Choosing the Correct Technique
Table 1. A guide to age-appropriate airway clearance techniques for children
| 0-1 years Infants | 1-3 years Toddlers | 4-12 years Children | 12-18 years Adolescents | |
|---|---|---|---|---|
| Modified Postural Drainage | Yes | Yes | Yes | Yes |
| Percussion and Vibration | Yes | Yes | Yes | Yes |
| Assisted autogenic drainage | Yes | Yes | ||
| Positioning and play | Yes | Yes | ||
| Bouncing on a fitball | Yes | Yes | ||
| Blowing games | Yes | |||
| Huffing | Yes (passive) | |||
| ACBT (includes huffing) | Yes | Yes | Yes | |
| Bottle PEP | Yes | Yes | Yes | |
| Autogenic Drainage | Yes | Yes | ||
| PEP mask | Yes | Yes | Yes | Yes |
| Mouthpiece PEP | Yes | Yes | Yes | |
| PariPEP with nebuliser | Yes | Yes | Yes | |
| Pari O-PEP / Flutter / AirPhysio | Yes | Yes | Yes | |
| Acapella | Yes | Yes | Yes | |
| Physical exercise | Yes | Yes | Yes | |
| HFCWO The Vest | Yes | Yes | Yes |
Nebuliser therapy for young children:
A mouthpiece is the preferred option, however infants and young children will require a mask to ensure delivery of the inhalation medication
It can be very challenging to commence inhalation therapy as the child may resist using a mask or mouthpiece
It is recommended to trial just holding the mask or mouthpiece and playing with it (becoming familiar with the equipment)
Pretend using the nebuliser (turned off) with their favourite teddy, parents or siblings
Use distractions such as singing their favourite song
