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Pediatric Dysphagia

Underlying etiologies associated with pediatric feeding and swallowing disorders include

  • complex medical conditions (e.g., heart disease, pulmonary disease, gastroesophageal reflux disease [GERD], delayed gastric emptying);
  • 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);
  • factors affecting neuromuscular coordination (e.g., prematurity, low birth weight, hypotonia, hypertonia);
  • genetic syndromes (e.g., Down syndrome, Pierre Robin Sequence, Prader–Willi, Rett syndrome, Treacher Collins syndrome, 22q11 deletion);
  • medication side effects (e.g., lethargy, decreased appetite);
  • neurological disorders (e.g., cerebral palsy, meningitis, encephalopathy, pervasive developmental disorders, traumatic brain injury, muscle weakness in face and neck);
  • 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);
  • structural abnormalities (e.g., cleft lip and/or palate and other craniofacial abnormalities, laryngomalacia, tracheoesophageal fistula, esophageal atresia, choanal atresia);
  • behavioral factors (e.g., food refusal); and
  • socio-emotional factors (e.g., parent–child interactions at mealtimes).

Atypical eating and drinking behaviors can develop in association with dysphagia, aspiration, or a choking event. They may also arise in association with sensory disturbances (e.g., hypersensitivity to textures), stress reactions (e.g., when trying new foods), or undetected pain (e.g., teething, tonsillitis). See for example, Dodrill (2017) and Manikam and Perman (2000). 

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