in safe feeding where there is little prospect of change, where there is limited support from carers or when the child uses good compensatory techniques with no risks to their health. Decision-making is defined as the process which in the therapist determining the ‘results best course of action at the time given the particular set of circumstances’ (RCSLT 2006, p. 33). Therapists are advised to consider ethical principles along with any applicable legal principles, clinical evidence, options in relation to risks/benefits and to involve the client and parents/carers in decision-making. When faced with ethical decisions, Arvedson and Lefton-Greif (2007) advise that the team consider options from the child’s best interests. They review some of the literature relating to ethical decisions for premature babies, children with complex needs, and in palliative care. They highlight the need for clinicians to consider children holistically and to be sensitive to stress on families, especially where children have long-term disabilities. The main considerations in assessing and managing eating and drinking difficulties in children have been outlined in this chapter. Feeding has been considered in relation to causes and signs of difficulty. The impact of feeding difficulty also needs to be assessed in relation to lengthy, stressful mealtimes, respiration and weight gain. A holistic approach is essential in management of eating and drinking difficulties in children. Feeding difficulties may be of short duration or long term, requiring consideration of changes due to maturation and the growing child’s needs. There is increasing evidence from research to help clinicians reach evidence-based decisions on management. However, as feeding difficulties are usually linked with physical, cognitive or behaviour difficulties, the influence of multiple factors continue to make a complex process.
in safe feeding where there is little prospect of change, where there is limited support from carers or when the child uses good compensatory techniques with no risks to their health. Decision-making is defined as the process which ‘results in the therapist determining the best course of action at the time given the particular set of circumstances’ (RCSLT 2006, p. 33). Therapists are advised to consider ethical principles along with any applicable legal principles, clinical evidence, options in relation to risks/benefits and to involve the client and parents/carers in decision-making. When faced with ethical decisions, Arvedson and Lefton-Greif (2007) advise that the team consider options from the child’s best interests. They review some of the literature relating to ethical decisions for premature babies, children with complex needs, and in palliative care. They highlight the need for clinicians to consider children holistically and to be sensitive to stress on families, especially where children have long-term disabilities. The main considerations in assessing and managing eating and drinking difficulties in children have been outlined in this chapter. Feeding has been considered in relation to causes and signs of difficulty. The impact of feeding difficulty also needs to be assessed in relation to lengthy, stressful mealtimes, respiration and weight gain. A holistic approach is essential in management of eating and drinking difficulties in children. Feeding difficulties may be of short duration or long term, requiring consideration of changes due to maturation and the growing child’s needs. There is increasing evidence from research to help clinicians reach evidence-based decisions on management. However, as feeding difficulties are usually linked with physical, cognitive or behaviour difficulties, the influence of multiple factors continue to make a complex process.
Chapter_22_Children_with_feeding_difficulties.docx