Is there an evidence base to the management of paediatric dysphagia?

Dysphagia is a prevalent, debilitating and costly disorder in terms of social distress to patients and their families, and admissions/readmissions to hospital. Dysphagia affects the volume, type and texture of food that can be eaten and the speed at which food can be ingested. As a result, some children are unable to meet their daily nutritional requirements and become malnourished. Feeding may also be ‘unsafe’ because of the risk of aspirating food and/or liquid into the airway. Evidence-based practice is a lifelong process of self-directed learning in which increased use of science, research and evidence is made to guide clinical decision making. In terms of speech pathology practice, it requires us as speech pathologists to integrate our individual clinical expertise with the best available evidence from systematic research. In paediatric dysphagia, this necessitates moving away from basing decisions on opinion, past practice and past teachings towards making clinical decisions that are guided by science, research and evidence. This paper will explore some of the issues facing speech pathologists working in the field of paediatric dysphagia and discuss the challenges that exist in establishing an evidence base for the management of paediatric dysphagia.