Systematic Evaluation of Variables Associated with Emesis: A Case Study

AbstractRecurrent emesis (i.e., vomiting) during mealtime is often a great concern of caregivers of children with pediatric feeding disorders. Identifying the cause and treating the emesis may be difficult due to the multiple factors that may contribute to the occurrence overtime. Emesis may result from various factors, some of which include volume sensitivity, inadequate oral motor skills, and environmental factors related to food novelty and texture. This case study describes a 6-year-old boy with spina bifida who was dependent upon gastrointestinal-tube feedings due to frequent emesis when fed orally. Upon admission to an intensive feeding program, several potential factors maintaining the emesis were identified based upon clinical assessment, observation, and caregiver report. These factors were each evaluated systematically and results indicated that emesis was more likely to occur when foods of novel taste and texture were presented. With exposure, rates of emesis decreased across both type and texture of food. However, emesis decreased more quickly for novel foods at a pureed texture compared to the same food at a higher texture. There were no significant differences in rates of emesis during environmental manipulations related to observer response or associated with volume sensitivity. The methods utilized in this study may be useful to practitioners to systematically evaluate the variables contributing to the occurrence and maintenance of emesis.
Source: Journal of Developmental and Physical Disabilities - Category: Disability Source Type: research