Special Considerations for the Pediatric Population Relating to a Swallow Screen Versus Clinical Swallow or Instrumental Evaluation

Abstract

Careful consideration should be taken to determine how a swallow screen could be implemented in the pediatric population. A variety of factors to be considered include: age, developmental level, feeding experience of the child, diagnosis, the status of the child's dysphagia, and the setting where the patient is treated. A swallow screen might be feasible in specific situations in the pediatric population to identify aspiration risk in those with a change in normal swallow status. Yet, more research is needed to improve the accurate identification for the pediatric population of aspiration risk and other signs of dysphagia that warrant an instrumental assessment. While risk for aspiration is a concern in this population, it is not the only concern due to the dynamic changes in feeding and swallowing performance that occur throughout childhood. These dynamic changes require a thorough clinical observation that neither a swallow screening nor instrumental assessment can provide the clinician. Thus, the clinical swallow evaluation (CSE) remains the most comprehensive tool available to assess oral feeding skill development and function, as well as, to identify risk factors for not only aspiration, but for other aspects of dysphagia, which may warrant an instrumental assessment.