• About
    • Disclosure and Disclaimer Policy
  • Blog
  • Shop Ebooks
  • Recommended Products

Pediatric Feeding News

Dedicated to up to date pediatric feeding and dysphagia information

Welcome!

Hi, I'm Krisi Brackett, MS SLP/CCC this blog is dedicated to current information on pediatric feeding and swallowing issues. Email me at feedingnewsletter@gmail.com with questions.

Read More About Me Here...
  • Feeding Flock
    Research
  • For Parents
    & Caregivers
  • View The
    Resources
  • Pediatric Feeding
    & Dysphagia Newsletter
    • Volume 1
    • Volume 2
    • Volume 3
    • Volume 4
    • Volume 5
    • Volume 6
    • Volume 7
    • Volume 8
    • Volume 9
    • Volume 10
  • Workshops &
    Presentations
  • Ask Me A
    Question
  • Links
    We Like

The Early Feeding Skills Assessment Tool (EFS)

July 7, 2015 by Krisi Brackett 2 Comments

This is feed 44re-posted with permission from Catherine Shaker from her website at http://www.Shaker4SwallowingandFeeding.com . Thank you Catherine!

Posted on May 16, 2015 by Shaker Seminars

 

An NICU SLP recently asked about resources for training neonatal nurses on feeding stress cues and stop signs. An SLP I know from Minnesota, Wendy, suggested the SLP take a look at the EFS. I responded to the post and share it with you here since it will let you know what you will hear about at our September 18-19 EFS training seminar in Hollywood, FL this year!

 

Hi Wendy,

 

Thank you for your kind comments about The Early Feeding Skills Assessment Tool (EFS). It has evolved over the years as a wonderful guide to cue-based feeding in the NICU. I especially am proud of it because it looks at feeding from the infant’s perspective and is grounded in physiology. It reflects how I conceptualize feeding in the NICU, which I refer to as “infant-guided”, i.e., a dynamic approach based on contingent co-regulation between infant and caregiver. That maybe a parent/family member, a nurse, or a therapist.

 

A little background for list serve readers. Both working in NICUs at the time, Dr. Suzanne Thoyre and I first collaborated in the early 1980s about infant feeding in the NICU and how to describe infant’s feeding skills. When Dr. Thoyre, as a part of her NICU research, wanted to teach mothers how to describe their infant’s feeding problems during phone follow-up post-NICU discharge, the EFS began to take shape. After using the EFS for years and working with each other to continue to improve it, we published it and began to share it with others in 2005. With multiple revisions, as research and our learning continues, it is now used in several NICUs across the US, both by nurses and SLPs as they assess infant feeding, and as Wendy mentioned, with families to help them understand their infant’s communication and physiology during feeding, using a common language with staff.

 

The EFS assesses the preterm infant’s ability to maintain physiologic stability during feeding, remain engaged in feeding, organize oral-motor function and coordinate sucking and swallowing with breathing. The EFS, by the nature of its design, considers not just oral-motor skills but rather, the whole infant, from posture, to physiology, to breathing, to state, to coordination, to swallowing, to oral-motor skills as well.

 

Beyond that, it focuses on the integration of these domains for function, all within a developmental care framework. It is unique in that it recognizes the value of understanding the infant’s adaptive responses to the feeding task, and how they are instructive to the caregiver.

 

The tool is also based on dynamic systems theory (that multiple systems synergistically affect each other during feeding) and these systems are assessed dynamically throughout an entire feeding, to arrive at a gestalt. Capturing variability across the entire feeding is a critical part of the analysis/integration of information. The items are designed to capture the variability in the infant’s learning of the foundational components of feeding skills, the continuum of that learning, and the emergence of skills; so it assesses  whether component skills are not observed, are emerging, or are indeed consistently expressed. It is often used serially to capture developmental progress in feeding over time.

 

The EFS leads the caregiver, by the nature of how it is designed, to the interventions that naturally flow from the results of the assessment. It profiles interventions to support adaptive function during feeding and swallowing, and therefore interventions for safety.

 

The EFS is user friendly in that it is not focused on understanding and identifying only isolated oral-motor components but rather making sense of what all caregivers “see” every day when they feed preterm infants–the infant’s communication/cues during feeding. It provides a common language about feeding terminology (such as what do we mean by an infant is “pacing” himself, or what is “coordinated”, for example) to help all team members, including families, get on the same page, so conversations and report have common meaning. Our original manuscript from 2005 about the EFS is on my website under the Publications tab. We do require training on use of the tool (offered at least yearly) to assure implementation in keeping with its intended purpose and parameters. SLPs typically then go back and teach their own NICU staff with resources provided during the training. I am so glad the EFS has advanced infant-guided feeding in your NICU, Wendy!

