai Y., and Kaneko Y.: A method for assessing oral functions in feeding. The 8th Congress of the International Association of Dentistry for the Handicapped. Bergen, Norway, July 1986.
Kaneko Y. Omoto K., Mukai Y.: Procedural sequences employed in a feeding training program. The 8th Congress of the International Association of Dentistry for the Handicapped. Bergen, Norway, July 1986.
Kaneko Y. Mukai Y., and Omoto K.: Primary oral reflexes in premature infants. The 10th Congress of the International Association of Dentistry for the Handicapped. Nice, France, September 1990.
Omoto K. Mukai Y., Kaneko Y., and Shishikura J.: Ultrasonic evaluation of swallowing in normal adults and disabled children with dysphagia. The 12th Congress of the International Association of Dentistry for the Handicapped. Trier, Germany, September 1994.
Resources
If you choose to download the items provided, kindly select the green box for further action.
<Speaker notes of the international meeting>
<Speaker notes of the lecture in Thailand>
<Others>