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Feeding and Swallowing Disorders in Children

Feeding and swallowing disorders (dysphagia) include difficulty with any step of the eating process, from accepting foods and liquids into the mouth to the entry of food into the stomach and intestines. A feeding or swallowing disorder may include eating and drinking behaviours that are not typical for the age of the child, such as not accepting age-appropriate liquids or foods, being unable to use age-appropriate feeding devices end utensils, or being unable to self-feed. A child with dysphagia may refuse food, accept only a restricted variety or quantity of foods and liquids, or display mealtime behaviours that are inappropriate for his/her age.

Dysphagia can occur at any phase of the swallow. Although there are differences in the structures of the swallowing mechanism in infants, children, and adults, and the way those structures work, typically, the phases of the swallow are defined as follows:

Oral Preparatory Stage- preparing the food or liquid in the mouth to form a bolus (collection of food or liquids), including sucking liquids, moving soft boluses around the mouth, and chewing solid food.

Oral Phase- moving the bolus back in the mouth toward the throat.

Pharyngeal Phase- initiating the swallow; moving the bolus through the throat.

Esophageal Phase- moving the bolus through the esophagus and into the stomach, via peristalsis (squeezing of the muscles). (Logemann, 1998).


All the swallowing phases are connected, and a problem during one of these phases will result in a problem in the other phases to some degree. We do not look at swallowing simply as a reflex, but as an elicited pattern response. The efficiency of each phase depends on the efficiency of the previous one, so we use a holistic approach to treat dysphagia, addressing all phases of the swallow.

The primary goals of feeding and swallowing intervention for children include the following:
  1. Adequate nutrition and hydration (fluids)
  2. Optimum feeding methods/techniques to make swallowing and feeding as safe and efficient as possible
  3. Collaboration with family to incorporate dietary preferences
  4. Age-appropriate eating skills in the most normal setting and manner possible (e.g., eating meals with peers at preschool)
  5. Minimized risk of pulmonary (lung) complications
  6. Maximized quality of life
  7. Prevention of future feeding issues with the most positive feeding/oral experiences possible, given the medical situation.
  8. Eating and drinking that is as safe and effective as possible

In pediatric dysphagia management, the overall health of the child is the primary concern. The intervention processes and techniques must never jeopardize the child’s safety, nutrition and pulmonary (lung) status.

At SVS, we are trained to work with children with dysphagia and their families to optimize the feeding skills and abilities of these children. Also, we work closely with other professionals to wean these children safely from tube feeding to oral feeding whenever possible.

Our speech-language pathologist Mohamed A. Mohamed is a Certified Vital Stimulation Therapy therapist (Vital Stim) and a Certified Orofacial Myologist, with solid experience in this area.

Swallowing, Voice and Speech Rehab SVS
7916 Hurontario Street, Unit #31
Brampton
ON
L6Y 0P6
905-302-0998

          


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