Customer-directed mealtime services for people with cerebral palsy across the lifespan: What do they need and when do they need it?
Tracks
4
Across the lifespan
Cerebral Palsy
Disability
Dysphagia
Evidence based practice
Mealtime support
Professional practice
Service delivery
Swallowing
Videofluoroscopic swallow study (VFSS)
| Friday, June 13, 2025 |
| 11:45 AM - 11:55 AM |
Overview
Lisa Moshovis and Assoc Professor Kelly Weir
Details
⏫ Research insights
⏲️ 11.45am - 12.05pm
⌛ 20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
⏲️ 11.45am - 12.05pm
⌛ 20-minutes
📚 Assumed knowledge of attendees: Foundational (new/casual familiarity with the topic e.g. treated a single case)
Presenter
Mrs Lisa Moshovis
Ability WA
Customer-directed mealtime services for people with cerebral palsy across the lifespan: What do they need and when do they need it?
11:45 AM - 12:05 PMPresentation summary
Introduction: One in five young people with cerebral palsy (CP) require modified texture diets/fluids, and/or tube feeding for adequate and safe nutrition. Swallow dysfunction for some individuals with CP persists and/or function deteriorates over the lifespan. However, little evidence exists to document this phenomenon or guide planning of mealtime services. This project aims to identify the clinical presentation of swallowing skills across time, and whether age or key transition periods are associated with a change in swallow function. Methods: Our research includes retrospective, cross-sectional and longitudinal data from approximately 360 customers with mealtime evaluations, who have attended a large, community-based, disability service provider in WA. Inclusion criteria: participants with CP with mealtime plans at infancy (0-12 months), toddler(1-3 years), school aged (4-8 years), pre-teens (9-12 years), adolescents(13-17 years) or adults (18 years+). Data extracted from client records include age, sex, body weight and height, motor impairments, communication ability, comorbidities, swallowing assessment results, and recommendations about mealtime management and/or enteral feeding. Descriptive analysis of the data will determine ages of recorded changes in swallowing or changes in method of intake. The relationship between risk factors will be analysed using univariate regression analysis. Variables consistently significant at the p<0.05 will be included in multivariate regression analysis. Longitudinal analysis will be conducted using multilevel mixed effects logistic (binary data) and linear (continuous data) regression. To ensure our approach to customer directed mealtimes is co-produced, we have a lived experience expert on our team. Results: Data analysis is currently underway, final results will be available by the time of the conference. Conclusion: We aim to use the findings from this unique data set to plan and advocate for a proactive approach to surveillance of swallowing function and provision of timely mealtime services for individuals with CP across the lifespan.
Refrences
1. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia in preschool children with cerebral palsy: oral phase impairments. Res Dev Disabil. 2014;35(12):3469-3481.5.
2. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. Pediatrics. 2013;131(5):e1553-1562.6.
3. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Longitudinal Study of Oropharyngeal Dysphagia in Preschool Children With Cerebral Palsy. Arch Phys Med Rehabil. 2016;97(4):552-560.e559.
4. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Longitudinal cohort protocol study of oropharyngeal dysphagia: relationships to gross motor attainment, growth and nutritional status in preschool children with cerebral palsy. BMJ Open. 2012;2(4).
5. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. Oropharyngeal Dysphagia and Cerebral Palsy. Pediatrics. 2017;140(6).
6. Balandin S, Hemsley B, Hanley L, Sheppard JJ. Understanding mealtime changes for adults with cerebral palsy and the implications for support services. J Intellect Dev Disabil. 2009;34(3):197-206.
7. Snider L, Majnemer A, Darsaklis V. Feeding interventions for children with cerebral palsy: a review of the evidence. Phys Occup Ther Pediatr. 2011;31(1):58-77
8. Blackmore AM, Bear N, Blair E, et al. Factors Associated with Respiratory Illness in Children and Young Adults with Cerebral Palsy. J Pediatr. 2016;168:151-157.e151.
9. Blackmore AM, Bear N, Blair E, et al. Predicting respiratory hospital admissions in young people with cerebral palsy. Arch Dis Child. 2018;103(12):1119-1124.
10. Blackmore AM, Bear N, Langdon K, Moshovis L, Gibson N, Wilson A. Respiratory hospital admissions and emergency department visits in young people with cerebral palsy: 5-year follow-up. Arch Dis Child. 2020;105(11):1126-1127.
11. Reid SM, Carlin JB, Reddihough DS. Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004. Dev Med Child Neurol. 2012;54(4):353-360.
