Q: I am seeing a 4-year-old boy with cerebral palsy. He is pocketing food and liquids on his weaker right side. Choking occurs at home, although we have not seen it at school. What can I do to help? I have had no dysphagia training at all.

A feeding problem in a child with cerebral palsy can be a serious issue because the child is in danger of aspiration. I do not give out this type of advice as a result, and can only offer you an opinion.

My opinion is that this child should have a formal evaluation by a feeding/dysphagia team. The treatment itself also should be under the direction of someone who knows this area, perhaps someone from the same team.

Although there are many things you can do in therapy and in the school, I would not embark on these treatment techniques until you had some type of formal training yourself. It would be best if the entire therapy and classroom staff could receive this training for this child and others who will come down the pike.

I am sorry I could not be more specific, but hopefully my advice will put this client and your school system on the right path.