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February 2005

New and innovative treatment methods for children with speech and swallowing difficulties

Melissa Serafin, Senior Speech Pathologist & Churchill Fellow
Westmead Centre For Oral Health, Westmead Hospital

An Adventure of a lifetime!

What is the Churchill Fellowship? Work colleagues, family and friends have all asked me how I was able to receive such a prestigious award in Australia. So I start from the beginning, November 2003 when I went onto the Churchill Trust web site and obtained a copy of the application forms. In June 2004 I received a letter from the Trust in the mail to inform me that I was I was going to Japan, 10 weeks that would change my life, my career and allow me to meet many wonderful people and learn a different language and culture.

I am a Senior Speech Pathologist at Westmead Centre For Oral Health, Westmead Hospital. My position is quite unique in that I work with Paediatric Dentists, Special Care Dentists, Orthodontists. And Lactation Consultants. I am a tertiary referral service and my position involves assessing and treating babies and children who have feeding difficulties or dysphagia.

Many people often wonder why a Speech Pathologist treats children and adults with dysphagia and feeding difficulties, when they should be focused on helping people to talk. As Susan Evans Morris describes, "The oral cavity provides the boundaries for the environment of sucking, chewing and bolus formation. It plays important roles in the preparation of food for swallowing, oral inspiration of air and sound production." (Evans Morris, S, Dunn Klein, M, 2000. pages 43,44) The muscles and structures of the mouth are used for both eating and swallowing as well as for speaking and communicating.

When we have knowledge of the mechanism of swallowing we can therefore understand why a Speech Pathologist treats patients with swallowing disorders. Difficulties with sucking from birth or problems with oral motor function as a toddler can impact on the ability to articulate sounds and communicate verbally.

At Westmead Centre for Oral Health we introduced an Oral Motor Functional Therapy Clinic. This clinic assesses and treats babies and children who have disabilities and suffer from dysphagia &/or oral motor difficulties. It was evident while working with these children that our team needed to expand their knowledge and we needed to learn more about feeding and mealtime management. This was my motivation to apply for the Churchill Fellowship.

Aim

The aim of my Fellowship in Japan was to learn new techniques for managing oral motor function disorders and swallowing disorders in children and adults with various disabilities. These included Cerebral Palsy and Down Syndrome. I was keen to investigate any new equipment being used during mealtimes to assist with improved feeding techniques such as palatal plates, spoons, forks, and drinking cups. My motivation came also from the notion that the same muscles used for eating and swallowing are also used for speaking, therefore, if a child or adult has a swallowing difficulty it is likely that they will have difficulty communicating verbally due to oral motor problems. Thus, if we can treat a child with eating and swallowing difficulties, then, we may be also able to enhance their communication skills.

Professor Ichijiro Morisaki, Osaka University and Professor Yoshiharu Mukai, Showa University, Tokyo at the Special Care Dentistry Conference in Osaka, Japan

Fellowship highlights

Photo: Feeding a boy with Cerebral Palsy at Kitaryou, Tokyo Metropolitan Kita Medical & Rehabilitation Centre. Using a flat metal spoon to promote lip closure, promote effective swallowing and reduce bite reflex on spoon.

Feeding techniques and flat spoons

Findings:

I truly recommend anyone from any profession or walk of life to apply for a Churchill Fellowship. It is not necessary to have done research or be famous in your job. All you need is the strength and the motivation to believe that you can make a difference to the people in your community. I feel such gratitude to the Churchill Trust that they have given me the opportunity of a lifetime that I will never forget.

For more information contact

Melissa Serafin
Senior Speech Pathologist
Westmead Centre For Oral Health
Westmead Hospital

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