Medical Assessment

The multidisciplinary assessment of pediatric feeding disorders must include a thorough physical examination of the child. This examination is needed to rule out structural and functional problems related to chewing, swallowing, and digesting food (Rudolph and Link 2002). However, as Rudolph and Link (2002) noted, the absence of apparent physical signs of dysfunction does not exclude the possibility of a physical cause. In addition to the basic physical examination, a variety of more invasive procedures may be helpful in identifying underlying medical causes of feeding problems. A full review of these studies is beyond the scope of this chapter; however, the reader is referred to Rudolph and Link (2002) for a more detailed discussion of the endoscopic and imaging studies that are indicated for children presenting with a variety of feeding problems. Also, tests that allow for observation of the feeding process in action (e.g., videofluoroscopic swallowing studies) can help identify problems involved in moving food through the digestive pathway. For discussion of indications for videofluoroscopic swallowing studies and fiber-optic endoscopic evaluations of swallowing, see Miller et al. (2001).

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