What can an occupational therapist help with?
An occupational therapist (OT) is specifically trained to find any difficulties in swallowing, fine motor, gross motor, and thinking skills.
These can affect a child's ability to do everyday tasks in the following areas:
- Self-care skills: eating, bathing, dressing, toileting and hygiene
- Play skills: playing with toys or a game, finding a toy, or playing with friends
- School skills: attention and memory skills, organizing a task, writing, using scissors
Swallowing and occupational therapy
Your child may have swallowing problems after surgery, or with certain types of tumours, such as posterior-fossa or brainstem tumours. Swallowing problems connected with surgery usually improve with time. For some children, swallowing problems may improve with chemotherapy or radiation therapy.
It is not uncommon for children to require a feeding tube after surgery or during treatment due to swallowing changes and/or poor intake. Your child should continue to work with the occupational therapist (OT) to safely eat and drink, even if they have a feeding tube.
How will swallowing problems affect your child?
Swallowing involves many nerves and muscles around the head and neck, such as the lips, cheeks, tongue, throat and trachea (the airway leading to the lungs).
If any of these structures are impacted by the tumour or treatment for the tumour, your child could lose coordination or strength of their swallow.
If there is a swallowing difficulty:
- Your child may not eat enough to keep up with their nutritional needs.
- Your child may be at risk for aspiration. This means that food or fluid goes into the lungs instead of the stomach. If this happens often, it can cause pneumonia.
Signs of swallowing problems
- Choking or coughing during eating or drinking
- A wet-sounding voice or breathing
- Frequent chest infections
- Being afraid to eat or drink
- Avoiding certain foods or drinks
- Complaints of food getting stuck or going the wrong way
- Drooling
- Pocketing of food in the mouth
What can be done?
The OT will watch and listen while your child is eating or drinking and may also ask your child to move the muscles of their tongue, lips, and cheeks. In some cases, the OT may recommend a feeding study, which is a video X-ray that finds out what your child can drink and eat safely. It is like a movie of what happens inside your child’s mouth and throat from when food enters their mouth until after they swallow.
An OT, radiologist, and X-ray technologist will take part in your child’s feeding study. During the feeding study, your child may be asked to drink different liquids and eat different foods. After the study, the OT will suggest how to feed your child.
The OT will work closely with the dietitian and health-care team to make sure your child’s nutritional needs are being met. The OT may recommend treatment strategies which may include changing the consistency of the food or drinks, changing the temperature or texture of food, modifying the child’s position, use of swallowing maneuvers, and/or use of feeding equipment.