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