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KMID : 1145820180010020041
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Swallowing Rehabilitation
2018 Volume.1 No. 2 p.41 ~ p.51
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The Swallowing Therapy for Child with VACTERL syndrome - A Case Report
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Yoon In-Jin
Shin Jee-Hee
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Abstract
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This report was to idendify about swallowing therapy and its effects for a child with VACTERL syndrome. The subject was a boy who diagnosed as VACTERL syndrome with anal atresia, tracheoesophageal fistula with esophageal atresia, and limb anomalies. At 11 months of age, he visited the Department of Pediatric Rehabilitation Medicine at a general hospital in Seoul for a choking. And then the Video Fluoroscopic Swallowing Study (VFSS) was examined, he got the level 8 on Penetration-Aspiration Scale (PAS) and the level 4 on American Speech Language and Hearing Association: National outcomes measurements system (ASHA NOMS). We applied swallowing therapy and neuromuscular electrical stimulation (NMES) for once a week, 30 minutes. As a rehabilitative approach, head-neck exercise, vocal folds adduction exercise, chin down against resistance, and airway closure exercise were applied to him. Simultaneously as a compensatory approach, effortful swallow technique training with chin-tuck was applied when swallowing liquids. Retest was performed at 15 months of age and showed improvement as PAS level 1 and ASHA NOMS level 5. As a results of test at 26 months of age, he was improved to the level 1 on PAS and the level 7 on ASHA NOMS, the swallowing therapy and NMES was finished. This study showed that swallowing rehabilitation and neuromuscular electrical stimulation treatment had a positive effect on VACTERL syndrome with pharyngeal swallowing disorders.
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KEYWORD
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Child, Dysphagia, Pharyngeal Phase, Swallowing Therapy, VACTERL Syndrome
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