Use of behavioral interventions and parent education to address feeding difficulties in young children with spastic diplegic cerebral palsy.

The purpose of this study was to assess the effectiveness of an intensive day patient pediatric feeding program using oral motor exercises, behavioral interventions, and parental education to increase the oral feeding of children with spastic diplegic cerebral palsy. Eight children between the ages of 18 months to 4.7 years participated in the feeding program for an average of 5.8 weeks. The program consisted of structured oral motor exercises, rewards for reinforcement of appropriate feeding behaviors such as accepting food, chewing, and swallowing, as well as extinction for inappropriate feeding responses. Results show improvement in mealtime skills and behaviors necessary for increasing oral intake. There was improvement in ability to open the mouth for the presentation of the food as well as improved timeliness of swallowing without gagging, expelling or holding food in the mouth. The children were able to tolerate longer meal sessions and consume a greater quantity of food resulting in greater caloric consumption. The children who were tube fed at admission were able to decrease the amount of tube supplementation due to their improved oral intake. Caregivers improved in their ability to feed their children by providing appropriate instructions, prompts and consequences (IPC) during meals.