2016年1月1日 星期五

影響嬰幼兒吞嚥障礙之口腔動作因素(Factor that limit oral motor skills for pediatric dysphagia )


影響嬰幼兒吞嚥困難的原因有很多
其中有些吞嚥障礙之嬰幼兒
是在吞嚥相關動作技巧有問題以致吞嚥障礙
以下整理 影響口腔動作技巧的相關因素
包含jaw, tongue,lips.palate以及相關感覺層面等
並針對其特定的專有名詞做解釋

the source from: 
Book: pre-freeding skills  (chapter 7 Factor that limit oral motor skills)

Jaw ()

●    Exaggerated jaw movement: The mouth may hang open or show excessive up-down movement when sucking. Inefficient sucking pattern with an increased feeding time and reduced feeding intake.
      (嘴巴可能似懸掛張開狀  在吸允時出現過度的張合動作,吸允缺乏效率-增加餵食時間和減少餵食量)

●    Jaw instability: jaw slips and shift forward or to side. Combination of low tone and poor control of TMJ Temporomandibular Joint) .
      (頷往前或往側邊滑動狀,伴隨低張或是顳顎關節控制不佳 )  
      if you are interested in TMJ ,

●    Jaw thrust: A strong downward extension of the lower jaw that occurs when the bottle,  breast, cup, or spoon is presented.
      (當給予奶瓶,杯子或湯匙時,下頷出現一個強力的向下延伸的動作)

●    Phasic bite: a rhythmical, repetitive opening and closing of jaw that occurs with gum or teeth stimulation. 
      (當刺激牙齦或是牙齒時,頷出現有節奏性且反覆性的張開和閉合動作)

●    Stability bite: as the child bite the cup or straw initially to achieve the external stability necessary for success. It a normal stage.
       (當孩子正學習使用杯子或是吸管時,為維持頷的穩定度而表性的行為,此為一正常的階段)

●    Jaw clenching: A tight closure of jaw that has reached an involuntary stage. Common in children who show strong flexor pattern in the neck,shoulder girdle, and arms
 (非自主性的緊咬,通常在頸部,肩夾帶及手臂伴隨強烈的屈張)

●    Tonic bite: A forceful or tense biting pattern that interferes with all aspect of feeding. (When touch the surface of gums or teeth.) It is difficult for child to release the bite and can frightening for the child.
      (當刺激牙齦或是牙齒時,出現有用力或具張力性的咬.對孩子來說很難放鬆且令孩子感到害怕)

●    Jaw retraction: A pulling backward of jaw, making it difficult to open the mouth fully.
 (頷往後牽引,導致很難完整張口)

Tongue(舌頭)

●    Bunched or bunchy tongue: the tongue configuration is humped or bunched rather than grooved.(舌頭呈隆起或束狀而非槽狀)

        -Low-tone tongue
         thick &bunched, lacks the center groove that help move the food or liquid  bolus.
         (舌頭低張:舌頭厚重狀,缺乏中線凹槽以幫助食物或液體食團的推送)

       -High-tone tongue: 
        increased rounding or humping of the tongue. This thick, bunchy tongue 
        shape may or may not also push in a forward protrusion.
        (舌頭高張:舌頭的隆起且較圓狀,舌頭可能也可能不會往前推進)

●    Tongue retraction: a pulling or falling back of the tongue, making breathing and sucking difficult.(舌頭後縮,舌根拱起)

●    Exaggerated tongue protrusion: extension and retraction movements of the tongue in which the emphasis is on the extensor portion of the movement. (e.g.Down syndrome )
(舌頭過度外伸,:唐氏症者)

●    Tongue thrust: a very forceful protrusion of the tongue from the mouth. Movement frequently is arrhythmical. Its intermittent occurrence can break a previously sustained rhythm.
     (將舌頭似用力推出嘴外的動作,動作多不規律.間歇性的出現該動作)


Lip()
●    Low-tone lips: reduced muscle tone in the lips, diminishing the ability to keep food and saliva from falling out of the mouth.
      (雙唇肌肉張力減少,食物和口水容易從雙唇流出)

●    Lip retraction(High-tone lips): the pulling back of the lips so tightly that they from a horizontal line over the mouth.
        (雙唇為往後拉緊狀.使得嘴唇似一拉緊的水平線)

●    Lip pursing: a reaction to lip retraction. When the child tries to close the lips from a retracted position, it appears as if the lip muscle are being drawn closed in a puckered way.
   (雙唇回縮.當孩子試圖將回縮的的雙存閉合.雙唇肌肉動作看似出現皺摺的方式做出閉合的動作)

Palate()

●    Cleft palate(唇顎裂)

●    Velopharyngeal insufficiency (VP動作不足)

●    Timing and coordination difficulties (顎的動作協調困難)

Sensory factors(感覺因素)

●    Hyperreaction (過度敏感)

●    Hyporeaction (過度低敏)

●    Sensory defensiveness(感覺防禦)

●    Sensory overload: a sensory response that varies according to the complexity and amount of the sensory input. (感覺超載)



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