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Recurrent aspiration — RACP Paediatrics MCQ

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ModerateRespiratoryRecurrent aspirationRACP Paediatrics

A 3-year-old with cerebral palsy and GMFCS level V has had 5 episodes of pneumonia over the past year affecting different lobes. The child has frequent drooling, choking with feeds, and a wet voice. What is the most likely underlying cause?

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Correct answer: E — Recurrent aspiration

Recurrent pneumonia in different lobes in a child with neurological impairment, drooling, and feeding difficulties strongly suggests recurrent aspiration. A videofluoroscopic swallow study (VFSS) or fibreoptic endoscopic evaluation of swallowing (FEES) should be performed. Modification of feeding consistency and positioning may be required.

Reference: RCH Melbourne – 2023 – Aspiration CPG; RACP Paediatric Curriculum – Respiratory