Feeding Assessment Using VDF In 2021 Far

Children who have neurological conditions nearly always have swallowing difficulties and other feeding challenges, so it was no surprise to doctors when Boaz*, a six-year-old boy with a congenital neurological condition, had difficulty with drinking liquids.

Boaz’s condition is among those neurological disorders that causes sporadic convulsions. Complicating matters even further, whenever he would drink water, the liquid would end up going into his windpipe and lungs rather than down through his esophagus and into his stomach, a condition known as pulmonary aspiration. As a result of repeated episodes of pulmonary aspiration, Boaz regularly suffered from bouts of pneumonia.

As if the challenge of a complicated neurological disorder and sporadic convulsions were not enough, Boaz and his family faced pulmonary aspiration, pneumonia and concerns over dehydration, among other worries, on a regular basis. In the hope of reducing some of the negative impact of his condition to his health and quality of life, his doctors referred him to the Feeding Rehabilitation Center at ALYN Hospital.

In 2021, with the help of a generous gift from a donor, ALYN launched several new services including the Swallow Study Lab, which quickly became a success by being the first child-friendly and special-needs oriented radiology environment for assessing the exact mechanism of the problem in swallowing and offer personalized solutions.

Using ALYN’s new Video Fluoroscopy (VDF) imaging system, the team of experts was able to conduct a swallow study in which they could monitor, on a live x-ray, exactly how Boaz drank very small amounts of water. Using the VDF, they watched as Boaz used his tongue to move the water to the back of his mouth and then used his throat muscles to attempt to swallow but was unable to due to an involuntary gagging reflex. In this way, they were able to assess the precise cause of the aspiration, which is the first milestone in any feeding rehabilitation program.

With the knowledge that children with Boaz’s condition are often able to drink carbonated liquids, the team decided to do an assessment using soda water and discovered that it was, in fact, the easiest liquid for Boaz to drink. They developed a strategy for his feeding rehabilitation program, which entailed teaching him how to effectively drink soda water. Boaz can now drink any carbonated liquid and is learning how to drink as efficiently as possible.

Understanding why the drinking of soda water does not cause pulmonary aspiration for a child with Boaz’s condition could be a game-changer for children with this condition worldwide, yet there has been little research conducted in this area thus far. ALYN’s Feeding Rehabilitation Center staff are now conducting clinical studies, including using Boaz’s case, to add to the body of knowledge that exists through presenting their research findings with the greater pediatric medicine and feeding disorder community.

For a video of the VDF in action (in Hebrew), WATCH HERE.

*Name has been changed to protect patient privacy.

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