{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:00:13Z","timestamp":1793253613939,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2011,11,15]],"date-time":"2011-11-15T00:00:00Z","timestamp":1321315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2003<\/jats:bold>The majority of children with cerebral palsy have feeding difficulties, which, if not managed, result in stressful mealtimes, chronic malnutrition, respiratory disease, reduced quality of life for caregiver and child, and early death. In well\u2010resourced countries, high\u2010 and low\u2010cost medical interventions, ranging from gastrostomy tube feeding to caregiver training, are available. In resource\u2010poor countries such as Bangladesh, the former is not viable and the latter is both scarce and its effectiveness not properly evaluated. The aim of this study was to evaluate the effectiveness of a low\u2010cost, low\u2010technology intervention to improve the feeding practices of carers of children with moderate\u2013severe cerebral palsy and feeding difficulties in Bangladesh.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold>An opportunistic sample of 37 caregivers and their children aged 1\u201311 years were invited to a six\u2010session training programme following an initial feeding assessment with brief advice. During home visits, pre\u2010 and post\u2010measures of nutritional status, chest health and feeding\u2010related stress were taken and feeding practices were observed. A control phase was evaluated for 20 of the participant pairs following initial assessment with advice, while awaiting full training.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold>A minimum of four training sessions showed significant improvements in the children's respiratory health (<jats:italic>P<\/jats:italic>= 0.005), cooperation during mealtimes (<jats:italic>P<\/jats:italic>= 0.003) and overall mood (<jats:italic>P<\/jats:italic>&lt; 0.001). Improvements in growth were inconsistent. Dramatic reductions were observed in caregiver stress (<jats:italic>P<\/jats:italic>&lt; 0.001). A significant difference in the outcomes following advice only compared with advice plus training was also observed.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold>In situations of poverty, compliance is restricted by lack of education, finances and time. Nonetheless, carers with minimal formal education, living in conditions of extreme poverty were able to change feeding practices after a short, low\u2010cost training intervention, with highly positive consequences. The availability of affordable food supplementation for this population, however, requires urgent attention.<\/jats:p>","DOI":"10.1111\/j.1365-2214.2011.01327.x","type":"journal-article","created":{"date-parts":[[2011,11,15]],"date-time":"2011-11-15T18:46:22Z","timestamp":1321382782000},"page":"878-888","source":"Crossref","is-referenced-by-count":79,"title":["Feeding difficulties in children with cerebral palsy: low\u2010cost caregiver training in Dhaka, Bangladesh"],"prefix":"10.1111","volume":"38","author":[{"given":"M. S.","family":"Adams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Z.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. A.","family":"Begum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Wirz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Hesketh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. R.","family":"Pring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,11,15]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Child and Mother Nutrition Survey 2005","author":"BBS\/UNICEF","year":"2007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/24.3.217"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/03670244.1993.9991328"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/001316446002000104"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980228)17:4<407::AID-SIM742>3.0.CO;2-L"},{"key":"e_1_2_8_7_1","first-page":"5","article-title":"Responsive feeding practices","volume":"20","author":"Engle P.","year":"2000","journal-title":"Health Child Dialogue"},{"key":"e_1_2_8_8_1","volume-title":"Statistical Methods for Rates and Proportions","author":"Fleiss J. L.","year":"1981"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)90360-1"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/J006v23n02_03"},{"key":"e_1_2_8_11_1","volume-title":"The Discovery of Grounded Theory","author":"Glaser B. G.","year":"1967"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004550010006"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700043993"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/138.4.799"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.39.9.578"},{"key":"e_1_2_8_16_1","first-page":"369","article-title":"Seeking optimal means to address micronutrient deficiencies in food supplements: a case study from the Bangladesh Integrated Nutrition Project","volume":"23","author":"Karim R.","year":"2005","journal-title":"Journal of Health, Population, and Nutrition"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1998.tb12343.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1995.tb13730.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700031500"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/25.6.427"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.08.058"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","DOI":"10.3362\/9781780441658","volume-title":"Appropriate Paper\u2010Based Technology (APT). A Manual","author":"Packer B.","year":"1995"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1997.tb07414.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2001.00644.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1992.tb11449.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)70032-X"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00262762"},{"key":"e_1_2_8_28_1","first-page":"320","article-title":"Intensive nutrition education with or without supplementary feeding improves the nutritional status of moderately\u2010malnourished children in Bangladesh","volume":"23","author":"Roy S. K.","year":"2005","journal-title":"Journal of Health, Population, and Nutrition"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-001-0070-z"},{"key":"e_1_2_8_30_1","first-page":"50","article-title":"Poor nutrition is a serious problem in children with cerebral palsy in Palawan, the Philippines","volume":"28","author":"Socrates C.","year":"2000","journal-title":"The Southeast Asian Journal of Tropical Medicine and Public Health"},{"key":"e_1_2_8_31_1","volume-title":"Cerebral Palsies: Epidemiology and Causal Pathways","author":"Stanley F. J.","year":"2000"},{"key":"e_1_2_8_32_1","volume-title":"Feeding the Disabled Child","author":"Sullivan P. B.","year":"1996"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2000.tb00678.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2002.tb00307.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2004.tb00443.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2005.tb01095.x"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(98)00088-4"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(92)90067-Y"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.2466\/pms.98.1.349-358"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601705"}],"container-title":["Child: Care, Health and Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2214.2011.01327.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2214.2011.01327.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,14]],"date-time":"2024-04-14T18:57:20Z","timestamp":1713121040000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2214.2011.01327.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,11,15]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1111\/j.1365-2214.2011.01327.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2214.2011.01327.x","archive":["Portico"],"relation":{},"ISSN":["0305-1862","1365-2214"],"issn-type":[{"value":"0305-1862","type":"print"},{"value":"1365-2214","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,11,15]]}}}