Pediatric Swallowing Overview

Principles

Definition

Pediatric swallowing is a specialized area of study and clinical practice focused on the physiological processes, developmental milestones, and potential disorders related to the act of deglutition in infants, children, and adolescents. This field investigates typical swallowing development and function, as well as the etiology, assessment, and management of dysphagia (swallowing difficulties) in the pediatric population, which is critical for ensuring adequate nutrition, hydration, growth, and respiratory health.

Ontological type

Clinical Assessment

Intervention Approaches

Etiology and Risk Factors

Key developments

Key Figures

Imaging and Quantification era

Peter J. Kahrilas [1] conducted imaging-driven pediatric swallowing research during the Imaging and Quantification era, with affiliations at Northwestern University [3] and Yale University [4]. Kahrilas [1] highlighted how swallowed bolus variables influence oral and pharyngeal swallowing phases [7], demonstrated volitional augmentation of upper esophageal sphincter opening during swallowing [8], and linked pharyngeal clearance to a combined manometric and videofluoroscopic approach [9], collectively advancing mechanistic phenotyping of pediatric dysphagia for this era. Ian J. Cook [2] collaborated with the University Gastroenterology [5] and McMaster University [6] during this era. Cook [2] advanced understanding by detailing the timing of videofluoroscopic, manometric events and bolus transit during the oral and pharyngeal phases [11], elucidating the opening mechanisms of the human upper esophageal sphincter [10], and examining the effects of swallowed bolus variables on swallowing [7], which helped establish dynamic models of airway protection and bolus coordination in pediatric swallowing.

Sensorimotor Multidisciplinary Care era

Jeri A. Logemann [1] is associated with Northwestern University [3] and the University of Wisconsin–Madison [4] during this era. Her key contributions include The evaluation and treatment of swallowing disorders [6], Temporal and Biomechanical Characteristics of Oropharyngeal Swallow in Younger and Older Men [7], and Effects of Two Breath-Holding Maneuvers on Oropharyngeal Swallow [8], which advanced standardized assessment and understanding of swallow mechanics for multidisciplinary care. Barbara C. Sonies [2] is affiliated with University of Maryland, College Park [5] during this era. Her key contributions include Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia [9], Emergence of oropharyngeal, laryngeal and swallowing activity in the developing fetal upper aerodigestive tract: an ultrasound evaluation [10], and Motor Strategy in Rapid Sequential Swallowing [11], which broadened noninvasive therapies, fetal and developmental assessment, and motor-control strategies in sensorimotor multidisciplinary care.

Holistic Cross-disciplinary Care era

Erika G. Gisel [1] is associated with McGill University [3] during the Holistic Cross-disciplinary Care era (2015–2021). Erika G. Gisel [1] advanced pediatric swallowing research by articulating the Pediatric Feeding Disorder concept in the 2018 paper Pediatric Feeding Disorder [6], helping to unify medical, nutritional, psychosocial, and skill-based domains within standardized care pathways. Susan E. Langmore [2] is linked with Boston University [4] and Augusta University [5] in this era, and her work on instrumental swallowing assessments is captured in the 2016 paper Parameters of Instrumental Swallowing Evaluations: Describing a Diagnostic Dilemma [7]. This contribution provided evidence-based parameters for instrumental evaluation that supported standardized, multidisciplinary protocols and telehealth-enabled screening as described in this era.