Swallowing Disorders in Children

• oral phase-- sucking, chewing, and moving food or liquid into the throat

• pharyngeal phase-- triggering the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway ( aspiration ) or to prevent choking

• esophageal phase-- relaxing and tightening the openings at the top and bottom of the feeding tube in the throat ( esophagus ) and squeezing food through the esophagus into the stomach

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Some causes of feeding and swallowing problems in children are:

• nervous system disorders (cerebral palsy, meningitis, encephalopathy)
• gastrointestinal conditions
• prematurity/low birth weight
• heart disease
• cleft lip or palate
• conditions affecting the airway

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Signs and symptoms of feeding and swallowing problems in very young children may include:

• arching or stiffening of the body during feeding
• irritability or lack of alertness during feeding
• failure to accept different textures of food
• prolonged feeding times (more than 30 minutes)

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General signs may include:

• excessive drooling or leaking food/liquid from the mouth
• gurgly, hoarse, or breathy voice quality
• coughing or gagging during meals
• recurring pneumonia or respiratory infections
• difficulty coordinating breathing with eating or drinking
• frequent spitting up
• less than normal weight gain or growth

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As a result , children may have :

• dehydration or poor nutrition
• risk of aspiration (food or liquid entering the airway)
• pneumonia or repeated upper respiratory infections that can lead to chronic lung disease
• embarrassment or isolation in social situations involving eating

For help , consult your doctor about the possible cause of the swallowing problem. An ASHA-certified speech-language pathologist can perform an evaluation of feeding and swallowing and provide treatment if appropriate. Many medical specialists and other health care professionals may work together to evaluate and/or treat feeding and swallowing problems.

To Find a speech-language pathologist near you.

A speech-language pathologist :

• will take a careful history of your child' s medical history, development, and symptoms
• will look at the strength and movement of the muscles involved in swallowing
• will observe feeding to see your child' s posture, behavior, and oral movements during eating and drinking
• may perform special tests to evaluate swallowing

Treatment varies greatly depending on the cause and symptoms of the swallowing problem, but may include:

• exercises for strength, sensation, and coordination of muscles involved in feeding and swallowing
• recommendations for special foods, equipment, or techniques to improve feeding and swallowing

Family members or caregivers can:

• ask questions to understand problems in feeding and swallowing
• make sure they understand the treatment plan
• attend treatment sessions and follow recommended techniques at home and school
• communicate with everyone who works with the child about the feeding and swallowing issues and treatment plan.

Swallowing Problems in Adults

• oral phase-- sucking, chewing, and moving food or liquid into the throat

• pharyngeal phase-- triggering the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking

• esophageal phase-- relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach

Some causes of feeding and swallowing problems  in adults are:

Damage to the nervous system, such as:

• Stroke
• Brain injury
• Spinal cord injury
• Parkinson' s disease
• Multiple sclerosis
• Amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease)
• Muscular dystrophy
• Cerebral palsy
• Alzheimer's disease

Problems affecting the head and neck, including:

• Cancer in the mouth, throat, or esophagus
• Injury or surgery involving the head and neck
• Decayed or missing teeth, or poorly fitting dentures

Many other diseases, conditions, or surgical interventions can result in swallowing problems. General signs may include:

• coughing during or right after eating or drinking
• wet or gurgly sounding voice during or after eating or drinking
• extra effort or time needed to chew or swallow
• food or liquid leaking from the mouth or getting stuck in the mouth
• recurring pneumonia or chest congestion after eating
• weight loss or dehydration from not being able to eat enough

As a result, adults may have:

• poor nutrition or dehydration
• risk of aspiration (food or liquid entering the airway) which can lead to pneumonia and chronic lung disease
• less enjoyment of eating or drinking
• embarrassment or isolation in social situations involving eating

For help, consult your doctor about the possible medical cause of the swallowing problem. An ASHA-certified speech-language pathologist can perform an evaluation of feeding and swallowing and provide treatment if appropriate. Many medical specialists and other health care professionals may work together to evaluate and/or treat feeding and swallowing problems.

Find a speech-language pathologist near you.

A speech-language pathologist:

• will take a careful history of medical conditions and symptoms
• will look at the strength and movement of the muscles involved in swallowing
• will observe feeding to see posture, behavior, and oral movements during eating and drinking
• may perform special tests to evaluate swallowing

Treatment varies greatly depending on the cause, symptoms and type of swallowing problem. A speech-language pathologist may recommend:

• exercises, positions, or strategies to help swallow more effectively
• specific food and liquid textures that are easier and safer to swallow

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Family members or caregivers can help:

• ask questions to understand the problem and the recommended treatment
   
• assist in following the treatment plan:
   
  • help with exercises
  • prepare the recommended textures of food and liquid, making sure that recommendations for eating safely are followed
  • keep track of how much food or liquid is consumed

• Digestive system, physiology: gastrointestinal physiology