Information for People with Disabilities

Understanding the state of the evidence regarding dysphagia in people with intellectual disabilities.

Introduction 

Dysphagia (difficulties in eating, drinking or swallowing) is associated with serious health complications and psychosocial sequelae. Dysphagia is a key concern in relation to people with intellectual disabilities. ^[1]

Prevalence 

Dysphagia in General Population

• Older people – an estimated 50-75% of care home residents have some difficulty swallowing. ^[2]
• Children – Research suggests that the incidence of feeding difficulties is between 25-45% in typically developing children. ^[3] A child’s ability to swallow medication is dependent on the individual. ^[4]

Dysphagia in Patients with learning disability ^[5]

• 5.0% of patients with a learning disability also had a diagnosis of dysphagia, with the highest prevalence recorded in patients aged 75 and over (11.7%).
• Dysphagia is more common in people with more severe learning disabilities, in people with learning disabilities who have cerebral palsy, and is also associated with motor impairment. Specific syndromes associated with learning disabilities can result in both anatomical and neurological precursors for dysphagia, including Down syndrome.

Healthcare and treatment ^[5]

There is very little research evidence available on current practice in relation to supporting people with learning disabilities and dysphagia. Individualised interventions include altering positioning, modification of food and drink consistency, giving advice on equipment, and working on the physical environment through carer training. Numerous barriers to compliance with eating and drinking recommendations have been identified. Education to increase knowledge of dysphagia and its associated risks amongst caregivers can increase adherence to dysphagia management guidelines. There is an urgent need for research on improving the management of dysphagia in people with learning disabilities including positioning, dietary modification and long-term postural care. which may prevent changes in body shape that can cause problems with swallowing.

The quality of caregiver support provided to people with learning disabilities and dysphagia can have an influence on health and ultimate risk of death. Despite dysphagia being identified as a key risk area for people with learning disabilities, less than 20% of inpatients with learning disabilities were found to have received a swallowing assessment.

ROS000051-010 DOP November 2023