Important features from history

• Length of meal times
  
• Recurrent chest infections: may indicate aspiration pneumonias
  
• Choking episodes

Examination

• Assessing malnutrition can be difficult, but growth charts are available for cerebral palsy and certain other neurodisabilites. Triceps skinfold thickness <10th centile is suggestive of malnutrition in cerebral palsy
  
• Examination for nutrition should include limb perfusion and muscle strength, including ability to cough and use accessory muscles of respiration

Management

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