A descriptive investigation of dysphagia in adults with intellectual disabilities.
One in twelve adults with ID has dysphagia—screen those with CP or severe impairment.
01Research in Context
What this study did
Casey et al. (2009) looked at how many adults with intellectual disability (ID) living in the community have trouble swallowing.
They checked medical charts and used a standard swallow test to spot dysphagia.
The team also noted who had cerebral palsy, how severe the disability was, and any other health issues.
What they found
About 8 out of every 100 adults with ID had dysphagia.
The risk was highest in people who also had cerebral palsy, could not walk, or had severe cognitive impairment.
No numbers on age or gender were given, but the link to CP and mobility was clear.
How this fits with other research
Giallo et al. (2006) had already shown that fast eating, cramming food, and losing food from the mouth predict choking in the same group.
Wormald et al. (2019) later found that adults with ID lose all their teeth 3–4 times more often than other adults, and missing teeth plus weak lip seal worsen chewing problems (M et al., 2023).
Together these papers form a chain: poor oral health → weak chewing → unsafe swallow → choking risk.
Why it matters
If you support adults with ID, add a quick swallow check during intake or annual reviews.
Flag anyone with CP, non-ambulatory status, or severe cognitive impairment for a speech-language pathologist referral.
Pair this with mealtime observations from Giallo et al. (2006) to catch both structural and behavioral red flags before choking happens.
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02At a glance
03Original abstract
BACKGROUND: Dysphagia has rarely been investigated in adults with intellectual disabilities (ID) despite being a serious condition affecting health and quality of life. METHOD: This study collected information about 101 adults with ID, living in community settings, referred for an assessment of their eating and drinking. Ninety-nine people were classified as having dysphagia from clinical and videofluoroscopic assessments. This information was used to give an indication of the prevalence of dysphagia in adults with ID and identify the co-occurrence of physiological and anatomical indicators and associated negative health conditions. RESULTS: Details of the characteristics and conditions associated with dysphagia are provided. These include cerebral palsy, increased physical disability and cognitive impairment. A tentative indication of the current prevalence of dysphagia was found (8.15%). CONCLUSION: Findings indicate that dysphagia is a significant issue for people with ID warranting further investigation. Practice implications detailed include increasing awareness of 'at risk' groups, changes in dysphagia with ageing, medication use and illness, and how findings can inform assessment and training.
Journal of intellectual disability research : JIDR, 2009 · doi:10.1111/j.1365-2788.2008.01115.x