Pediatric Dysphagia: Physiology, Assessment, and Management

Dodrill, Pamela; Gosa, Memorie M.

doi:10.1159/000381372

Cited by 191 publications

(190 citation statements)

References 61 publications

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“…Abnormalities in triggering of the swallow include absent swallow, delayed trigger of swallow, suck-swallow-breathing (SSB) incoordination, and pharyngeal phase symptoms include laryngeal penetration, aspiration, choking, pharyngeal residue and nasopharyngeal reflux. [14] Common criteria by healthcare professionals for referral of infants and children for feeding and swallowing evaluation included: suckling and swallowing incoordination, weak suck, breathing disruptions or apnoea during feeding, excessive gagging or recurrent coughing during feeds, diagnosis of disorders associated with dysphagia or under-nutrition, severe irritability during feeding, history of recurrent pneumonia and feeding difficulty, concern for possible aspiration during feeds, lethargy or decreased arousal during feeds, tedious feeding times and nasopharyngeal reflux during feeding.…”

Section: Participantsmentioning

confidence: 99%

Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital

Schoeman

Kritzinger

2017

S Afr J CH

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The study was a retrospective review of medical and SLT records from 2010 to 2014 and included infants, aged 24 -42 weeks' gestational age Background. The prevalence of neonatal dysphagia is increasing, as medical advances contribute to the survival of critically ill and preterm infants. Additional factors such as low birth weight (LBW), gastro-oesoephageal reflux disorder, failure-to-thrive (FTT), and HIV may increase the complexity of dysphagia symptoms. Knowledge of context-specific risk factors for dysphagia may lead to an effective pathway of diagnosis and management in vulnerable neonates. Objective. To describe the feeding characteristics and categories of underlying medical conditions in infants of gestational age 24 -42 weeks. Methods. The study was a retrospective review of 231 purposively selected medical and speech-language therapy records. Participants had a mean stay of 28.5 days in a neonatal intensive care unit in a peri-urban public hospital and were referred for a swallowing and feeding assessment. An existing seven-category framework for the classification of suspected dysphagia was used. Results. Most participants (90.0%) presented with multiple medical conditions. Underlying neurological conditions (48.5%) and feeding difficulties secondary to systemic illness (65.8%) contributed mostly to suspected dysphagia in the sample. It was found that 71.0% of infants presented with feeding difficulties secondary to other conditions such as LBW and prematurity, highlighting the need for an expanded dysphagia classification framework. Conclusion. The results concur with the outcomes of previous studies and confirm the need for a unique classification framework in South Africa. Dysphagia is a complex condition and frequently cannot be attributed to a single risk factor. RESEARCH This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital J Schoeman, B Com Pathol, M Com Pathol; A Kritzinger, DPhil

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Section: Participantsmentioning

confidence: 99%

Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital

Schoeman

Kritzinger

2017

S Afr J CH

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“…9 The exclusion criteria were a history of oropharyngeal disease or surgery, having a diagnosis of gastroesophageal reflux, or prior participation in a swallowing rehabilitation program. Ethical approval was obtained from the Hacettepe University Non-invasive Clinical Research Ethics Committee (Approval number: GO16/57-05).…”

Section: A Teri Als An D M Eth Od Smentioning

confidence: 99%

“…The inclusion criteria for swallowing difficulty complaints or symptoms were problems in controlling food or saliva in the mouth, inability to swallow solid food, difficulty initiating a swallow, coughing and/or choking during swallowing, unexplained weight loss, a gurgly or wet voice after swallowing, and nasal regurgitation. 9 The exclusion criteria were a history of oropharyngeal disease or surgery, having a diagnosis of gastroesophageal reflux, or prior participation in a swallowing rehabilitation program.…”

Section: A Teri Als An D M Eth Od Smentioning

confidence: 99%

Both pharyngeal and esophageal phases of swallowing are associated with recurrent pneumonia in pediatric patients

Arslan

Demir

Karaduman

2016

Clinical Respiratory J

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“…Pediatric swallow is distinct from an adult's in pathophysiology, etiology, and presentation . Due to the high incidence of silent aspiration in children, clinical examination is often considered unreliable in detecting patients at risk of aspiration.…”

Section: Introductionmentioning

confidence: 99%

Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia

et al. 2018

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Objectives: The clinical variables that are predictive of aspiration pneumonia are not clear in the pediatric population. This study was conducted in order to identify the demographic, clinical, and radiological risk factors for the development of aspiration pneumonia in children referred to the dysphagia clinic.Methods: A retrospective analysis of medical records of 88 children referred to the dysphagia clinic who had undergone videofluroscopic swallow study (VFSS).Results: Oropharyngeal dysphagia was found in 61.3% (54 of 88). Incidence of aspiration pneumonia was 39.8% (35 of 88).Conclusion: Respiratory symptoms such as cough, choking, excessive secretions, and pharyngeal dysmotility other than aspiration in VFSS were not predictors of pneumonia. Infants and children with laryngotracheal anomalies, demonstrable aspiration in VFSS, and major cardiac illness are at risk of presenting with aspiration pneumonia. Whether gastroesophageal reflux disease (GERD) or esophageal dysmotility are causative of aspiration in the rest of the population needs to be investigated by future prospective studies.

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Pediatric Dysphagia: Physiology, Assessment, and Management

Cited by 191 publications

References 61 publications

Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital

Risks associated with suspected dysphagia in infants admitted to a neonatal intensive care unit in a South African public hospital

Both pharyngeal and esophageal phases of swallowing are associated with recurrent pneumonia in pediatric patients

Observations from a pediatric dysphagia clinic: Characteristics of children at risk of aspiration pneumonia

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