Introduction

The development of feeding skills is an extremely complex process influenced by multiple anatomic, neurophysiological, environmental, social and cultural factors. This entire process is dynamic because of ongoing growth and development. Functional feeding skills, which depend on the integrity of anatomic structures, undergo change based on neurological maturation and experimental learning.

There are a variety of neurological, neuromuscular conditions in children and in infants that can impair the physiological phases of sucking and swallowing and cause disorders of feeding and dysphagia.

In recent years, there has been an increase in infant swallowing disorders as a result of improved survival rates for infants born prematurely or with life-threatening medical disorders. Disorders of feeding and swallowing in children are serious and potentially fatal problems. Aspiration due to dysphagia may lead to severe pulmonary disease, and impaired oral and pharyn-geal function may rapidly result in failure to thrive. Prompt evaluation of swallowing disorders is therefore critical.

The differential diagnosis of dysphagia in children is widespread. The diagnostic work-up can be extremely difficult and exhaustive in many cases. Because of this complexity, multidisciplinary team evaluations should be conducted.

Successful rehabilitation of children with swallowing disorders requires knowledge of the parameters of normal and abnormal swallowing plus skill in the integration of a variety of essential therapeutic techniques.

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