Original Research

Exploring swallowing, feeding and communication characteristics of toddlers with severe acute malnutrition

Casey J. Eslick, Esedra Krüger, Alta Kritzinger
South African Journal of Communication Disorders | Vol 69, No 1 | a874 | DOI: https://doi.org/10.4102/sajcd.v69i1.874 | © 2022 Casey J. Eslick, Esedra Krüger, Alta Kritzinger | This work is licensed under CC Attribution 4.0
Submitted: 22 November 2021 | Published: 31 October 2022

About the author(s)

Casey J. Eslick, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Esedra Krüger, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Alta Kritzinger, Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa


Share this article

Bookmark and Share

Abstract

Background: Severe acute malnutrition (SAM) is associated with cognitive and motor deficits. Little is known about the swallowing, feeding and communication characteristics of hospitalised toddlers with SAM, limiting the abilities of speech-language therapists to provide effective early intervention.

Objective: To explore the background, swallowing, feeding and communication characteristics of toddlers with SAM during in-patient nutritional rehabilitation.

Method: An exploratory, prospective, collective case-study was conducted with three hospitalised toddlers who were 12–18 months old and independently diagnosed with SAM, at least 1 week after transitioning to oral feeding. Detailed case histories were compiled through medical file perusal and parent interviews. Cross-sectional clinical bedside assessments were completed with the Rossetti Infant-Toddler Language Scale and Schedule for Oral-Motor Assessment.

Results: All three participants had a history of feeding difficulties before admission. Despite intact pharyngeal swallows, heterogeneous oral-sensorimotor dysfunction and disruptive feeding behaviours were identified. Risk for oropharyngeal dysphagia indicates the need to modify dietary consistencies to prevent prolonging recovery or SAM relapse. Participants had mild-to-moderate language delays, particularly in interaction-attachment, play and language comprehension, with an atypical moderate receptive and mild expressive language delay profile. None of the participants were referred for speech-language therapy.

Conclusion: This exploratory research showed the oral-sensorimotor skills, swallowing and communication characteristics of children with SAM. Speech-language therapists could address oral-sensorimotor functioning, feeding difficulties and communication interaction delays before discharge to community-based management for SAM. Further investigation with a larger sample size is recommended.

Contribution: Novel description of the oral-sensorimotor skills for feeding and the communication development of three severely malnourished toddlers with HIV and tuberculosis co-infection was presented. The complexity of the three cases is highlighted.


Keywords

communication difficulties; early identification; oral-sensorimotor dysfunction; oropharyngeal dysphagia; severe acute malnutrition; speech-language therapist; swallowing and feeding characteristics; toddler

Metrics

Total abstract views: 400
Total article views: 265


Crossref Citations

No related citations found.