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Transition From Tube to Oral Feeding in the School Setting

Justine J. Sheppard
Teachers College, Columbia University, New York, NY

Mary L. Osborne
Pamela Payne
Lake Drive School, Mountain Lakes, NJ

Contact author: Laura McKirdy, Lake Drive School, 10 Lake Drive, Mountain Lakes, NJ 07046. E-mail: lmckirdy{at}mtlakes.org.

Purpose: A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills.

Method: The program combined educational and therapeutic goals. It was implemented in a regional public school for children with hearing impairments. A team approach was used. Collaboration with the student's families, medical care providers, personal assistants, and classroom staff was maintained.

Results: Detailed case reviews are provided for 2 of the children who completed the program at age 8;1 (years;months) and 7;8 after 29 and 26 months of treatment, respectively. At the end of the program, tube feeding was discontinued; the children were feeding themselves and taking medications orally. One child was using mature eating skills to eat an unrestricted diet; the other was eating a modified diet consisting of a full nutrient drink and limited smooth and lightly textured solids.

Conclusion: Successful transition to oral feeding and advancement of developmental eating skills were accomplished in a school setting for long-term tube-fed children with medically complex conditions. The program included collaboration with family and medical personnel as well as integrated therapeutic and educational goals.

KEY WORDS: dysphagia, tube feeding, eating skills, school-based program

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