Outcomes of Using LNMES on Tracheostomized Children

Inclusion Criteria: PATIENT COHORT * Children between 0-4 years 11 months * Currently have tracheostomy tubes * MBSS must indicate penetrations of more than 50% of swallows or aspiration of thin, ½ nectar-thick, nectar-thick or honey-thick liquids. * The child must be on a modified diet of honey-thick liquids, nectar-thick liquids, ½ nectar-thick liquids, or no liquids by mouth. * Able to tolerate a voice valve PARENT COHORT * At least one primary caregiver of a qualifying child (see Child cohort). * Parent/caregiver must be at least 18 years of age or older, provide primary care, and have medical decision making rights for the child. Exclusion Criteria: PATIENT COHORT * Children who are not on modified diets or using a g-tube as an alternate means of nutrition * Children with suspected or diagnosed heart problems * Children with suspected or diagnosed epilepsy * Children with a tendency to hemorrhage following acute trauma or fracture * Children who have undergone recent surgical procedures when muscle contraction may disrupt the healing process * Children for whom the LNMES would be: 1) over carotid sinus, 2) over neoplasm, 3) over active infection and 4) over areas of skin which lack normal sensation * Children with difficulty tolerating tactile stimulation and tolerate the whole duration of the LNMES sessions. * Children with difficulty tolerating tactile sensory stimulation such as tape and electrodes on the anterior aspect of the neck. PARENT COHORT * The caregiv…