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Schoolchildren With Dysphagia Associated With Medically Complex Conditions

Joan C. Arvedson
Children's Hospital of Wisconsin–Milwaukee Medical College of Wisconsin–Milwaukee

Contact author: Maureen A. Lefton-Greif, Division of Pediatric Pulmonary, Johns Hopkins Children's Center, The David M. Rubenstein Child Health Building, 200 North Wolfe Street, Eudowood Division of Pediatric Respiratory Sciences, Room 3017, Baltimore, MD 21287-2533. E-mail: mlefton{at}jhmi.edu.

Purpose: This article reviews population trends and general characteristics of children with dysphagia in schools, provides an overview of dysphagia teams and the roles of the speech-language pathologist (SLP) in school and hospital settings, and describes assessment and treatment of swallowing and feeding problems in children with complex medical histories.

Method: A review of the literature of swallowing and feeding problems in young children and population trends for children who are at risk for dysphagia was completed. Two case studies are presented to illustrate the complexities that are common to this population and to provide practical information to maximize the health and education outcomes of children with dysphagia.

Results: SLPs in schools are increasingly evaluating and treating children with dysphagia associated with medically complex conditions. There is a rising incidence in preterm births and the survival of medically fragile children, suggesting that a greater number of children will be at risk for dysphagia in the future. Limited evidence is available to support most therapeutic interventions.

Conclusion: School-based SLPs are uniquely positioned to identify swallowing and feeding problems, evaluate and treat children with dysphagia, participate on dysphagia teams in the school setting, and interact with the medical team.

KEY WORDS: deglutition, feeding, swallowing, pediatric, team

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