Occupational Therapy Intervention in Cerebral Palsy Children with Oral Motor Dysfunction (OMD) and its Impact on Occupational Goals and Quality of Life of their Mothers

Studies have shown that 80% of children with developmental delay due to CP have accompanying oral-motor dysfunction⁽¹⁾. Little attention is paid towards feeding problems though it is a major cause of distress for their caregivers, specially the mothers.

The Aim of this study was to evaluate the impact of Occupational Therapy(OT) Intervention for OMD in the child with Cerebral Palsy (CP) and to assess and compare it to the changes in the occupational goals and quality of life of these mothers due to the introduction of the intervention program.

Children with CP (n=30), aged between 6 months to 4 years and their mothers who reported of feeding issues, were selected. Each child was assessed on ORAL MOTOR DYSFUNCTION (OMD) SCALE, to assess the level of their functioning and decide the intervention. After a month of conventional therapeutic intervention, the children were reassessed to establish a baseline. Their mothers were assessed on WHOQOL-Bref and COPM to obtain pre-intervention data. After 3 months of OT intervention and feeding session, the children and their mothers were reassessed on the respective scales to obtain the postintervention scores.

The comparison of the data obtained from OMD Scale between the initial evaluation and the baseline pre-intervention stage showed that there was significant change only in the domain of oral motor responses (Z =-3.071 p=.002, n=30) whereas after the intervention all the domains showed statistically significant changes (p =.01). Wilcoxon's comparison for WHOQOL-Bref score revealed a statistically significant result (p=.01, Z=-4.785). The comparison of performance score and satisfaction score on COPM revealed a statistical correlation at p=.01 level (Z (p²-p¹) =-4.440 and Z (S²-S¹) =-4.685). Spearman's 2-tailed correlation for WHOQOL-Bref and OMD scale was in statistically insignificant. On the other hand, CIS(Change In Satisfaction) score on COPM and OMD score were significantly correlated (rho=.393, p=.032, n=30) but CIP (Change in Performance) score and OMD score showed a clinically non-significant yet negative correlation (rho=-.262, p=.162, n=30).

This study provided a scientific support for use of OT intervention in oral motor dysfunction in CP. Knowledge of feeding techniques helps the mother to care the child better. Minimal enhancement in the child's feeding ability increases the satisfaction level of the mother but did not prevent guilt and anxiety about perception of self-efficacy and calls for psycho-social support.