Dysphagia in pediatric population has increased significantly over the last years in relation to advances in survival of premature infants and children with complex anomalies. In the year 2020 children with dyspahgia and their parents had to witness the initial interruption of care due to the sudden Covid-19 pandemic. The possibility to provide speech therapy treatment for dysphagia even at distance appeared to be a valid alternative to face this complex situation. The following study describes a mixed telepractice and in-presence taking charge program piloted in one pediatric patient with Epileptic Encephalopathy genetically determined and dysphagia for both solids and liquids. This single case study aimed to promote the innovative use of telerehabilitation in caregiver training for the treatment of dysphagia in children. Clinical and instrumental evaluations of swallowing abilities were performed at baseline and at the end of the ten months rehabilitation program, consisting in a monthly in-presence outpatient meeting and a weekly in-remote meeting. In addition, a remote monitoring satisfaction survey was submitted to the caregiver at the end of the study. The treatment involved training to the parent regarding diet modifications, the use of adaptive feeding equipment, appropriate positioning, chewing training and sensory stimulation. Final evaluations show improvements in the patient’s oro motor skills and in semisolids and semiliquids’s sucking; reduction of sialorrhea, mealtime duration and episodes of coughing. The overall experience of distance therapy has been evaluated as "positive" by the parent, despite the preference for in-presence therapy.
La disfagia in età pediatrica negli ultimi anni sta aumentando notevolmente in rapporto ai progressi nella sopravvivenza di neonati prematuri e bambini con patologie complesse. Nell’anno 2020 i bambini con disfagia e i loro genitori si sono trovati di fronte ad un’improvvisa sospensione dei trattamenti riabilitativi a causa della pandemia da Covid-19. Da subito la possibilità di garantire il trattamento logopedico della disfagia anche a distanza è sembrata essere una valida alternativa per affrontare questa complessa situazione. Il seguente studio descrive un programma di presa in carico mista in remoto ed in presenza di una paziente con encefalopatia epilettica geneticamente determinata e disfagia per liquidi e solidi. Questo studio su caso singolo ha lo scopo di promuovere l’utilizzo innovativo della teleriabilitazione nell’addestramento del caregiver per il trattamento della disfagia in età evolutiva. Sono state eseguite valutazioni strumentali e cliniche delle abilità deglutitorie inizialmente ed al termine di un programma di riabilitazione della durata di dieci mesi articolato in un incontro mensile in presenza presso l’ambulatorio ed uno settimanale in remoto. In aggiunta, al termine dello studio è stato sottoposto al caregiver un questionario di soddisfazione dell’intervento eseguito in remoto. Il trattamento ha previsto l’addestramento del genitore riguardo le modificazioni della dieta, l’utilizzo di ausili alimentari, il posizionamento appropriato della bambina, il training masticatorio e la stimolazione sensoriale. Le valutazioni finali mostrano miglioramenti nelle abilità oro motorie della bambina e nella suzione di semisolidi e semiliquidi; riduzione della scialorrea, della durata del pasto e degli episodi di tosse. L’esperienza complessiva della terapia a distanza è stata valutata dal genitore come “positiva”, esprimendo comunque una preferenza per il trattamento in presenza.
La riabilitazione della disfagia pediatrica durante la pandemia da Covid-19. Proposta di trattamento logopedico: studio su caso singolo.
PAOLUCCI, VERONICA
2020/2021
Abstract
Dysphagia in pediatric population has increased significantly over the last years in relation to advances in survival of premature infants and children with complex anomalies. In the year 2020 children with dyspahgia and their parents had to witness the initial interruption of care due to the sudden Covid-19 pandemic. The possibility to provide speech therapy treatment for dysphagia even at distance appeared to be a valid alternative to face this complex situation. The following study describes a mixed telepractice and in-presence taking charge program piloted in one pediatric patient with Epileptic Encephalopathy genetically determined and dysphagia for both solids and liquids. This single case study aimed to promote the innovative use of telerehabilitation in caregiver training for the treatment of dysphagia in children. Clinical and instrumental evaluations of swallowing abilities were performed at baseline and at the end of the ten months rehabilitation program, consisting in a monthly in-presence outpatient meeting and a weekly in-remote meeting. In addition, a remote monitoring satisfaction survey was submitted to the caregiver at the end of the study. The treatment involved training to the parent regarding diet modifications, the use of adaptive feeding equipment, appropriate positioning, chewing training and sensory stimulation. Final evaluations show improvements in the patient’s oro motor skills and in semisolids and semiliquids’s sucking; reduction of sialorrhea, mealtime duration and episodes of coughing. The overall experience of distance therapy has been evaluated as "positive" by the parent, despite the preference for in-presence therapy.| File | Dimensione | Formato | |
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Tesi Paolucci Veronica - CORRETTA.pdf
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https://hdl.handle.net/20.500.12075/1069