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Overcoming Feeding Aversions and Swallowing Problems: Samantha Shines On

Samantha Shine 300x230When Samantha Shine came to TIRR Memorial Hermann Pediatric Outpatient Rehabilitation in September 2014, the 3-year-old was still eating puréed food – very slowly – and was underweight for her age. Six months later, she eats breakfast, lunch and dinner with her family and is moving toward a healthy weight.

Samantha is the beneficiary of a rehabilitation program for infants, children and adolescents who have feeding aversions or dysphagia. “It was taking us about an hour and a half to feed Samantha,” says her mother, Darlene Shine. “It was difficult to go out to eat as a family, and if we went away for the weekend, we had to take the blender. We spent many, many long hours at the kitchen table.”

In her search for help, Shine read about VitalStim® Therapy, the only FDA approved treatment approach that successfully combines neuromuscular electrical stimulation and traditional dysphagia speech therapy techniques. After she learned about the program at TIRR Memorial Hermann Pediatric Outpatient Rehabilitation at the Kirby Glen Center, the family was paired up with speech pathologist Sabrina Filoteo, CCC-SLP.

“Samantha presented with oral motor weakness secondary to cerebral palsy,” Filoteo-Salinas says. “By age 3 she should have graduated to solid food, but due to her oral motor weakness and decreased coordination she could swallow only about half of the puréed food she was receiving. Her overall pharyngeal swallow was fine – her only dysfunction was within the oral phase. Following her swallowing evaluation, I recommended the use of neuromuscular electrical stimulation in conjunction with traditional dysphagia treatment to help improve her swallowing function and increase her food intake.”

Samantha started VitalStim therapy three times a week in conjunction with traditional swallowing therapy. To compensate for her bilateral cochlear implants, Filoteo-Salinas used signs and gestures to explain the treatment she would receive.

“Eventually we were able to phase out baby food, but Samantha also had an aversion to cold foods,” her mother says. “If we offered her ice cream, she would scream and pull at her hair.”

Filoteo-Salinas desensitized Samantha by presenting cold foods to her in a therapeutic manner. “I used an ice finger and started by stroking her cheeks and mouth to help normalize her sensitivity to cold textures,” she says. “After she could tolerate that, I very slowly moved inside her mouth. We use baby steps to approach kids who demonstrate hypersensitivity and aversive behaviors, and teach their parents how to continue these exercises and approaches at home. Eventually, Samantha would take the ice finger herself and voluntarily place it in her mouth.”

They also worked to improve her ability to chew. “Samantha and her family have done a phenomenal job,” Filoteo-Salinas says. “She’s eating more age-appropriate foods, and ate an entire turkey sandwich during our last session. Eliminating her need for puréed foods has reduced stress on her family and allowed her to participate fully in the important social activity of family dining. Her mother and father have provided wonderful support and been great teammates throughout the process. Working together, we’ve dramatically expanded Samantha’s repertoire of food.”

Today Samantha eats ham, chicken and steak – everything her parents eat. “Sabrina is a creative therapist with great ideas, who has a wonderful rapport with Samantha,” Darlene Shine says. “We couldn’t have asked for a better therapist. Thanks to Sabrina’s efforts, Samantha has gained weight and is now able to share ice-cream cones with her family.”