Dysphagia is a swallowing and feeding disorder that occurs when a child has difficulty swallowing either foods or liquids (including saliva), or both.
In severe cases, some children with dysphagia cannot swallow at all.
Generally, signs of dysphagia include:
- Coughing or choking when eating, drinking, or swallowing saliva
- Regurgitating food, at times through the nose
- Feeling as though food is stuck in the throat or chest
- Persistent drooling
- Difficulty or inability to properly chew food
- Gurgling noises when eating or drinking
Symptoms of dysphagia also differ slightly depending on the age of the child.
| Symptoms of dysphagia in infants and toddlers: Arching back Coughing Choking Difficulty breathing while eating Excessive crying Vomiting (more than spit-up) | Symptoms of dysphagia in young children: Coughing: Choking Difficulty breathing while eating Drooling Eating slowly Feeling like there is food stuck in throat Weight loss/lack of weight gain Voice sounds different |
What causes Dysphagia?
As swallowing is a complex process, there are many reasons why dysphagia can develop. Causes of dysphagia include neurological problems like strokes, developmental conditional conditions like learning disabilities and cerebral palsy, or even other complex medical conditions.
The importance of early intervention for your child
Common problems related to dysphagia are coughing or choking when food or liquids go down the wrong pipe and irritate or block a child’s airway. Without appropriate treatment, this can lead to repeated chest infections over time.
Due to a fear of choking, some children may even avoid eating and drinking. This leads to weight loss, a lack of essential nutrients for physical and mental development, and malnutrition and dehydration in severe cases. This also affects a child’s quality of life and may also cause behavioral problems as these children find mealtimes stressful.
The sooner a child receives the necessary support, the better their prognosis and outcome. With the support of an experienced speech and language therapist, the speech therapist will help the child capitalize on strengths and address weaknesses regarding feeding, facilitate participation in various activities, and promote a meaningful and functional mealtime experience for children and their families.
How is Dysphagia diagnosed?
Dysphagia is typically diagnosed by an experienced speech and language therapist (SLT) who will conduct a swallow test. A swallow test provides a good initial assessment of a child’s swallowing abilities.
The speech and language therapist will first ask the child to swallow some water. While swallowing, the SLT will record the amount of time taken to drink the water and the number of swallows required. Next is the food segment of the swallow test. The child will be asked to chew and swallow a soft piece of pudding or fruit. This allows the SLT to assess so how well the child’s lips, tongue and the muscles in their throat work.
How is Dysphagia treated?
Treatment selection will depend on the child’s age, cognitive and physical abilities, and specific swallowing and feeding problems. Dysphagia can often be improved with careful management, including speech and language therapy, psychotherapy to assist with behavioral and social difficulties, and medication or surgery if needed.
Behavioral interventions may also be carried out to increase the occurrence of appropriate actions or behaviors and reduce maladaptive behaviors, as well as to implement basic mealtime principles, such as scheduled mealtimes in a neutral atmosphere with no food rewards.
Speech Therapy
A speech and language therapist is the first line of treatment. The SLT will support a child and their caregivers in the following ways:
- Determining the optimum feeding methods and techniques to maximize swallowing safety and feeding efficiency.
- Teaching a child special swallowing exercises and positioning techniques to protect the airway and ensure safer transit of food and liquid.
- Educating parents on how to adjust the type of food the child eats to ensure adequate nutrition and hydration.
- Collaborating with family to incorporate dietary preferences
- Helping the child attain age-appropriate eating skills in the most normal setting and manner possible (e.g., eating meals with classmates in school and with the family at home)
If you suspect your child has dysphagia, reach out to the experienced child speech therapists and child psychologists at Annabelle Kids located in Singapore for assessment and management of feeding disorders.