CLINICAL TOPICS

Pediatric Dysphagia

Overview

Incidence and Prevalence

Signs and Symptoms

Causes

Common causes of pediatric dysphagia include

  • developmental disability (i.e., disability with onset before the age of 22 that warrants lifelong or extended medical, therapeutic, and/or residential supports and is attributable to a mental or physical impairment or a combination of mental and physical impairments);
  • neurological disorders (e.g., cerebral palsy, meningitis, encephalopathy, pervasive developmental disorders, traumatic brain injury, muscle weakness in face and neck);
  • factors affecting neuromuscular coordination (e.g., prematurity, low birth weight);
  • complex medical conditions (e.g., heart disease, pulmonary disease, gastroesophageal reflux disease [GERD], delayed gastric emptying);
  • structural abnormalities (e.g., cleft lip and/or palate, laryngomalacia, tracheoesohageal fistula, esophageal atresia, head and neck abnormalities, choanal atresia);
  • genetic syndromes (e.g., Pierre Robin, Prader-Willi, Treacher-Collins, 22q11 deletion);
  • medication side effects (e.g., lethargy, decreased appetite);
  • sensory issues as a primary cause or secondary to limited food availability in early development (e.g., in children adopted from institutionalized care; Beckett et al., 2002, Johnson & Dole, 1999);
  • behavioral factors (e.g., food refusal);
  • social, emotional, and environmental issues (e.g., difficult parent-child interactions at mealtimes).

Results or long-term effects for a child diagnosed with pediatric dysphagia include

  • poor weight gain velocity and/or under nutrition (failure to thrive),
  • aspiration pneumonia and/or compromised pulmonary status,
  • food aversion,
  • oral aversion,
  • rumination disorder (unintentional and reflexive regurgitation of undigested food that may involve re-chewing and re-swallowing of the food),
  • dehydration,
  • ongoing need for enteral or parenteral nutrition.

Roles and Responsibilities

Assessment

Treatment

Resources

References

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