What can I expect during my clinic evaluation?
Our multidisciplinary team will review your child’s medical, developmental, and treatment history. This will involve collecting information on your child’s current feeding information, conducting a meal observation as well as an oral motor assessment. We will also take your child’s height/weight and review your child’s growth chart percentiles, and conduct a daily calorie count to determine your child’s current intake and his or her nutritional needs. The clinic last on average 2 hours. At the completion of this comprehensive assessment, each discipline will provide recommendations that may include further medical/diagnostic assessment, as well as strategies to be incorporated into the child’s existing care in the home or community. We will also inform you if your child is a candidate for the intensive day patient or outpatient feeding programs.
Who will be present at the clinic evaluation?
- Pediatric Nurse Practitioner
- Pediatric Gastroenterologist
- Speech Language Pathologist
- Behavioral Psychologist
- Registered Dietician
What is the Day Patient Program?
The day patient program requires for the patient and a caregiver to attend Monday through Friday between the hours of 8:15am and 3pm. A typical schedule includes four treatment sessions daily. The sessions last on average 45 minutes. Between meals, your child will have access to free play, structured activities run by volunteers and a nap area. Typical length of admission for the day patient program is three to six weeks; the multidisciplinary team conducts family meeting every Friday where progress is assessed and discharge date is determined based on achievement of the child’s treatment goals.
What is the Outpatient Program?
Outpatient therapy consists of regularly scheduled weekly visits with a speech language pathologist (SLP). At the outset of treatment, the SLP will meet with caregivers to develop feeding goals for outpatient. Treatment sessions will last on average 45-60 minutes, which may involve oral motor desensitization/stimulation, implementation of a treatment protocol and debriefing with caregiver. A plan will be developed for caregivers to train and carryover treatment to home environment.
Who supplies the food for my child during treatment?
The Center for Pediatric Feeding Disorders will supply common foods and beverages (e.g., pancakes, chicken nuggets, milk, bananas, oatmeal, yogurt) during the admission to the day patient Program; however, if your child is formula dependent, caregivers will be asked to supply the formula. Additionally, if your child is on a highly specialized diet or if your family prefers to offer organic or culturally specific foods, caregivers will be asked to supply those items.
The family is responsible for supplying food and beverages for the clinic evaluation and outpatient visits.
What is required of me as a caregiver for the Day Patient Program?
The first two days of admission, a number of assessments are conducted where primary caregiver involvement is essential. A family meeting will be conducted shortly thereafter to formulate and discuss the plan for admission goals and to go over parental rights and requirements for the program. Family meetings during which your child’s progress will be discussed are conducted every Friday. During these meetings, you will have the opportunity to ask questions, voice your concerns and provide input to optimize your child’s progress.
Caregiver training is an important part of every child’s admission. As soon as your child successfully meets established criteria with clinicians, caregiver training will be initiated. Clinicians will guide you and teach you the protocol until you are able to implement it independently without therapist assistance in the clinic setting. You will then be given homework assignments and may be asked to record meals at home utilizing the meal protocol. As part of treatment carryover, sessions may be conducted in other areas such as cafeteria, picnic table in the park, etc. Additionally, you will be given an opportunity to bring other family members, home care therapists and/or school staff for training.
What happens after discharge from the Day Patient Program?
Upon discharge from our day patient Program, you will be given a DVD recording of your child’s meal with a feeding therapist implementing the treatment protocol. A written protocol will be supplied as well. If school staff or other individuals who may be implementing meals with your child upon discharge are unable to attend the program for training, we will collaborate via phone and encourage those individuals to observe the training DVD. Families are given the opportunity to return for follow-up appointments. Follow-up appointments tend to last 45 minutes and involve having a clinician observe a caregiver implementing the treatment protocol. Recommendations will be provided based on child and caregiver behavior observed during the meal observed during the follow-up appointment.
Do you provide transportation?
We do not provide transportation; however, our intake coordinator will be happy to assist you with scheduling pick up and drop off accommodations if your insurance offers transportation benefits.
What is Vital Stim?
Vital Stim therapy is a form of Neuromuscular Electrical Stimulation (NMES) that is approved by the FDA for the treatment of dysphagia. Electrical stimulation is used to aid muscle strengthening to rehabilitate the swallow. The sensory stimulation that is provided also helps muscle recruitment and swallow function.
Is my child a candidate for Vital Stim therapy?
If your child completed an instrumental swallow study and has been diagnosed with dysphagia, and if the treating clinician recommends Vital Stim therapy, he/she may be a candidate. A medical clearance and a prescription is required to initiate therapy.