What is the leading cause of oropharyngeal dysphagia in children with Down syndrome?

Hypotonia, or decreased muscle tone, is the leading cause of oropharyngeal dysphagia in children with Down syndrome. In these children, hypotonia affects the muscles involved in swallowing, leading to difficulties in coordinating the movements necessary for safe and effective swallowing. This condition can result in problems such as aspiration, where food or liquid enters the airway instead of the esophagus, and can cause feeding difficulties along with an increased risk of respiratory complications.

While digestive problems directly relate to the gastrointestinal system and can affect overall feeding, they do not primarily account for the problems seen in oropharyngeal dysphagia. Pneumonia, although a significant health concern in children with swallowing difficulties, is more of a consequence of dysphagia rather than its primary cause. Aversive feeding behaviors can also be a factor in some children, often stemming from negative past experiences with eating or medical procedures, but they are not the underlying physiological cause of oropharyngeal dysphagia in this population. Thus, hypotonia stands out as the primary issue impacting the swallowing process in children with Down syndrome.