 

I hope this is helpful.

 

Catherine

 

Catherine S. Shaker, MS/CCC-SLP, BCS-S

 

Board Certified Specialist – Swallowing and Swallowing Disorders

Florida Hospital for Children, Orlando, FL

http://www.Shaker4SwallowingandFeeding.com

* Note: Suzanne Thoyre, RN, PhD is a Professor of the School of Nursing, UNC- Chapel Hill. Her nursing research and clinical interests are in the area of development, taking both a physiological and behavioral approach to understanding the feeding problems of preterm infants.

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)

Related

Filed Under: General Feeding Information, Oral-motor and Sensory Tagged With: bottle, catherine shaker, cue based feeding, early feeding skill, feeding therapy, NICU, Pediatric Dysphagia, speech therapy, Suzanne Thoyre, swallowing

Comments

    Leave a Reply Cancel reply

    Your email address will not be published. Required fields are marked *

  1. Barb kline says

    July 8, 2015 at 1:04 pm

    Our SLP staff utilizes the EFS in our large metropolitan NICU. It is user friendly and asks all the right questions. It is a guide, along with strong clinical acumen, experience and validated instrumentation when necesssary, in establishing an individualized pathway/protocol for successful oral feeding to be safely (airway protected) achieved for each patient. I encourage both new and seasoned therapists to take a careful look at this and utilize appropriately in your own settings.

    Barb Kline, M.A., CCC-SLP, BCS-S
    bkline@chmca.org

    Reply
  2. Becky says

    July 14, 2015 at 7:29 am

    this is a rich article for every mother especially the first time mothers.id recommend it to new born group on face book.thanks for sharing

    Reply

Cart

Products

  • When Your Child Can't Or Won't Eat $10.00

Recent Posts

  • CAN-EAT Approach
  • Education: When Frameworks Collide: Putting Intuitive Eating and the Division of Responsibility in Feeding to Work in Pediatric Nutrition Counseling
  • ABSSD Summer Webinar – Pediatric
  • What Makes Nutrition Confusing? The 101 on Structure Function Claims
  • Melanie Potock’s coming to NC

Recent Comments

  • Katharine Dundee on When Your Child Can’t Or Won’t Eat
  • Raquel Castillo on Feeding Flock – Feeding Assessment Tools
  • Emily Dalton on Feeding Flock – Feeding Assessment Tools
  • Alana on Feeding Flock – Feeding Assessment Tools
  • Cindy Belliveau on Oral Dysphagia (oral motor delay): Making recommendations for appropriate diet textures for the child with feeding difficulty

Upcoming Events

<
< 2023 >
December
>
Month
Month
List
Week
Day
SMTuWThFS
     12
3456789
10111213141516
17181920212223
24252627282930
31      

CAN-EAT Approach

https://www.motivationsceu.com/product-page/306-can-eat-approach-using-medical-motor-behavioral-strategies?utm_campaign=a06ccbfa-5b57-43e9-90a0-2c95a6f4c3b3&utm_source=so&utm_medium=mail&cid=d21aaf4f-6a55-4afb-aa47-c880a936a14d Hello! If you want to spend Friday and Saturday with me, this weekend's course is on West Coast time! Join me for 2 days of a deep dive into the medical side Keep Reading >>

Feeding Treatment

Challenging case with advice from Rowena Bennett

I presented a case to Rowena Bennett, RN, RM, MHN, CHN, IBCLC, author of Your Baby's Bottle Feeding Aversion. We have used Rowena's techniques many times to help our infants who come to us with bottle refusal or sleep feeding issues. She graciously Keep Reading >>

The Sensory-Motor Approach to Modified Baby-Led Weaning for Babies with Feeding Challenges

by Jill Rabin & Lori Overland Baby-Led Weaning has become “all the rage” with many parents choosing this method of transitioning their little ones to solid foods. Everyone is jumping in, with speech pathologists, dietitians, Keep Reading >>

To Pace or Not To Pace – And the Survey Says…

By Lisa Kleinz MA, SLP/L, CLC CNT Director of Education, Dr. Brown Dr. Brown’s Medical Healthcare Professional Pacing Survey Results– Where to go if guided by the data? Keep Reading >>

Book Review: Broccoli Boot Camp

Book Review: Broccoli Boot Camp by Keith Williams, PhD, BCBA & Laura Seiverling, PhD, BCBA I love to put up resources that I find helpful. If you are looking for an Keep Reading >>

