Swallowing disorders can occur at different stages of the swallowing process:
- Oral phase - Difficulty in sucking, chewing, movement of solid and liquid food in the throat
- Pharyngeal phase - difficulty in closing the vocal cords or obstruction/choking to initiate swallowing, to perform the spiral movement of swallowing and to prevent aspiration (escape of food and fluids into the airway)
- Esophageal phase - Difficulty in opening and closing of the upper and lower ring of the esophagus, difficulty in the spiral movement necessary for swallowing.
What are some causes of feeding and swallowing problems in children?
- Nervous system disorders (Cerebral Palsy, Meningitis, Encephalitis)
- Gastrointestinal conditions
- Low birth weight/ Premature birth
- Heart disease
- Cleft lip and palate
- Conditions affecting the airway
Symptoms of feeding and swallowing problems
Very young children may have the following conditions:
- Stiffening or bending over while eating
- Overstimulation or arousal deprivation during feeding
- Not accepting different food consistencies
- Long feeding times (more than 30 minutes)
General symptoms may include the following conditions:
- Excessive drooling or leakage of food or liquids from the mouth
- Wet voice, hoarse or breathy voice
- gagging, choking or coughing during meals
- Recurrent pneumonia or respiratory infections
- Difficulty in matching eating and drinking with breathing
- Frequent spitting
- Less than normal weight gain or growth
The impact of these problems on children
- Lack of water or malnutrition
- Risk of aspiration (food or fluids entering the airway)
- Recurrent upper respiratory tract infections that can lead to pneumonia or chronic lung disease
- Being alone or bored during meals in social settings (restaurants, etc.)
Where can I get help for my child?
You can consult your doctor about possible causes of swallowing problems. Speech and language therapists can provide prevention treatments, swallowing and nutritional assessment, if appropriate. Many medical and other health professionals work together in the assessment and/or treatment of swallowing and nutrition problems.
What do speech and language therapists do when assessing swallowing problems?
- They take a careful history of the child's health history, development and symptoms.
- They look at the movement and strength of the muscles involved in swallowing.
- They observe mouth movements during eating and drinking and posture and behavior during feeding.
- They perform special tests to assess swallowing problems.
What types of treatment can help with swallowing problems?
The types of treatment depend largely on the symptoms and causes of swallowing problems. These may include the following conditions:
- Exercises to coordinate, stimulate and strengthen the muscles involved in swallowing and feeding.
- Equipment, special foods or techniques to improve swallowing and feeding.
What can family members or caregivers do to help?
- Ask questions to understand your child's feeding and swallowing problems.
- Make sure you understand your child's treatment plan.
- Continue with treatment periods/sessions and follow recommended techniques at home and at school.
- Communicate with everyone who works with your child to get their input on your child's treatment plan, feeding and swallowing problems.
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