Jay Paul Willging MD, Robin T. Cotton MD

Feeding disorders in children are the result of a diverse group of causes. Twelve children with dysphagia and structural abnormalities of the aerodigestive tract were evaluated by fiber-optic endoscopic evaluation of swallowing. The structural anomalies included vocal cord paralysis (4), posterior laryngeal cleft (5), and tracheoesophageal fistula (8). Behavioral abnormalities were manifested in 1 patient, with severe oral aversion. Poor oromotor skills were identified in 8 patients. Generalized pharyngeal motility problems were apparent in 2 patients. Two children had normal swallows. Children with structural aerodigestive tract abnormalities must be enrolled in an appropriate speech pathology program to encourage the development of age-appropriate oral motor skills. This will allow initiation of oral feeding when the clinical condition permits.