More This Way

Swallowing

What is a MBSS- video for kids

I wanted to share a video we made to help children coming to UNC for a modified barium swallow study. Please share with your clients if you think it is helpful. It's also on our feeding team page Keep Reading >>

Swallowing Difficulties May Be Caused by Misfiring Neurons

in Genetic Engineering & Biotechnology News (GEN) Pediatric dysphagia (swallowing difficulties) is a frequent and serious clinical complication in a large number of clinically defined neurodevelopmental disorders including the genetic Keep Reading >>

Swallow: A Documentary- Dysphagia

Nice Documentary on Dysphagia from the National Foundation of Swallowing Disorders. Keep Up the Good Work Everyone! Keep Reading >>

A Survey of Clinician Decision Making When Identifying Swallowing Impairments and Determining Treatment

A Survey of Clinician Decision Making When Identifying Swallowing Impairments and Determining Treatment Speech-language pathologists (SLPs) are the primary health care providers who manage dysphagia. A report from the American Keep Reading >>

Oral-Motor and Sensory

Musculus masseter pars coronidea

Scientists Just Identified a Brand New Muscle Layer in The Human Jaw  DAVID NIELD23 DECEMBER 2021  It turns out there are still exciting new discoveries to be made in a field as well-studied as human anatomy: researchers have confirmed the Keep Reading >>

Poster: Child Cain’t Chew

This poster from 2018 was shared with me by Sally Asquith who gave permission to post here. The objective of this study: REVIEW CURRENT LITERATURE PERTINENT TO THE ROLE OF ORAL-MOTOR DEVELOPMENT IN DX AND TX OF PFD. COMPLETE A RETROSPECTIVE Keep Reading >>

The Sensory-Motor Approach to Modified Baby-Led Weaning for Babies with Feeding Challenges

by Jill Rabin & Lori Overland Baby-Led Weaning has become “all the rage” with many parents choosing this method of transitioning their little ones to solid foods. Everyone is jumping in, with speech pathologists, dietitians, Keep Reading >>

Grasshoppers…..

I hope I grabbed your attention with the title. More to come on grasshoppers. I had a wonderful opportunity this week- I got to spend an afternoon with Marsha Dunn Klein! This was an incredible treat for me and after several hours with Marsha, I Keep Reading >>

More This Way

Case Studies

Challenging case with advice from Suzanne Evans Morris, PhD

In this post, I have described a challenging case  and solicited advice from Suzanne Evans Morris, PhD, one of the experts in our field. Suzanne graciously provided commentary and advice and challenged me to look differently at the feeding Keep Reading >>

Complex Case – Changing Therapy Strategies When Needed

Complex Case - Changing Therapy Strategies When Needed *I shared this case with Suzanne Evans Morris and she provided some   guidance and analysis at the end. Hope you enjoy  John is a 6 year old male with a complex medical Keep Reading >>

Feeding Harley

I am excited to share Harley’s story, written by his Mother about her journey to help her son wean from his g-tube and become an oral feeder. Thank you Liz for sharing and inspiring us all to continue looking for answers! I feel I do need post a Keep Reading >>

Cases From Clinic

Cases From Clinic This is my second post highlighting some of our kids and how we provide multidisciplinary intervention using a medical/nutritional/behavioral approach. I post this hoping it might give some treatment ideas to clinicians. There Keep Reading >>

More This Way

search

Categories

Recent Posts

  • CAN-EAT Approach
  • Education: When Frameworks Collide: Putting Intuitive Eating and the Division of Responsibility in Feeding to Work in Pediatric Nutrition Counseling
  • ABSSD Summer Webinar – Pediatric
  • What Makes Nutrition Confusing? The 101 on Structure Function Claims
  • Melanie Potock’s coming to NC

Recent Comments

  • Katharine Dundee on When Your Child Can’t Or Won’t Eat
  • Raquel Castillo on Feeding Flock – Feeding Assessment Tools
  • Emily Dalton on Feeding Flock – Feeding Assessment Tools
  • Alana on Feeding Flock – Feeding Assessment Tools
  • Cindy Belliveau on Oral Dysphagia (oral motor delay): Making recommendations for appropriate diet textures for the child with feeding difficulty

Archives

search

Categories

Archives

My Account | Shop | Shopping Cart
Copyright ©2023, Pediatric Feeding News. All Rights Reserved. Custom design by Pixel Me Designs
 

Loading Comments...