Interventions for oropharyngeal dysphagia in children with neurological impairment (Review)

Abstract

Oropharyngeal dysphagia, or swallowing difficulty, can be defined as problems with chewing and preparing food, difficulty moving food through the mouth to the back of the tongue, and difficulty with swallowing and movement of food through the 'throat' or pharynx. Many children with neurological impairment experience swallowing difficulties, including those with acquired brain impairment (for example, cerebral palsy, traumatic brain injury, stroke), genetic syndromes (for example, Down syndrome, Rett syndrome) and degenerative conditions (for example, myotonic dystrophy). This review examined the effectiveness of interventions for oropharyngeal dysphagia in children with neurological impairment. The three studies included in the review examined oral sensorimotor treatments and lip strengthening interventions. We were interested in three primary outcomes, which were physiological functions of the oropharyngeal mechanism for swallowing (for example, lip seal maintenance), the presence of chest infection and pneumonia, and diet consistency, and three secondary outcomes, which were changes in growth, child's level of participation in the mealtime routine, and the level of parent or carer stress associated with feeding. We concluded that there is currently not enough high-quality evidence from randomised controlled trials or quasi-randomised controlled trials for any particular type of oropharyngeal dysphagia intervention in this population of children. There is a need for larger-scale randomised controlled trials to evaluate the effects of interventions for oropharyngeal dysphagia in children with neurological impairment