sEMG biofeedback as a tool to improve oral motor control and functional swallowing in school age children with cerebral palsy: a case series

The number of children with complex medical needs has risen in recent years, due to the increase in medical technology and subsequent increased survival rate of premature infants. This has led to an increasing number of children with complex neurological conditions, such as Cerebral Palsy, being seen by speech-language therapists to address their complex feeding and communication needs in schools (Arvedson 2008). Surface electromyography (sEMG) has been successfully used as a tool to facilitate therapy in adult dysphagia rehabilitation (Huckabee & Cannito 1999), and has been used in studies of dysarthric speech in children with Cerebral Palsy (Marchant, Mc Auliffe & Huckabee 2007). This case series report examines the effect of oral motor control therapy with sEMG biofeedback to increase motor control and inhibit increased muscle tone. Three participants aged 6, 16, and 18 were selected from the population of Kimi Ora Special School. Each of the three participants were offered sixty, twice daily treatment sessions of 30 minutes each focusing on active relaxation, and reducing duration of return to reset after recruitment of the masseter and submental muscles using sEMG biofeedback. After each session each participant was fed a prescribed amount of thin fluid and a range of food textures to encourage generalization of increased control of the submental and masseter muscles during eating and drinking. One participant was withdrawn after 42 sessions, and two participants completed all 60 sessions. Results showed variable improvement in feeding skills, with a notable improvement in anterior food loss. All participants were able to participate fully in the treatment and made significant gains in their ability to control their muscles during treatment sessions which was reflected in the reduction of sEMG amplitudes. This study demonstrated that oral motor control therapy with sEMG is a viable treatment tool, which warrants further larger scale research into its effectiveness