October 2023 Pediatrics Newsletter


“Supporting the fighters, Admiring the survivors, Honoring the taken, and Never Ever Giving Up H O P E”

Hi all! For anyone new to the newsletter, my name is Ashley Stone, and I am the pediatric SLP at DiagnosTEX. Our outpatient Modified Barium Swallow Study clinic is now open for pediatric patients of all ages! We have supported seating devices for those in need and have the capability to also complete studies in a side-lying position. We accept most insurances. Contact me for more information on how to make a referral. My contact information is at the end of this newsletter.

Research Review – Duncan DR, Larson K, Davidson K, May K, Rahbar R, Rosen RL. Feeding Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration. J Pediatr Gastroenterol Nutr. 2019 Feb;68(2):218-224. doi: 10.1097/MPG.0000000000002167. PMID: 30320668; PMCID: PMC6501833.

The primary aim of this study was to determine if children with laryngeal penetration who received intervention had fewer hospitalizations and improved symptoms compared to those without any intervention. These authors reviewed the records of children under the age of 2 that presented with laryngeal penetration, but no aspiration, during a Modified Barium Swallow Study conducted at Boston Children’s Hospital in 2015. In total, 137 subjects were included in the retrospective study.

Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration diagram


  • 62% - deep penetration
  • 32% - shallow penetration
  • 31% - consistent penetration
  • 54% - inconsistent penetration
  • 15% - only 1 instance of penetration

Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration data table

The key take-away points, in my opinion:

  • Decreased total & pulmonary hospitalizations for those receiving some intervention (thickening or changing flow rate).
  • No significant decrease in total & pulmonary hospitalizations for those who received no intervention. This may suggest that symptom improvement does not naturally occur over time. However, in my experience, I have noticed that children who penetrate/aspirate on the bottle, tend to do well once they have transitioned to a straw cup. This study only looked at bottles.
  • Patients whose penetration was believed to be transient & therefore did not receive intervention, ended up with pulmonary/gastrointestinal hospitalizations, indicating that any degree of laryngeal penetration should be treated with intervention.
  • An association was made between coughing & the presence of laryngeal penetration. Hybrid & Zoom: October 11th – 12th from 4-6pm

There is a lot of good information in this article that I employ you to read on your own time. I was able to find this article for free at www.ncbi.nlm.nih.gov/pmc/articles.

Medical Needs “Closet” – I am starting a “closet” of medical/feeding/dysphagia supplies that can be distributed to families in needs. I know there are so many blessed families that get excess of supplies from insurance, and those supplies often get thrown away. I am still working out the kinks of how to determine who gets supplies & how to distribute them, so I am not ready to distribute just yet. HOWEVER, if you personally have supplies or know of a family that does and want to donate, please reach out to me! Stay tuned for more info as this develops.

Come see DiagnosTEX at the Concept Pelvic Health Trunk-or-Treat on Oct 26th from 6-8pm.

1801 Rufe Snow Dr; Keller, Tx 76248

AmpCare: Have you heard about AmpCare and want to become a certified user? They offer In-person certification courses, as well as a hybrid option. This month, they are only offering the hybrid course in our area. Check their calendar on the website for future dates (swallowtherapy.com).

Contribution: Do you have an interesting topic that you would like to share in a newsletter, whether it be a research article you have read or a patient you have treated? Email me if you are interested!

I, and the rest of the DiagnosTEX staff, look forward to helping you serve your patients and ensure a safe diet for ALL children.

Keep an eye out for a newsletter each month & feel free to share with your colleagues and friends!

Dates to Remember:
October 4/5 – Yom Kippur
October 10 – Columbus Day
October 16 – Boss’ Day
October 22 – National Stuttering Awareness Day
October 23-31: Red Ribbon Week