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使用全球强化喂养疗法(GIFT)对唐氏综合征儿童的喂养和吞咽技能进行评估与康复干预。

Assessment and Rehabilitation Intervention of Feeding and Swallowing Skills in Children with Down Syndrome Using the Global Intensive Feeding Therapy (GIFT).

作者信息

Franceschetti Silvia, Tofani Marco, Mazzafoglia Serena, Pizza Francesca, Capuano Eleonora, Raponi Massimiliano, Della Bella Gessica, Cerchiari Antonella

机构信息

Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

Management and Diagnostic Innovations & Clinical Pathways Research Area, Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

出版信息

Children (Basel). 2024 Jul 12;11(7):847. doi: 10.3390/children11070847.

Abstract

BACKGROUND

Children with Down syndrome (DS) experience more difficulties with oral motor skills, including chewing, drinking, and swallowing. The present study attempts to measure the preliminary effectiveness of Global Intensive Feeding Therapy (GIFT) in DS. GIFT is a new rehabilitation program addressing the specific difficulties and needs of each child, focusing on sensory and motor oral abilities. It follows an intensive schedule comprising 15 sessions over 5 consecutive days, with 3 sessions per day. The principles of GIFT are applied with specific objectives for DS.

METHODS

GIFT was preliminarily implemented among 20 children diagnosed with DS. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the International Dysphagia Diet Standardization Initiative (IDDSI), and the Pediatric Screening-Priority Evaluation Dysphagia (PS-PED) were used. Data were analyzed using the Wilcoxon signed-rank test before (T0) and after intervention (T1) and at one-month follow-up (T2). The effect size was also measured for specific outcomes, using Kendall's W.

RESULTS

Our findings revealed that children with DS showed no risk of dysphagia according to the PS-PED (mean score 2.80). Furthermore, statistically significant improvements in chewing performance were observed, as measured by the KCPS ( < 0.01), as well as in texture acceptance and modification, as measured by the IDDSI post-intervention ( < 0.01). For both the KCPS and IDDSI, a large effect size was found (Kendall's W value > 0.8). Parents/caregivers continued using GIFT at home, and this allowed for a positive outcome at the one-month follow-up.

CONCLUSIONS

GIFT proved to be effective in the rehabilitation of feeding and swallowing disorders in children with DS, as well as for food acceptance.

摘要

背景

唐氏综合征(DS)患儿在口腔运动技能方面存在更多困难,包括咀嚼、饮水和吞咽。本研究旨在评估全球强化喂养疗法(GIFT)对DS患儿的初步疗效。GIFT是一项新的康复计划,针对每个孩子的特定困难和需求,专注于口腔感觉和运动能力。它遵循密集的日程安排,连续5天共15节课程,每天3节。GIFT的原则针对DS设定了具体目标。

方法

对20名诊断为DS的儿童初步实施GIFT。为评估GIFT的疗效,使用了卡拉杜曼咀嚼表现量表(KCPS)、国际吞咽障碍饮食标准化倡议(IDDSI)和儿科吞咽障碍筛查-优先评估(PS-PED)。在干预前(T0)、干预后(T1)和1个月随访(T2)时,使用Wilcoxon符号秩检验对数据进行分析。还使用肯德尔W系数测量了特定结果的效应量。

结果

我们的研究结果显示,根据PS-PED,DS患儿无吞咽困难风险(平均得分2.80)。此外,通过KCPS测量,咀嚼表现有统计学意义的改善(<0.01),干预后通过IDDSI测量,质地接受度和调整也有改善(<0.01)。对于KCPS和IDDSI,均发现了较大的效应量(肯德尔W值>0.8)。家长/照顾者在家中继续使用GIFT,这使得在1个月随访时取得了积极结果。

结论

GIFT被证明对DS患儿的喂养和吞咽障碍康复以及食物接受度有效。

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