Dysphagia in Children

Speech-Language Pathologists (SLP) play an integral role in evaluating and treating pediatric patients with dysphagia related to aerodigestive disorders. Non-supportive anatomy, cardio-respiratory and medical status, state control, neurologic functioning, postural stability and control, gastrointestinal functioning, hunger and satiation, developmental abilities, oral-motor skills, oral/pharyngeal reflexes, airway protection and secretion management can create barriers to successful oral feeding. Swallowing is broken down into four phases and difficulties can occur during any phase or in combination with another phase of swallowing. Dysphagia is diagnosed by both clinical and instrumental evaluation. Objective evaluations of swallowing include the Video Fluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES). A Video Fluoroscopic Swallow Study (VFSS) is a radiographic study assessing oropharyngeal swallow function. The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is conducted by passing a laryngoscope through the nose to just below the soft palate for a "bird's eye view" of laryngeal anatomy and swallow function. Following a diagnosis of dysphagia from either a clinical or instrumental assessment, there are a variety of avenues that can be pursued including diet modifications, compensatory strategies, and use of specialized equipment to ensure a safe feeding plan and reduce the risk of aspiration. In conclusion, through numerous evaluation and intervention approaches, the contributions of SLPs helps provide input for well-rounded, multi-disciplinary plans supporting successful oral feeding.