BACKGROUND: Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. OBJECTIVE: To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. METHOD: A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. RESULTS: EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. CONCLUSION: Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.
BACKGROUND: Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. OBJECTIVE: To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. METHOD: A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. RESULTS: EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. CONCLUSION: Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.
Authors: Julia T Schiele; Hendrik Schneider; Renate Quinzler; Gabriele Reich; Walter E Haefeli Journal: Ann Fam Med Date: 2014 Nov-Dec Impact factor: 5.166
Authors: Hsiewe Ying Tan; Anthony L Zhang; Charlie C Xue; Dacan Chen; Cliff Da Costa; George B Lenon Journal: BMJ Open Date: 2013-12-30 Impact factor: 2.692
Authors: Lucas A Badenduck; T Wayne Matthews; Alanna McDonough; Joseph C Dort; Kristin Wiens; Rachelle Kettner; Susan Crawford; Bonnie J Kaplan Journal: J Otolaryngol Head Neck Surg Date: 2014-04-22
Authors: Jeanette M Johnstone; Brenda Leung; Barbara Gracious; Leanna Perez; Gabriella Tost; Andrew Savoy; Irene Hatsu; Andrew Hughes; Alisha Bruton; L Eugene Arnold Journal: Contemp Clin Trials Commun Date: 2019-10-26