12. Himmelmann K, Sundh V. Survival with cerebral palsy over five decades in western Sweden. Dev Med Child Neurol. 2015;57(8):762-767.
13. Meehan E, Freed GL, Reid SM, et al. Tertiary paediatric hospital admissions in children and young people with cerebral palsy. Child Care Health Dev. 2015;41(6):928-937.
14. Young NL, McCormick AM, Gilbert T, et al. Reasons for hospital admissions among youth and young adults with cerebral palsy. Arch Phys Med Rehabil. 2011;92(1):46-50
2. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy. Pediatrics. 2013;131(5):e1553-1562.6.
3. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Longitudinal Study of Oropharyngeal Dysphagia in Preschool Children With Cerebral Palsy. Arch Phys Med Rehabil. 2016;97(4):552-560.e559.
4. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PS, Boyd RN. Longitudinal cohort protocol study of oropharyngeal dysphagia: relationships to gross motor attainment, growth and nutritional status in preschool children with cerebral palsy. BMJ Open. 2012;2(4).
5. Benfer KA, Weir KA, Bell KL, Ware RS, Davies PSW, Boyd RN. Oropharyngeal Dysphagia and Cerebral Palsy. Pediatrics. 2017;140(6).
6. Balandin S, Hemsley B, Hanley L, Sheppard JJ. Understanding mealtime changes for adults with cerebral palsy and the implications for support services. J Intellect Dev Disabil. 2009;34(3):197-206.
7. Snider L, Majnemer A, Darsaklis V. Feeding interventions for children with cerebral palsy: a review of the evidence. Phys Occup Ther Pediatr. 2011;31(1):58-77
8. Blackmore AM, Bear N, Blair E, et al. Factors Associated with Respiratory Illness in Children and Young Adults with Cerebral Palsy. J Pediatr. 2016;168:151-157.e151.
9. Blackmore AM, Bear N, Blair E, et al. Predicting respiratory hospital admissions in young people with cerebral palsy. Arch Dis Child. 2018;103(12):1119-1124.
10. Blackmore AM, Bear N, Langdon K, Moshovis L, Gibson N, Wilson A. Respiratory hospital admissions and emergency department visits in young people with cerebral palsy: 5-year follow-up. Arch Dis Child. 2020;105(11):1126-1127.
11. Reid SM, Carlin JB, Reddihough DS. Survival of individuals with cerebral palsy born in Victoria, Australia, between 1970 and 2004. Dev Med Child Neurol. 2012;54(4):353-360.
12. Himmelmann K, Sundh V. Survival with cerebral palsy over five decades in western Sweden. Dev Med Child Neurol. 2015;57(8):762-767.
13. Meehan E, Freed GL, Reid SM, et al. Tertiary paediatric hospital admissions in children and young people with cerebral palsy. Child Care Health Dev. 2015;41(6):928-937.
14. Young NL, McCormick AM, Gilbert T, et al. Reasons for hospital admissions among youth and young adults with cerebral palsy. Arch Phys Med Rehabil. 2011;92(1):46-50
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Lisa is the Clinical Lead in Mealtimes at Ability WA and a Senior Speech Pathologist with over 20 years clinical experience. She works closely with individuals with a disability across the lifespan, who have dysphagia or mealtime needs. Lisa also weaves research seamlessly into her clinical role as she strives for excellence to best support individuals to achieve their goals and improve their quality of life. As a clinician researcher, Lisa has contributed to six journal articles related to identifying respiratory risk factors, reducing respiratory hospitalisations and the prevention and management of respiratory disease in young people with cerebral palsy. She is a highly sort after leader within the disability sector.
Assoc Professor Kelly Weir
The University Of Melbourne & Royal Children's Hospital
Customer-directed mealtime services for people with cerebral palsy across the lifespan: What do they need and when do they need it?
11:45 AM - 12:05 PM**********
Associate Professor Kelly Weir is a Joint Director of Allied Health Research at The Royal Children’s Hospital and The University of Melbourne. She is a certified practicing speech pathologist with over 35 years clinical and research experience, predominantly in tertiary state-wide paediatric hospitals in Australia. Kelly researches and teaches in the assessment and management of infants and children with paediatric dysphagia and feeding disorders in neonatal intensive care, tertiary paediatric acute/critical care, children with disability and paediatric palliative care. She currently leads the Allied Health Research Capacity and Development Program at The Royal Children’s Hospital, Melbourne.
The information contained in this program is current at of the time of publishing but is subject to changes made without notice.
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