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Suffolk Center for Speech

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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

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