Overview of dysphagia in people with developmental disability

Dysphagia (ie difficulty swallowing) is common and often overlooked in people with developmental disability—prevalence data suggests that dysphagia affects over 50%. Dysphagia is especially common in people with Down syndrome or intellectual disability, and those with cerebral palsy.

The occurrence of dysphagia may vary according to life stage. Infants diagnosed with or at risk of cerebral palsy or intellectual disability, and older people with developmental disability, are more likely to have difficulty swallowing. Many common medications can cause or exacerbate dysphagia—see Drug-related dysphagia.

Consequences of dysphagia can include:

• aspiration (eg inhaling food, fluid, saliva)
• respiratory disease (eg aspiration pneumonia)
• death (ie from choking on food)
• nutritional compromise (eg malnutrition, dehydration)
• social isolation, poor psychosocial health (eg depression, anxiety)
• reduced quality of life (eg loss of preferred foods, reduced participation in the social aspects of meals).

Aspiration pneumonia and choking on food are common causes of premature death in people with developmental disability.

Eating and drinking foods and fluids that are not of the appropriate texture or thickness can be life threatening to a person with dysphagia. The person may also need specific supports for positioning, mealtime assistance, and assistive technology to have safe mealtimes.