PART II: Feeding and Swallowing in Craniofacial Anomalies: Keeping up with Medical Management

January 9, 2015 9:00am - 4:30pm


This event is open to OT/ST/PT.

This course is  approved for 6 CCUs by  TPTA.

This course is approved for 6 CEUs by TSHA and TOTA.


Elizabeth E. Sperry, Sc.D., CCC-SLP

Course Location:

Therapy 2000

2535 Lone Star Dr

Dallas, TX


Course Description:

Newborns who are healthy with normal anatomy and neurological function usually become efficient feeders fairly soon after birth.  When an infant is born with an orofacial cleft or other craniofacial (CF) anomaly normal breathing and feeding can be disrupted, which can negatively impact respiratory health, nutrition, oral-motor development and caregiver bonding.  There is a very broad range of feeding and swallowing problems related to structural and functional differences; therefore early differential diagnosis of an infant’s feeding and swallowing function is essential so that appropriate therapeutic intervention can be established.  CF anomaly disorders are rarely static in their presentation.  As an individual grows and undergoes staged surgical reconstruction the anatomy and physiology of their feeding and swallow function changes, so continual reassessment and establishment of new therapeutic intervention strategies are needed.

Part I of this course initially focused on establishing a thorough understanding of normal oropharyngeal anatomy and physiology, and swallow function.  Participants were then introduced to various types of orofacial clefts and CF anomalies and how the resultant structural malformations could impact feeding and swallowing function.  The differentiation between primary feeding problems and feeding problems secondary to a compromised airway was emphasized.  Therapeutic intervention strategies were outlined for each phase of medical management.

This 6-hour presentation will expand upon the previous course’ exploration of the impact that CF malformations have on oro-motor mechanics and the oral and/or pharyngeal phase of swallow function by including more complex CF malformations.  We will further delve into the dynamic changes that will take place in soft tissue and skeletal anatomy as a function of growth and staged surgical reconstructions (i.e., maxillary and/or mandibular distraction osteogenesis, TMJ arthroplasty and tongue reduction).  Participants will learn how to determine when oral motor and swallow therapy needs to be suspended due to anatomical and/or physiological constraints which comprise the patient’s ability to achieve a successful swallow, and how to make decisions about appropriate oral motor intervention and feeding adaptation(s) and strategies to implement to assure successful oral feeding.

Case studies will be presented throughout this presentation supplemented by photographs, radiologic imaging techniques (x-rays, panoramic x-rays, CT scans and MRIs), innovative computerized 3D images of the airway, nasopharyngoscopic evaluations, and videofluorographic swallow studies.  With each diagnostic protocol participants will learn to identify: (1) normal anatomical landmarks, (2) the impact that the structural anomaly has on normal breathing and swallow function, and (3) the staged post-operative changes that occur in anatomy and physiology from infancy through early adulthood.

About Our Speaker:

Elizabeth E. Sperry, Sc.D., CCC-SLP

Dr. Sperry has extensive experience in the evaluation and treatment of feeding, oral motor, speech and resonance disorders related to clefts and other craniofacial anomalies in individuals from birth through adulthood.  She is an invited instructor at Baylor School of Medicine/School of Orthodontics; and a frequent invited speaker at presentations, workshops and lectures for local, state, national and international medical institutions, associations and conferences.   Dr. Sperry has published numerous papers, professional journal articles and book chapters.  She is one of the few non-surgeons elected as a member of the prestigious International Society of Craniofacial Surgery (ISCFS).

Learner Objectives:

As a result of this course participants will be able to:

1. List and classify types of orofacial clefts and complex CF anomalies;
2. Evaluate and describe feeding and swallowing disorders related to orofacial clefts and complex CF anomalies based on anatomical and physiological factors;
3. Outline key considerations in generating a treatment plan;
4. Demonstrate management techniques for feeding and swallowing disorders through staged surgical intervention procedures; and
5. Define and evaluate diagnostic procedures during case presentations, explain the rationale for recommended therapy approaches and identify areas of concern that could impact progress in therapy.

9:00 pm – 4:30 pm


“Based on our CEU application method, TSHA requires all speech professionals miss no more than 10 minutes of class to receive full credit. Partial credit is not available for speech therapistsIf you are late to class at start or after break by more than 10 minutes, no credit can be granted, although you are still warmly welcome to attend.”

Thank You for your understanding of this externally mandated requirement.


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