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Feeding the Disabled Child.
  1. A D KINDLEY, Consultant paediatrician

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    Feeding the Disabled Child. By P B Sullivan and L Rosenbloom. Clinics in Developmental Medicine No 140. (Pp 160; £37.50 hardback.) Cambridge University Press, 1996. ISBN 1-898 68308-5.

    Unlike its subject, this slim volume, in familiar red, is not deficient in energy nor micronutrients. Feeding the Disabled Child is a wide based review of a rapidly developing subject, the fundamental human activity of feeding, which in the severely disabled child can be perverted by disability from a pleasurable activity to an ordeal for the child and a chore for the parent. Normal development of feeding is considered; an interlocking web of neural development, coordination, learned skill, and opportunity. Then the causes of feeding difficulty in the disabled child are reviewed, the effects of inadequate intake of basically adequate food, ineffective feeding, and the effects of reflux. The interlocking nature of problems is demonstrated by chapters on the consequences of malnutrition on neurodevelopment and the effects on the respiratory system of neurological deficit. Then the authors move to the assessment of a child with disability and feeding difficulties, a process focusing on strengths as well as weaknesses, clinically, nutritionally and by investigation. Two problems which greatly worry parents, drooling and constipation, receive a chapter each. Therapeutic options in the disabled child are considered over two chapters and then the authors round off with personal views on the ethics and implications of feeding programmes for the child with the disability.

    If the reader wishes to know how many nerves are involved in swallowing or about feeding teams, about Sandifer’s ‘head cocking’ syndrome or the management of reflux, then this volume will help. The authors have made their ‘object’ improving the quality of life of the individual and the carer. This book will, with humanity and erudition, assist others in that aim.