By Justine Joan Sheppard, PhD, CCC-SLP, BRS-S
We expect that our children will learn to eat, drink and swallow their saliva without difficulty. We expect that they will grow steadily in height and weight as a result of their good eating skills, their safe and efficient swallowing and the good food we provide for them.. As infants they master sucking from a nipple. As they age they are offered various foods. By the time they are three years old they will typically develop the skills and behaviors needed to eat table foods with their family in a variety of social settings. Over these first years we have the expectation that the child’s eating and saliva control will follow a typical sequence.
However, many children experience difficulty. Infants who are born prematurely have to be helped to master sucking skills, and often to transition to solid foods. Infants who are transitioning to spoon feeding may experience difficulty swallowing the thicker foods and the larger bites that are offered. They may cough, gag, vomit and refuse food, and they may drool excessively. In those first two, years infants may experience difficulties learning to chew, to drink from a cup and to feed themselves. Some children may have difficulty learning the co-ordinations and developing the stamina and strength to direct food toward the stomach during swallowing and avoid miss-swallowing into the airway. As many as 25 to 40% of typically developing infants and children have been estimated to experience feeding and swallowing disorders at some time during these early years. In children with disability these problems may persist as they grow older. The estimate for children with disability is that 33 to 80% experience these problems. Some of these children will have difficulty maintaining good nutrition and hydration and healthy lungs because of swallowing problems. Some will not advance to eat table foods, to feed themselves or to eat easily with others.
Parents may work out these problems by themselves or with the advice of family and friends. They may discuss the problem with the child’s doctor. On recommendation of the doctor or on their own, they may consult with a speech-language pathologist (SLP). SLPs have special training for treating swallowing and feeding disorders. They evaluate the child to see what may be causing the problem and what can be done to improve skills to get the child back on the right, developmental track. They work with the child and the parent as the condition improves to assure that the child is eating and swallowing safely. They help the family to get any specialized medical or clinical care that may be needed.
When there is a feeding and swallowing disorder, the goal is to improve the child’s eating and swallowing skills and eating enjoyment as soon as possible. In this way, good eating behaviors and good motivation to eat can be maintained.
For more information, visit www.swallowingdisorders.org.