Pediatric Dysphagia

Speech-language pathologists (SLPs) play a central role in the assessment, diagnosis, and treatment of infants and children with swallowing and feeding disorders. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment), prevention and advocacy, education, administration, and research. See ASHA’s Scope of Practice in Speech-Language Pathology (ASHA, 2016b).

 Appropriate roles for SLPs include the following:

  • Providing prevention information to families of children at risk for pediatric feeding and swallowing disorders as well as to individuals working with those at risk.
  • Educating other professionals on the needs of children with feeding and swallowing disorders and the role of SLPs in diagnosing and managing these disorders.
  • Participating in decisions regarding the appropriateness of instrumental evaluation procedures and follow-up.
  • Conducting a comprehensive assessment, including clinical and instrumental evaluations.
  • Considering culture as it pertains to food choices, perception of disabilities, and beliefs about intervention (Davis-McFarland, 2008).
  • Diagnosing pediatric oral and pharyngeal swallowing disorders (dysphagia).
  • Recognizing signs of ARFID and making an appropriate referral.
  • Referring the patient to other professionals as needed to rule out other conditions, determine etiology, and facilitate patient access to comprehensive services.
  • Recommending a safe swallowing and feeding plan for the Individualized Family Service Plan (IFSP), Individualized Education Program (IEP), or 504 Plan.
  • Counseling children and their families to provide education to prevent complications related to feeding and swallowing disorders.
  • Serving as an integral member of an interdisciplinary feeding and swallowing team.
  • Providing quality control and risk management.
  • Consulting and collaborating with other professionals, family members, caregivers, and others to facilitate program development and to provide supervision, evaluation, and/or expert testimony, as appropriate (see ASHA’s resources on interprofessional education/interprofessional practice (IPE/IPP) and person- and family-centered care).
  • Remaining informed of research in the area of pediatric feeding and swallowing disorders while helping to advance the knowledge base related to the nature and treatment of these disorders.
  • Advocating for families and individuals with feeding and swallowing disorders at the local, state, and national levels.

Experience in adult swallowing disorders does not qualify an individual to provide swallowing assessment and intervention for children. An understanding of adult anatomy and physiology of the swallow may provide a good basis for understanding dysphagia in children; however, additional knowledge and skills specific to pediatric populations are needed. As indicated in the Code of Ethics (ASHA, 2016a), SLPs who serve this population should be educated and appropriately trained to do so.

As indicated in the Speech-Language Pathology Assistant Scope of Practice (ASHA, 2013), speech-language pathology assistants (SLPAs) may demonstrate or share information with patients, families, and staff regarding feeding strategies developed and directed by the SLP. However, they may not perform diagnostic evaluations of feeding and swallowing, including swallowing screenings/checklists; tabulate or interpret results and observations of feeding and swallowing evaluations performed by SLPs; or perform oral pharyngeal swallow therapy with bolus material.  

Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.