Epidemiology and etiology

Data on the incidence of swallowing disorders are lacking, because in clinical practice, disorders of swallowing are often considered in the general context of a feeding disorder. Feeding is a complex process that involves a number of phases in addition to the act of swallowing, including the recognition of hunger (appetite), the acquisition of food and the ability to bring the food to the mouth.1 The estimated prevalence of feeding problems in the pediatric population ranges from 25 to 35% in normally developing children, and from 40 to 93% in children with developmental delay.2,3

Disorders of sucking and swallowing may be caused by multiple etiological factors that may interfere with the child's ability to coordinate swallowing and breathing maneuvers and may be manifested as a unique set of symptoms. Potential causes are in three broad categories: immaturity, delay, or a defect in neuromuscular control; an anatomic abnormality of the aerodigestive tract; and/or systemic illness. The magnitude of the dysfunction depends on the balance between the extent of the structural or functional abnormality and the child's compensatory adaptations.4 Disorders associated with sucking and swallowing difficulties are listed in Table 15.1.5

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