Dysphagia: Vranch House at Work: Vranch House School

The Devon & Exeter Spastics Society working with the Medical Physics Department of the University of Exeter began research into Dysphagia - or the difficulties with Feeding and Swallowing associated with neurological problems - in 1987. The outcome of the research, which still continues, is the Exeter Dysphagia Assessment Technique (or EDAT). This is a non-invasive, objective assessment of feeding patterns conducted by a multi-disciplinary clinical team using technology developed during the research phase. The assessment can provide information on:

+	The child's oral motor functioning and sensory perception.
+	Physical abilities, eg; seating, posture and head control
+	Eating and drinking skills.
+	Amount of co-ordination achieved between respiration patterns and feeding during the: anticipatory phase oral phase pharyngeal phase of feeding

After the assessment the Team will collate and analyse the information and write a report which is sent to both the referer and the parents of the child. The report contains:

+	The diagnosis made by the team.
+	A summary of the assessment results.
+	The team's recommendations including immediate suggestions.
+	Longer-term possible treatments where appropriate.
+	A review date.

The EDAT assessment is carried out in an ordinary room and involves the child sitting in an appropriate chair for about 10 minutes. During this time a plastic tube is placed just inside the nose and attached to the EDAT equipment together with connections from a little pad taped to the arm and a small microphone which is hand-held against the throat. The child is spoon-fed a drink. Most children find the procedure comfortable and non-threatening and parents are welcome to attend the session.

The intention of the Feeding and Swallowing Clinic is to facilitate the feeding policy at Vranch House school which is:

"We aim to develop mealtimes that are happy and sociable experiences for all. The comfort and safety of the child is of paramount importance. We strive to achieve mealtimes that are stress-free, enabling maximum independence and good communication whilst providing adequate or boosted nutrition for the child's growth and well-being."

References: The Exeter Dysphagia Assessment Technique by W. Selley, F.Flack, R.Ellis, W.Brooks, in Dysphagia 4; 227-235 (1990) Coordination of Sucking, Swallowing and breathing in the newborn: Its relationship to infant feeding and normal development by W.Selley, R.Ellis, F.Flack and W.Brooks, in British Journal of Disorders of Communication 25; 311-327 (1990) Dysphagia in Cerebral Palsy: A Comparative Study of the Exeter Dysphagia Assessment Technique and a Multidisciplinary Assessment, L. Parrott, W.Selley, W.Brooks, P.Lethbridge, J.Cole, F.Flack, R.Ellis, and J.Tripp, in Dysphagia 7; 209-219 (1992) Deglutition apnoea as indicator of maturation of suckle feeding in bottle-fed preterm infants by M.Hanlon, J.Tripp, R.Ellis, F.Flack, W.Selley, H.Shoesmith, in Developmental Medicine & Child Neurology 39; 534-542 (1997)

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