Gosa Memorie M, Carden Hillary T, Jacks Courtney C, Threadgill Amy Y, Sidlovsky Tara C
The University of Alabama, Tuscaloosa, AL, USA.
Le Bonheur Children's Hospital, Memphis, TN, USA.
J Pediatr Rehabil Med. 2017 May 19;10(2):107-136. doi: 10.3233/PRM-170436.
A rise in pediatric patients with swallowing and feeding problems has resulted in increased interest in multidisciplinary treatments to address these issues. This evidence based systematic review (EBSR) examined the published evidence for the use of common strategies used by clinicians across disciplines to treat pediatric swallowing and feeding problems.
A systematic search of 10 electronic databases was completed to identify relevant, peer reviewed literature published in English prior to December 2015 reporting original data that addressed at least one of the five identified clinical questions.
Sixty-one studies of varying methodological quality were included. The majority of the included studies (60/61) focused on the use of behavioral therapies to remediate swallowing and feeding disorders in children and reported mixed findings across all of the targeted outcomes.
There is insufficient quantity of evidence to determine the effects of oral motor, sensory, and pharmaceutical therapies on functional feeding outcomes in pediatric populations. A larger body of phase 1 evidence is available that establishes the efficacy of behavioral strategies to treat some swallowing and feeding difficulties in small cohort and single subject studies. This analysis identified limited high quality (phase 4) research articles that establish the efficacy and benefit of joint nutrition and behavior intervention programs and systematic desensitization and operant conditioning behavioral therapy approaches to improve functional feeding and swallowing outcomes in children.
患有吞咽和进食问题的儿科患者数量增加，这使得人们对解决这些问题的多学科治疗方法的兴趣日益浓厚。本循证系统评价（EBSR）研究了临床医生跨学科使用的常见策略用于治疗儿科吞咽和进食问题的已发表证据。
对10个电子数据库进行系统检索，以识别2015年12月之前发表的、经同行评审的英文文献，这些文献报告了至少针对五个已确定临床问题之一的原始数据。
纳入了61项方法学质量各异的研究。纳入的大多数研究（60/61）侧重于使用行为疗法来矫治儿童的吞咽和进食障碍，并且在所有目标结果方面报告了不一致的结果。
现有证据数量不足，无法确定口腔运动、感觉和药物疗法对儿科人群功能性进食结果的影响。有更多的1期证据表明，在小队列研究和单病例研究中，行为策略对治疗某些吞咽和进食困难有效。该分析确定了有限的高质量（4期）研究文章，这些文章证实了联合营养与行为干预计划以及系统脱敏和操作性条件反射行为疗法在改善儿童功能性进食和吞咽结果方面的有效性和益处。
