Original article
Reported Eating Ability of Young Children With Cerebral Palsy: Is There an Association With Gross Motor Function?

Presented in part as a free oral presentation to the American Academy for Cerebral Palsy and Developmental Medicine, September 22–25, 2010, Washington, DC.
https://doi.org/10.1016/j.apmr.2012.10.007Get rights and content

Abstract

Objective

To examine the association between parent-reported ability of young children with cerebral palsy (CP) to eat different food textures and gross motor functional abilities.

Design

Prospective, longitudinal, representative cohort study.

Setting

Community and tertiary pediatric hospital settings.

Participants

Children (N=170; 110 boys [65%]) were assessed on 396 occasions (range, 1–4 occasions), including 67 at 1 year 6 months (49 boys), 99 at 2 years (66 boys), 111 at 2 years 6 months (71 boys), and 119 at 3 years (64 boys).

Interventions

Not applicable

Main Outcome Measures

Gross motor function was determined using the Gross Motor Function Classification System (GMFCS). Parent-reported eating ability was determined using 4 items of the Pediatric Evaluation of Disability Inventory. The association between capability to eat food textures and GMFCS level was examined using generalized estimating equations.

Results

The distribution of GMFCS levels at initial presentation was as follows: I, n=62; II, n=32; III, n=24; IV, n=22; and V, n=30. Reported capability to eat cut-up/chunky and “all textures” of table foods decreased significantly as GMFCS level increased. A decreased capability to eat pureed/blended and ground/lumpy foods compared with GMFCS I was significantly associated with GMFCS levels IV and V only.

Conclusions

Reported attainment of eating skills was closely associated with GMFCS level in young children with CP across age levels. These results emphasize the need for early oral-motor and feeding screening in young children with CP across gross motor functional abilities.

Section snippets

Methods

This study used data collected as part of a prospective, longitudinal, representative population cohort study investigating the relationship between brain structure and gross motor function in young children with CP. The CP Child study involved the recruitment of young children with CP across Victoria and Queensland, Australia, born between January 1, 2004, and December 31, 2005, in Victoria, and between January 1, 2006, and December 31, 2008, in Queensland. Children with a suspected or

Results

A total of 396 assessments were performed on 170 individual children (110 boys [65%]), with a mean of 2.3 (range, 1–4) assessments per child; 53 children were assessed once, 35 were assessed twice, 55 were assessed 3 times, and 27 were assessed 4 times. Children attended at time points of 18±1, 24±1, 30±1, and 36±1 months corrected age. The numbers of children included in each age band, by sex and GMFCS levels, are shown in table 1.

The distribution of GMFCS levels at initial presentation was as

Discussion

Reported attainment of eating ability was significantly associated with gross motor functional ability as rated on the GMFCS in young children with CP between 1 year 6 months and 3 years corrected age. Children's ability to consume food textures with advancing complexity (eg, ground/lumpy, cut-up/chunky foods, all textures) was best in those with GMFCS I and progressively decreased as GMFCS level increased (or gross motor functional ability decreased). Children classified as GMFCS levels IV and

Conclusions

We observed a significant association between reported capability on food textures assessed on the PEDI and gross motor functional abilities using the GMFCS in very young children with CP. Capability on complex textures decreased as gross motor function decreased, and this was consistent across age bands from 1 year 6 months to 3 years corrected age. Future studies investigating the prevalence of OPD using objective assessment of feeding skills, relationship with capability on food textures,

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Acknowledgments

We thank Laura Pareezer, Clinical Trials Coordinator, Queensland Cerebral Palsy and Rehabilitation Research Centre, for her time on recruitment and administrative support; physiotherapists Chris Finn, Rachel Jordan, and Anne Moodie for data collection for the GMFCS classification; and dietitian Jacqueline Walker for data collection for reported feeding ability.

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    • Supported by the National Health and Medical Research Council (Australia) (grant nos. 465128, 569605) and Queensland Health: Health Practitioner Grant.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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