Objective measures of dysphagia complexity in children related to suckle feeding histories, gestational ages, and classification of their cerebral palsy

Data collected during the routine assessment of 117 dysphagic children with cerebral palsy have been related to both suckle feeding histories and gest ational ages and to the classification of cerebral palsy. In addition, a co ncurrent survey involving 281 children with cerebral palsy in special schoo ls was undertaken which revealed that the sample of referred children appea red to be a true representation of a wider population of dysphagic children with cerebral palsy. A Feeding Difficulty Symptom Score (FDSS) describes t he severity of swallowing symptoms reported. A numerical Dysphagia Complexi ty Index (DCI) quantifies numerically the neurological complexity of the sw allowing difficulty. The FDSS correlates closely with the DCI. Twenty-seven percent of mothers of the children who were referred for advice on their p resent swallowing difficulties stated that they recalled no suckle feeding problems. However, there was no difference in the severity of present swall owing difficulties between those infants who suckle fed well and those who experienced severe difficulties. Those referred children with cerebral pals y born at term exhibited more complex later swallowing problems and were mo re likely to be classified as athetoid than those born preterm.