A videofluoroscopic study of 13 infants and children with Pompe disease showed that dysphagia was always present, and swallowing difficulty did not correlate with gross motor function (Jones et al., 2010). Speech problems can also occur in Pompe disease, with disorders of articulation and/or nasal resonance occurring in approximately 80% of the subjects in a recent report (Muller et al., 2009). Of note, the authors speculated that speech deficits in Pompe disease likely occurred due to “disturbance in muscular control of the speech mechanisms resulting in weakness secondary to lower motor neuron involvement”.