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Signs, Symptoms, and Potential Causes of Pediatric Dysphagia
Possible Signs of a Feeding/Swallowing Disorder
- Refusing to eat
- Eating very little for a prolonged period of time
- Spitting out food
- Frequent coughing or throat clearing during or soon
after eating - Excessive drooling
- Food leaking from mouth
- Refusing to eat certain textures or temperatures of
food - A “wet” or “gurgly” sounding voice or cry after
eating - Excessive spitting up or vomiting after eating
Reflux
- Occurs when the contents of the stomach, including the stomach acid,
return to the esophagus. - Can occur when eating or drinking but also when there is any kind of
change in intra-abdominal pressure - Some symptoms of children with GERD may include:
- Vomiting
- Coughing, gagging, or choking
- Exhibit abnormal postures
- Unexplained irritability
- Failure to Thrive
- Weight below the 3rd percentile for age
- Organic, non-organic or mixed etiology
- Organic causes include endocrine deficiencies, chronic disease,
enzyme defects or congenital/genetic anomalies or oral-motor
dysfunction - Non-organic causes include poor caregiver-child interaction, psychosocial
issues, environmental deprivation, child abuse and poor feeding
practices - Factors related to caregiver-centered FTT include lack of nutritional
information, improper feeding techniques, unrealistic expectations
about feeding, inability to accurately assess the child’s needs, neglect
and isolation
Aspiration
- Occurs when food travels into the airway instead of into the stomach
- Often suspected by observation of coughing, wet voice, throat
clearing, or diagnosis of pneumonia - Aspiration may be seen on different textures so a child could be
perfectly safe eating purees and solids but aspirate on thin liquids - If you suspect aspiration, contact your pediatrician to discuss the
possibility of a swallowing evaluation
Sensory Issues
- Reactive Sensory Defensiveness can occur when an infant has not
received positive sensory input to the mouth - When sensory input is provided, it may be experienced as very strong
and uncomfortable - Primary Sensory Defensiveness to facial and oral stimulation occur
as a primary difficulty in some children - Child’s basic perception is one of danger, and the sensory stimulus is
often perceived as an attack - Not based on some past, negative experience
- May occur as a response to touch, movement, smell, taste, and texture
in food - Eating Aversion is the result of a complex interplay of sensorimotor,
gastrointestinal, and environmental responses - Typically perceived as a behavioral issue
- Many of these children have subtle sensorimotor and gastrointestinal
issues that make eating uncomfortable - These children may choose a non-eating behavior to reduce or
prevent discomfort
SOURCE: ASHA
-Sharon P. M.S. CF-SLP TSSLD