Overall Contraindications/Precautions
› There is a high risk of infant mortality in CHARGE syndrome due to heart conditions and choanal atresia. Parents are
often focused on infant survival and surgical procedures during the first few months of life rather than on other aspects of
development(1)
› Symptoms associated with CHARGE syndrome vary, and precautions will differ according to the individual patient and the
severity of accompanying language, cognitive, vision, hearing, and/or motor impairments
› Feeding difficulties associated with CHARGE syndrome are diagnosed in infancy; therefore, evaluation precautions will also
be determined by the patient’s age and family concerns
› When performing a feeding assessment with children with CHARGE syndrome, the assessment team must take into account
hearing and vision deficits associated with the syndrome
› To conduct a feeding and swallowing evaluation and to provide swallowing treatment for a child with CHARGE syndrome,
speech-language pathologists (SLPs) are required to have graduate, postgraduate, or continuing education training
specifically in pediatric dysphagia assessment and treatment(14)
› To perform videofluoroscopic swallowing studies (VFSSs), SLPs must have established competencies in the use and storage
of barium used in VFSSs(15)
› Children with dysphagia are at risk for insufficient food/liquid intake, stunted skeletal growth, poor weight gain, anemia,
dental problems, nutritional deficiencies, aspiration, and/or penetration of oral intake.(16) Early assessment of swallowing
in children with CHARGE syndrome is indicated to detect these potential problems and implement early intervention
programs(16)
› Ensure that the family/caregivers and patient (if age appropriate) are aware of the risks associated with f