4. Tom Statters Product Design BSc
Personal Design Project 4
Introduction
This report will address the issues faced by the sufferers of Dysphagia, a common condition
associated with Cerebral Palsy and other neurological disorders that affect movement and co-
ordination. A child with cerebral palsy is likely to encounter a number of health concerns
during his or her lifetime – one of the most stressful irritating in to manage – is dysphagia.
Commonly known as oral-motor dysfunction, dysphagia is a medical term for difficulty
swallowing. Typically, this condition occurs because the muscles used to push food down the
oesophagus have been affected, making the movement of food and liquids from the back of a
person’s mouth to the stomach very difficult. (Choices, 2015)
This condition is not only prevalent in cases cerebral palsy – but can also be caused by other
health conditions such as a stroke, head injury or even cancer of the mouth or oesophagus.
Although little known, dysphagia has some devastating consequences. According to a report
covering the prevalence of dysphagia in multiple conditions by The Royal College of Speech
& Language Therapists, 57% of children with cerebral palsy have problems sucking
problems and 38% have issues with swallowing in their first 12 months of life, whilst by the
same age up to 80% had been fed non-orally on at least one occasion. On top of this, a study
by Calis et al in 2008 displayed that a staggering 99% of children with severe cerebral palsy
suffer from dysphagia. (RCSLT, 2009)
5. Tom Statters Product Design BSc
Personal Design Project 5
Literature Review
Dysphagia is the medical term for difficulty swallowing. Some people with dysphagia have
problems swallowing certain foods or liquids, while others are unable to swallow at all.
6. Tom Statters Product Design BSc
Personal Design Project 6
Research Finding
Justification of Selected Methods
From my secondary research I have decided that the most effective way to learn more about
the issues faced by people suffering from Dysphagia would be to partake in some user
shadowing. This would involve me observing an occupational therapist, full time carer or
parent feeding a child with cerebral palsy. This method would allow me to gain rich, first
hand information from someone who experiences the difficulties of feeding severely disabled
children on a daily basis. In order to get the most rounded and detailed research I will look
into the varying severity of each child’s condition, this is will allow me to discover the issues
faced by those with the most critical conditions and how those will differ from those who are
in the middle and also those who have the least severe disabilities.
It has become clear that a project like this may not be solely for the person with the disability,
it could also be for the parent or the carer. Raising a child with Cerebral Palsy is a full time
job in itself, one which eats into all other aspect of a parent’s life. Simple tasks that you
would usually go unnoticed now become extremely difficult chores that you would rather
avoid. For instance, leaving the house to go into town or to the beach would involve packing
multiple food bags, feeding tubes and equipment, but when your child need feeding where
are you going to be able to do it? Are you going to feel comfortable feeding your child
through a gastric tube in public? Will the process of packing all this equipment make you
avoid going out in the first place? These are the sorts of questions that I will need to be
asking to parents and carers in order to some detailed knowledge on how people deal with
these issues.
Summary of primary research finding
I began my primary research by emailing occupational therapist, Gill Ritchie. I asked her
about the issues she encountered when dealing with children with severe physical and
learning disabilities. Gill brought up the issue of feeding children with cerebral palsy and said
that dysphagia created many problems that affected feeding a child. I decided that it would be
best to visit Gill whilst she was feeding a child with cerebral palsy.
From this visit I identified several issues that are faced by the child and carer during meal
times. These are some of the issues I found:
• The positioning of the child during eating is a big issue, the majority of sufferers need
to be in an upright position during feeding to ensure their feeding passages are clear
and unobstructed. This means that some must have supports keeping their body or
head in a fixed position, these supports are usually adjustable attachments to the
wheelchairs.
• A large portion of cerebral palsy sufferers also have limited motor skills in their
hands and arms, making feeding themselves near on impossible.
• Vomiting and choking is a dangerous hazard for these children with limited motor
skills in their mouth, this means that a normal diet is not suitable. At a young age
formula is used to ensure the child gets enough nutritional value in their diet. This
diet may continue in the most severe cases of disability. For the less severe, food is
7. Tom Statters Product Design BSc
Personal Design Project 7
blended or mashed and drink is thickened to prevent the likelihood of choking and
vomiting.
• Another issue Gill mentioned was the lack of suction some children have which
prevents them from using particular suction cups.
From what I learned from the visit to Gill, speaking to the teachers and carers that work at a
school for children with severe disabilities was clearly the next step. Having emailed several
schools, I got a reply from the Head Teacher of Oakfield School. David Stewart invited me to
a User Group Meeting.
Here I presented the information I had gathered about Dysphasia to the group, David and the
other researchers agreed that Dysphasia was a big issue that could improved on. David
invited me to come and observe a typical lunch time at the school, to get a better
understanding of what happens during a meal time.
Conclusion should indicate the details of new product/service/proposition
9. Tom Statters Product Design BSc
Personal Design Project 9
References
Choices, N. (2015) Dysphagia (swallowing problems) - causes - NHS choices. Available at:
http://www.nhs.uk/Conditions/Dysphagia/Pages/Causes.aspx (Accessed: 16 April 2016).
RCSLT (2009) RCSLT RESOURCE MANUAL FOR COMMISSIONING AND PLANNING SERVICES
FOR SLCN Dysphagia. Available at:
http://www.rcslt.org/speech_and_language_therapy/commissioning/dysphagia_manual_072014
(Accessed: 16 April 2016).
