title: Oropharyngeal aspiration and silent aspiration in children.
abstract: BACKGROUND
  Limited information exists about the nature of and factors associated with oropharyngeal aspiration (OPA) and silent aspiration (SA) in children. A prospective study was undertaken to determine the factors associated with fluoroscopically identified OPA and SA.
  
  
  METHODS
  Three hundred children presenting with feeding difficulties underwent a videofluoroscopic swallow study (VFSS) for evaluation of swallowing. Swallowing performance on each food and fluid consistency was rated using the penetration-aspiration scale, and children were classified into the following groups: OPA, SA, overt aspiration (OA), and no aspiration (NA).
  
  
  RESULTS
  OPA occurred in 34% of children; of these, 81% had SA. SA was significantly associated with neurologic impairment (OR, 4.65; 95% CI, 2.26-9.54), developmental delay (OR, 4.62; 95% CI, 2.28-9.35), aspiration lung disease (OR, 3.22; 95% CI, 1.29-8.05), and enteral feeding (OR, 2.03; 95% CI, 1.04-3.62). Similar results were found for OPA. Children with SA were more likely to have neurologic disease (OR, 4.1; 95% CI, 1.1-15.8) than those with OA. Age or gender differences, gastroesophageal reflux disease, recurrent respiratory tract infections, and asthma were no more likely to occur in children with OPA, SA, or OA.
  
  
  CONCLUSIONS
  SA is very common in children with feeding difficulties and is most likely to occur in children with a neurologic problem. Limited medical diagnoses distinguished between aspirators (OPA, SA) and those with NA. VFSS should be performed in children with feeding difficulties and diagnoses of neurologic impairment, cerebral palsy, aspiration lung disease, and/or enteral feeding because of the increased likelihood of SA.
authors: Speech Pathology Department, Royal Children's Hospital, Brisbane, QLD; Queensland Children's Medical Research Institute, University of Queensland, QLD. Electronic address: k.weir1@uq.edu.au.
authors: Kelly A
authors: KA
authors: Weir
authors: SpeechNet Speech Pathology Services, Queensland, QLD.
authors: Sandra
authors: S
authors: McMahon
authors: Department of Respiratory Medicine, Royal Children's Hospital, Brisbane, QLD.
authors: Simone
authors: S
authors: Taylor
authors: Department of Respiratory Medicine, Royal Children's Hospital, Brisbane, QLD; Queensland Children's Medical Research Institute, University of Queensland, QLD; Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
authors: Anne B
authors: AB
authors: Chang
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D001239:Inhalation; D008171:Lung Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D015999:Multivariate Analysis; D011015:Pneumonia, Aspiration / Q000150:complications / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D014741:Video Recording; D055815:Young Adult