Dysphagia (Swallowing)

Dysphagia, or difficulty with feeding/swallowing, occurs in the pediatric population primarily in individuals with multiple impairments or as part of an underlying disorder. Conditions which might predispose an infant or child to swallowing difficulties include central or peripheral nervous system disorders (ex. Cerebral palsy, head trauma, brain tumor, stroke) and structural and/or physiological abnormalities of the oral cavity, pharynx or throat and esophagus (ex. Cleft palate, laryngeal abnormalities, gastroesophageal reflux disease). The process of swallowing is very complex and involves transporting material from the oral cavity or mouth to the stomach without allowing entry of those materials into the airway. In order for swallowing to be successful, the central and peripheral nervous systems must be intact and functioning and the muscles of the lips, tongue, pharynx (including the larynx), and esophagus must be coordinated in their movement.

Some examples of dysphagia might include:

  • Difficulties with sucking
  • Difficulty coordinating sucking, swallowing, breathing
  • Difficulty transitioning onto more solid foods or foods with texture
  • Difficulty chewing and manipulating food in the mouth
  • Difficulties with nasal reflux (food coming back out through the nose)
  • Frequent coughing or choking due to possible aspiration of material into the airway.

Evaluation of dysphagia can be very complex. Speech-language pathologists assess infants and children in order to determine the nature of the swallowing problem and what kinds of techniques or diet modifications might be helpful in reducing or eliminating the difficulty swallowing. A clinical swallowing evaluation can be completed where the speech pathologist observes the child eating at the bedside or in the therapy department. A modified barium swallow study is another method of evaluation, where the child is viewed under x-ray so that the actual swallowing process from the mouth to the pharynx and into the esophagus can be seen. Once the evaluation is completed, the speech-language pathologist will make recommendations regarding positioning, feeding techniques and appropriate food consistencies. Sometimes, if the problem is severe, a feeding tube may be recommended so that the child will receive adequate nutrition without compromising the airway. The child may also be referred for treatment if there are difficulties with oral motor skills or behavioral issues contributing to the difficulties that can be improved with individual therapy.

For further information about scheduling, call 205-638-9149 and ask to speak to a speech-language pathologist.