The Effect of the Inability to Intake Chewable Food Texture on Growth, Dietary Intake and Feeding Behaviors of Children with Cerebral Palsy


JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES, vol.30, no.2, pp.205-214, 2018 (SSCI) identifier identifier


The study investigated growth, dietary intake and the feeding behaviors of children with cerebral palsy (CP) who could not manage chewable food textures. The study included 2 groups: a study group of children with CP whose diet did not consist of chewable foods, and a control group of typically developing children, who consumed all food. The International Dysphagia Diet Standardisation Initiative (IDDSI) was used during group allocation. Dietary assessment was performed using the 24-hour diet recall method; food type, amount ingested, and texture were considered to determine the IDDSI levels. The z-scores of nutritional indicators were calculated and a parent report instrument, the Behavioural Paediatrics Feeding Assessment Scale (BPFAS), was used to assess feeding behaviors. Eighty-five children were included. There was no differences between groups in terms of age (p=0.16) and sex (p=0.73). The mean weight (p=0.002) and height (p=0.011) for age Z-scores of study group were lower. Also in the study group, daily calorie and fat intakes were lower (p=0.038,p=0.011;respectively), whereas water from food and calcium intakes were higher (p=0.001,p < 0.001,respectively). Feeding problems were determined in 48% of study group, whereas in 5.7% of the control group (p < 0.001). Parents in the study group reported higher stress levels and more concerns about the child's feeding behavior (p < 0.001). Children with CP have deficits in their obtainment of the necessary nutrition and hydration. The inability to intake any chewable food may contribute to these problems, and also cause negative feeding behaviors, and more problematic perceptions by parents.