slp 477 exam 4 (final exam)

ch 10-12 (final)

What is the most appropriate instrumental evaluation to assess infant pharyngeal swallow function without radiation exposure?

Fiberoptic endoscopic evaluation of swallowing (FEES)

Which phase of swallowing in infants involves bolus transfer from the tongue to the pharynx?

oral phase

Which of the following is a behavior-based pediatric swallowing screening tool?

Mealtime Behavioral Questionnaire

A child frequently spits out food and gags on textured solids. Which phase is most likely affected?

oral prep phase

What is a key difference in infant anatomy that supports safe swallowing compared to older children?

higher laryngeal position

What condition is most likely to disrupt suck-swallow-breathe coordination in a premature infant?

nasal congestion

Which of the following is a non-instrumental assessment tool used to evaluate oral feeding skills in infants?

Pediatric Swallowing Assessment Scale

What is a common feeding sign in infants with laryngomalacia?

Stridor during feeding

Which of the following reflexes supports nipple finding in newborns?

rooting reflex

What is the first step in evaluating pediatric feeding and swallowing difficulties?

Review medical and developmental history

Which of the following contributes to efficient suckling in a newborn?

buccal fat pads

In infants, the swallow is triggered at which anatomical landmark?

Anterior faucial pillars

A 2-month-old infant is bottle-fed and takes over 45 minutes to finish feeds. What is the best recommendation?

Refer for feeding and swallowing assessment

The oral preparatory phase in infants includes only voluntary movements.

False: includes both reflexive (involuntary) and emerging voluntary movements

The pharyngeal phase of swallowing in infants is completely under voluntary control.

False: involuntary

A hyperactive gag reflex in toddlers is always a normal developmental finding.

False: mild gag is normal but hyperactive gag reflex may signal sensory issues, orol motor delays, neurological concerns, GERD

Drooling beyond 24 months may suggest oral-motor immaturity or dysfunction.

True

Coughing while drinking from a bottle in an infant can be a sign of aspiration

True

Silent aspiration is difficult to detect without instrumental assessment.

True

Poor coordination of suck-swallow-breathe is frequently seen in premature infants.

True

A tongue thrust reflex persisting past infancy may affect later speech and feeding development.

True

Parental feeding practices and mealtime routines are not relevant to pediatric dysphagia assessments.

False: they can help find the cause of swallowing issues and guide better feeding strategies.

Feeding and swallowing difficulties in infants can affect growth, hydration, and quality of life.

True

Rooting reflex

helps infant locate nipple

Suck reflex

draws liquid into mouth

Gag reflex

prevents entry of material into throat

Swallow reflex

transfers bolus from oral cavity

Oral motor assessment scale

evaluates oral mvmt during feeding

Pediatric Eating Assessment Tool

Screens for feeding and swallowing difficulties

Mealtime Behavioral Questionnaire

Captures behavior during meals

Fiberoptic Endoscopic Evaluation of Swallowing

Visualizes pharyngeal and laryngeal function

Cranial Nerve V (Trigeminal)

chewing & jaw stability

Cranial Nerve VII (Facial)

Lip closure and facial movement

Cranial Nerve IX (Glossopharyngeal)

Gag reflex and taste

Cranial Nerve XII (Hypoglossal)

Tongue movement and strength

Velum

Seals nasopharynx

Larynx

Protects the airway during swallowing

Tongue

Directs bolus and supports suction

Buccal fat pads

Provides cheek stability during feeding

Cerebral palsy

Poor oral tone and limited control

Prematurity

Poor coordination of suck-swallow-breathe

Down syndrome

Large tongue, hypotonia

Autism spectrum disorder

Sensory-based food aversions

Wet vocal quality

Penetration or aspiration

Coughing during feeding

post-swallow residue

Arching and crying

Gastroesophageal reflux

Nasal regurgitation

Velopharyngeal dysfunction

Begins purees

4-6 months

Transition to solids (time)

6-9 months

Drinks from open cup (time)

9-12 months

Uses spoon independently (time)

12-18 months

Rooting reflex (time)

3-6 months

Suck reflex (time)

6-9 months

Phasic bite reflex (time)

4-6 months

Transverse tongue reflex (time)

9-12 months

Turning head away

Avoidance due to stress

Holding food in mouth

Oral-motor delay

Gagging without oral input

Hypersensitivity or reflux

Refusing to sit at table

Sensory-based feeding aversion

Infant arches during bottle

Reflux evaluation

Child refuses all meats

Behavioral feeding screen

Gulping sounds during bottle

Instrumental assessment referral

Toddler feeds longer than 45 minutes

Oral-phase evaluation

Side-lying bottle feeding

Reduce fatigue

External pacing

Improve coordination

Flavored boluses

Increase oral sensory input

Slow-flow nipples

Flow regulation

Provide food chaining chart

Encourage variety

Teach paced feeding

Improve coordination

Demonstrate oral massage

Strengthen oral patterns

Video record mealtime

Support home carryover

What feeding strategy is commonly used for preterm infants to help organize sucking patterns?

Non-nutritive sucking

Which of the following is a potential benefit of using a side-lying feeding position in infants?

Reduces fatigue and improves coordination

Which of the following describes a treatment strategy commonly used with infants with gastroesophageal reflux?

Using upright feeding posture

What intervention is most appropriate for an infant with poor lip closure during feeding?

Lip-strengthening exercises

What is the most appropriate technique for improving bolus propulsion in children with weak tongue muscles?

Tongue resistance exercises

What is the primary purpose of non-nutritive sucking?

Facilitate oral-motor development and readiness to feed

Which of the following is TRUE about infant-driven feeding programs?

They support cue-based feeding to promote safety and comfort

Which of the following would be part of an oral stimulation program for a child with reduced oral tone?

Pressure brushing and jaw tapping

What is a common modification for a child with delayed swallow initiation?

Introducing sour bolus stimuli

What is a key characteristic of food chaining?

Gradually introducing new foods based on accepted preferences

What is the rationale for using thickened liquids in pediatric dysphagia management?

They slow bolus flow and reduce aspiration risk

What best describes the purpose of a spoon placement technique in oral motor feeding therapy?

To improve bolus control and lip closure

Which team member is most responsible for positioning and adaptive equipment during pediatric mealtimes?

Occupational therapist

What treatment approach emphasizes behavioral reinforcement during pediatric feeding therapy?

The Sequential Oral Sensory (SOS) approach

Which technique is used to increase swallow initiation through sensory input?

Thermal-tactile stimulation

What would be an appropriate intervention for a toddler with food refusal and tantrums at meals?

Providing distraction-free mealtime environment

Which feeding posture is recommended for an infant with laryngeal penetration on thin liquids?

Side-lying

Children with Down syndrome may benefit from thickened liquids due to hypotonia.

True

Texture progression is part of most pediatric feeding therapy programs.

True

A child’s sensory processing profile should be considered in feeding treatment planning.

True

Children with autism spectrum disorder often benefit from rigid mealtime routines only.

False: some autistic children prefer predictable routines, every child diff

Oral aversion can be addressed using graded exposure to sensory input.

True

Children with cleft palate may need special bottle systems and positioning.

True

It is appropriate to work on feeding skills even if a child is currently tube-fed.

True

External pacing may support infants who cannot coordinate sucking and breathing.

True

Multisensory approaches may help children expand food acceptance.

True

Parent training is essential to successful pediatric feeding intervention.

True

Side-lying feeding position

Improves coordination in infants with fatigue

External pacing

Supports swallow-breathe coordination