Approach to obtaining a swallow study in a five-year-old with a disability and significant procedural anxiety: A case report.
Tyler Estes, Aaron Gaul, Allison Thornton and 1 others
PMID 38788098WHAT IT FOUND
A five-year-old with cerebral palsy and severe x-ray anxiety completed a swallow study after desensitization visits, gradual exposure to equipment and staff protective gear, and buspirone.
The study allowed his diet to include moderately thickened liquids.
Key findings
01A complex intervention involving desensitization visits, gradual exposure to the radiology suite, staff donning protective equipment slowly, changing lighting, moving the fluoroscopy machine, adjusting patient positioning, and adding buspirone allowed the child to complete the swallow study without issue.
02Benzodiazepines were avoided because sedation and muscle relaxation could interfere with the quality of the swallow study.
03The completed swallow study led to a diet upgrade to include moderately thickened liquids.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single case report, so it cannot determine if this approach works for other children. The success relied on a highly coordinated interdisciplinary effort and multiple visits over months, which may not be feasible in all settings. The specific contribution of buspirone versus the behavioral desensitization cannot be separated. The child's specific triggers (fear of dark room and PPE) may not apply to other patients with procedural anxiety.
Declared interests
The authors have no disclosures or conflicts of interest.
The easy way to misread this
Do not assume that buspirone or desensitization will work for all children with procedural anxiety. This was a single case with specific fears (darkness, protective gear) that were addressed individually. The outcome cannot be generalized to patients with different triggers or disabilities.