Clinical presentation of dysphagia in a person with developmental disability

A person with dysphagia or aspiration of food or fluids may present with:

• visible or audible signs of swallowing difficulty (eg coughing, choking, drooling, food avoidance or refusal, slow eating)
• choking on foods, fluids or saliva
• fatigue associated with eating or drinking
• being underweight or unintentional loss of weight
• acute or recurrent respiratory illness or symptoms (eg pneumonia, night cough, asthma-like wheezing, recurrent chest infections).

Silent aspiration (ie aspiration that occurs without triggering a cough reflex) is common in children with developmental disability. It can only be determined by specific instrumental investigations (see Investigations).