Assessment and intervention for dysphagia in infants and children: beyond the neonatal intensive care unit.

Over the last 10 years, the assessment and intervention for feeding and swallowing problems in infants and children have attracted increased attention on a national and international level. Increases in the population of children with dysphagia are due, in large part, to advances in medical and surgical management of at-risk term infants, improved medical support for viability of younger and smaller preterm infants, and increases in the number of children on the autism spectrum. Because of legislative initiatives, settings in which children are seen for assessment and intervention have shifted, with services provided more often in the natural environments of homes, daycares, preschools, and schools, as well as in hospitals and outpatient clinics in the United States. Assessment of infants and children with dysphagia continues to include clinical and instrumental evaluations with clinical assessment including a specific focus on the feeding environment. Speech-language pathologists are increasingly assuming consultative roles to support the needs of children in all settings. Areas for further research in the era of evidence-based practice include efficacy of oral exercises and other intervention strategies.