Modeling of a controlled flow cup for improved transitional drinking development in children.

INTRODUCTION: Clinical observations of children with swallowing disorders using a traditional "sippy" or transitional drinking cup identified a need for a novel cup. Children with swallowing disorders are often unable to initiate the forces required to activate the cup and/or maintain suction pressure. Furthermore, fast flow rates can result in choking. METHODS: A new cup design tool is proposed using fluid-cup interactions to capture the changing geometry of the fluid during drinking. A Petri net formulation is integrated with standard fluid flow principles. A new parametric cup simulation provides visualization and direct implementation for microcontroller prototypes. A vent-based controller is developed and modeled for a novel transitional drinking cup design. A simulated pouring study is performed for water and a baseline liquid volume of 200 ml in the cup. The study varies rotation rates, initial volume, system control and desired flow rates. RESULTS: Volumetric flow rate curves over time are generated and compared in relation to a target flow rate. The simulation results show expected behavior for variations in cup parameters. CONCLUSION: The new simulation model facilitates future dysphagia research through rapid prototyping by tuning cup geometry, liquid parameters and control signals to meet the varying needs of the users.

A Comparison of Measurements of a Pediatric Supplement.

This study evaluated the flow properties of viscosity and flow rate for water and two common pediatric liquids. The flow properties of the test liquids are of interest to create a cup simulation model and "smart" prototype training cup. Two objective methods of determining flow properties were utilized: a rheometer to assess viscosity and a modified version of the International Dysphagia Diet Standardization Initiative (IDDSI) to assess flow rate. Rheometer results concluded that the pediatric supplements were less than 50 cP at all shear rates evaluated and exhibited shear-thinning properties, placing both liquids into the "thin" category. The IDDSI, which was performed according to standardized protocol and also with experimental modifications of varying syringe volumes, determined that all three test liquids had greater than 1 mL/s flow rate across all syringe types/sizes. The experimental modification of the IDDSI with 60 mL syringe volume was found to be the most consistent and applicable with discrete values obtained across all liquids tested. A flow rate factor equation can be determined with the use of a 60 mL syringe, with our laboratory setup, to create the cup simulation model. This computer-generated cup simulation model also aims to integrate engineering with clinical practice to develop a "smart" prototype training cup equipped with software to control flow rate.

Correction to: A Comparison of Measurements of a Pediatric Supplement.

The original version of this article unfortunately contained mistakes.

Open-Cup Drinking Development: A Review of the Literature.

To date, a lack of published research studies exist that systematically analyze the factors involved with the progression of open-cup drinking in typically developing infants and toddlers. As a result, clinicians who are working with children that have delays in open-cup drinking development have a limited framework from which to base clinical decisions. The purpose of this review is to collate works from disparate and related fields to provide a brief review of the literature of pertinent sensorimotor and cognitive components necessary for successful open-cup drinking development.

Altering the gag reflex via a palm pressure point.

BACKGROUND: The gag reflex regularly interferes with dental procedures. The authors hypothesize that applying pressure to a specific point on the palm alters the gag reflex and that hypersensitive gag reflexes may be categorized according to oropharyngeal landmarks. METHODS: Thirty-six neurologically intact subjects underwent a series of gag reflex trials (baseline, sham and treatment). The authors developed a hand pressure device for subjects to wear, which provided a consistent force, and they described a gag trigger point index (GTPI) scale. On the basis of the GTPI, they divided subjects into a hypersensitive group and an expected-sensitivity (control) group. RESULTS: The trigger point of the gag reflex moved posteriorly in all subjects as a result of pressure to the palm point. Statistical results from repeated measures analysis of variance support the GTPI baseline data, and group assignments helped predict mean GTPI scores across conditions. The authors noted a significant treatment-group interaction effect, which indicated that the difference in mean GTPI responses between the hypersensitive and expected-sensitivity groups depended on the treatment being used. CONCLUSIONS: The authors introduce a treatment involving the stimulation of a pressure point that consistently altered the gag reflex trigger. The results of the study show the need for a more detailed, systematic approach to studying the hypersensitive gag reflex. CLINICAL IMPLICATIONS: The change in trigger point in the hypersensitive group represented a functional gain. Application of the pressure point during dental procedures would decrease the likelihood of triggering a gag reflex.

System design for a pediatric physical therapy strength testing glove.

The goal of this project is to develop a strength testing glove that will improve current methods of muscle strength measurement by enabling physical and occupational therapists to quantitatively assess patient progress. The project was realized through research, human testing, prototype construction, component testing, and analysis of data. This design will provide a cheaper, more flexible, more versatile, and more quantitative method of muscle strength measurement for medical professionals. This design could potentially change the current approach pediatric physical therapists take in testing and tracking patients muscle strength.