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Physical Rehabilitation Medicine/Cerebral Palsy Feeding difficulties


Dear Nancy

Could you please help. my son, 9 years old with quadraplegic CP, from time to time reists being fed. He normally feeds well on blended food and drinks water ok.

However in the past, after the treatment with antibiotics cough medecines etc the paedeatrician diagnoesd hime with gum disease, and he was treated, and was OK, however now it has hapenned again. He does not open his mouth readily or cannot open his mouth readily though he seems hungry. He finally opens his mouth wide after a few seconds of seeming to try.

He is on Baclofen, and Artane, 3 times a day, 7mg each does of Baclofen and 1 mg Artane,

What should we look for? He needs to go to the dentist every month to get teeth filled temporary fillings, that is, and has problems with his teeth from time to time.

What sort of things should we look for?

See if it is a reflex action?
See if he shows pain when the spoon is in his mouth?

Please feel free to ask any questions.

It's a bit difficult to give proper advice without examining your son, so I'll give you some general advice for feeding difficulties.
It sounds like he has "oral defensiveness", which is common in individuals with neurological disorders (like spastic CP). You may want to Google, "techniques for reducing oral defensiveness", so you can gradually desensitize him.
In the meantime, it helps to have a mealtime routine. Allow him extra time when feeding. Show him the spoon before you put food on it. Tell him it's time to eat, put a bib on him, and show him the dish with the food in it. Demonstrate by putting the spoon in your mouth, and make a big deal out of the fact "Mommy loves to eat from the spoon! Let's have some food from the spoon! Yummy food! Lucky boy! You get some yummy food!" You can even let him explore the spoon with his mouth without any food on it, if it helps.
Because he probably has sensitive teeth and gums, food should be slightly warm. Liquids should be room temperature. Avoid acidic or sugary foods and liquids, as they can be uncomfortable for people with sensitive teeth.
I hope this helps.
Best regards,

Physical Rehabilitation Medicine

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Nancy Brough, MA, former speech pathologist


I can answer any question about swallowing disorders and acquired and/or developmental communication disorders. Examples are aphasia, brain injury (traumatic or from strokes), and degenerative neurologic diseases. I also have specialized knowledge in craniofacial disorders (i.e., cleft palate.)


Experience in the area: I practiced as a speech pathologist for 20 years.

BA/MA Communicative Disorders, CSUN 1981/1986 Clinical training at UCLA and West Los Angeles Veterans Administration Medical Center.

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