Feeding Disorders in Williams
Syndrome
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1
The Children's Hospital of Philadelphia, United States
Statement of Purpose: Children with Williams Syndrome are at risk for a myriad of developmental disabilities because of the complicated medical and neurological conditions. Little has been written about the specific types of feeding problems in these children. A better understanding of how this syndrome affects a child’s ability to manipulate increasingly complex food textures and advance oral motor function could provide improved outcomes for feeding and swallowing development and optimal growth in children with Williams Syndrome.
Methods: Children with identified feeding and swallowing problems were evaluated by the Speech Pathologist, with over 15 years experience in dysphagia, as a member of an Interdisciplinary Feeding Clinic and a Multispecialty Williams Syndrome Clinic. Oral motor function and swallowing patterns were assessed in children with complex medical conditions, which predisposed them to feeding and swallowing problems. Williams syndrome is associated with oral motor delay and feeding difficulty in infancy and early childhood. Experience in treating these children has contributed to the identification of specific problems, therapeutic interventions, and parent education, which improve feeding ability.
Results: Identified feeding problems included disordered sucking in infancy, inefficient oral motor patterns, delay in chewing skill acquisition, limited volume, growth failure, and dysphagia. The constellation of conditions in Williams Syndrome, which are associated with feeding disorders, were identified and correlated with the occurrence and severity of the feeding disorder. Those conditions include developmental delay, cardiovascular disease, neurological abnormalities, failure to thrive, and gastrointestinal problems. Hypotonia and GI dysmotility were prevalent in the children evaluated and significantly contributed to decreased sucking strength and endurance, inadequate strength for chewing, food refusal, difficulty drinking, poor appetite, limited interest in eating, and drooling, which impacted sufficient oral intake and weight gain. Treatment strategies to improve function included identifying adequate seating and positioning to support optimal oral motor function; providing specialized bottle/nipple systems; and modifying food texture and consistency to decrease effort and increase volume at mealtime.
Discussion: Children with Williams Syndrome are predisposed to feeding problems and reduced oral motor function impacted by hypotonia, which has been shown to affect a child’s ability to suck and swallow, manipulate solid food, and acquire developmental feeding milestones. In addition, gastrointestinal conditions can affect a child’s physiological state of comfort during feeding and impact hunger and motivation to eat. Experience has provided consistent information with earlier findings that corroborate the need for appropriate assessment and intervention to establish positive growth and optimize development in children with William’s Syndrome.
Conference:
12th International Professional Conference on Williams Syndrome, Garden Grove,CA, United States, 13 Jul - 14 Jul, 2008.
Presentation Type:
Poster Presentation
Topic:
Multidisciplinary Poster Session
Citation:
Greis
SM
(2009). Feeding Disorders in Williams
Syndrome.
Conference Abstract:
12th International Professional Conference on Williams Syndrome.
doi: 10.3389/conf.neuro.09.2009.07.039
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Received:
04 May 2009;
Published Online:
04 May 2009.
*
Correspondence:
S. M Greis, The Children's Hospital of Philadelphia, Philadelphia, United States, greis@email.chop.edu