Pediatric Swallowing Disorders: How They Differ from Adult Cases

Q: What is a swallowing disorder (dysphagia)?

A: Dysphagia is difficulty moving food, liquid, or saliva safely from the mouth to the stomach. It can happen in people of all ages—but in children, it often looks very different from adult cases.

Q: How do pediatric swallowing disorders differ from adult ones?

A:

• Cause:
  • Children: Often developmental, structural (tongue tie ankyloglossia, cleft palate), sensory, or related to prematurity.
    
  • Adults: More commonly linked to stroke, surgery, aging, or neurological disease.
    
• Presentation:
  • Children: Difficulty transitioning from milk to solids, gagging, picky eating, coughing during meals, slow weight gain.
    
  • Adults: Coughing with liquids, sensation of food “sticking,” weight loss, aspiration pneumonia.
    
• Impact:
  • Children: Affects growth, nutrition, airway development, and social participation.
    
  • Adults: Affects nutrition, safety, and independence.

Q: What are signs of pediatric swallowing disorders?

A:

• Frequent coughing, gagging, or choking while feeding
  
• Long feeding times (>30–40 minutes)
  
• Food refusal or strong aversions to textures
  
• Recurrent respiratory infections or pneumonia
  
• Poor weight gain or growth delays
  
• Wet or gurgly voice after swallowing
  
• Mouth breathing or difficulty coordinating suck-swallow-breathe sequence

Q: How are pediatric swallowing disorders evaluated?

A: At BreatheWorks, evaluation includes:

• Review of medical and feeding history
  
• Oral motor assessment (tongue, lips, jaw strength and coordination)
  
• Swallow observation (liquids, purees, solids as age-appropriate)
  
• Breathing patterns (mouth vs. nasal)
  
• Posture and airway evaluation
  
• Collaboration with pediatricians, ENTs, GI specialists, and dentists/orthodontists for a full picture

Q: How does therapy help children with swallowing disorders?

A: Therapy may include:

• Oral motor strengthening (lips, tongue, jaw)
  
• Swallow retraining for safe and efficient patterns
  
• Sensory desensitization to expand texture tolerance
  
• Breathing and posture support for airway protection
  
• Parent/caregiver coaching to build safe mealtime routines
  
• Feeding strategies (pacing, positioning, texture adjustments)

Q: Can therapy be done virtually for children?

A: Yes. Our telehealth program matches in-person outcomes. Virtual care includes:

• Observation of real mealtime routines at home
  
• Parent/caregiver coaching in real time
  
• Live exercise demonstrations for oral motor skills
  
• Ongoing progress tracking

This makes care accessible nationwide—even for families far from our clinics.

Q: Where does BreatheWorks provide care?

A:

• In-person clinics: Portland, OR • Eugene, OR • Lake Oswego, OR • Bellevue, WA • Amarillo, TX
  
• Virtual therapy: Available nationwide

Quick FAQs 

Can children outgrow swallowing disorders? Not always—some improve with age, but many need therapy to ensure safe and efficient swallowing.

How do pediatric swallowing issues affect speech? Shared oral muscles mean swallowing challenges often overlap with speech delays.

Can picky eating be a swallowing issue? Yes—sometimes avoidance of textures comes from discomfort or poor swallowing coordination.

Is pediatric swallowing therapy safe for infants? Yes—with careful evaluation and parent involvement, myofunctional therapy is safe and effective.

Next Steps 

If your child struggles with swallowing or feeding, early therapy can prevent long-term complications and reduce family stress.

• Schedule a pediatric swallowing evaluation (in-person or virtual)
• Providers: Refer a child to BreatheWorks