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Pediatric Aerodigestive Program

The UF Pediatric Aerodigestive Program treats children experiencing a wide range of disorders that affect breathing, swallowing, speech and growth.

Doctor checking a child's heartbeat

As a tertiary referral center, UF Health Shands Children’s Hospital offers care for some of the most complex pediatric patients in the state of Florida. The Pediatric Aerodigestive Program, or ADP, is part of the University of Florida Department of Otolaryngology. The program is staffed by a versatile group of pediatric subspecialty teams. These teams treat children experiencing a wide range of disorders that affect breathing, swallowing, speech and growth.

Pediatric specialists from otolaryngology (also known as Ear, Nose, and Throat), pulmonary, gastroenterology, speech pathology, nutrition and radiology make up the core members of the team. The type of conditions we treat include:

  • Structural and/or functional airway diseases
  • Esophageal disorders
  • Parenchymal lung diseases
  • Injury from aspiration or infection
  • Chronic respiratory failure
  • Gastroesophageal reflux
  • Dysphagia

Our goal is to provide patient-centered, evidence-based, cost-effective care to children with aerodigestive disorders.

Our program is proud to be part of UF Health Shands Children’s Hospital since 2020. The hospital is nationally ranked among the best in four pediatric specialties, according to the 2023-24 U.S. News & World Report Best Children’s Hospital rankings.

Conditions and disorders we treat

Some of the conditions and disorders we treat are:

Our specialists work together with patient families to create a comprehensive medical and surgical plan. When necessary, we prioritize using the least invasive approach to treatment. We create a pathway that leads to successful growth and development, while ensuring safety and efficiency.

We hold meetings to discuss our complex cases and communicate with all the providers involved. This is especially important when surgical evaluations or procedures are being considered.

In addition, we recently began a monthly ADP multidisciplinary clinic. In this clinic, patients and families meet with physicians from multiple areas of discipline in one location. From there, a comprehensive plan is developed to ease the burden of travel to multiple appointments for our patient families.

Our clinic is held at UF Health The Oaks – ENT & Allergy on the third Tuesday morning of each month. Patients can be referred to our UF ADP clinic by placing a referral to one or more of the subspecialties (ENT, pulmonary or gastroenterology) and requesting evaluation in ADP clinic.

Finally, we discuss and evaluate hospitalized patients, giving input to the primary team to guarantee a satisfactory transition home with close follow-up. Our goal is to provide timely access to services for our patients because delays in the diagnosis and treatment of aerodigestive conditions can affect their well-being and quality of life. We are proud to share that all physicians maintain continuity of care throughout the length of treatment.

Procedures

Some common procedures our team may suggest include:

Flexible bronchoscopy: This procedure looks inside the respiratory tract (nose, throat and large airways) with the use of a bronchoscope. This is a long camera that allows us to take pictures and videos of the airway. In addition, samples of fluid can be obtained and sent for analysis. It is completed while under anesthesia.

Flexible laryngoscopy: This procedure evaluates the upper airway, including the nasal cavity, oropharynx (throat) and the larynx (voice box and vocal cords). This is typically performed awake in the clinic to evaluate the movement of the vocal cords.

Direct laryngoscopy and rigid bronchoscopy: This procedure evaluates the upper portion of the respiratory tract, including the larynx (voice box and vocal cords) and upper trachea (or windpipe) with a rigid instrument and camera. This allows for identification and operative treatment of certain anatomical conditions. It is completed while under general anesthesia.

Esophago-gastro-duodenoscopy (EGD): This process assesses the digestive tract from the mouth to the first part of the small intestines and allows for biopsies to be done. It is completed while under anesthesia.

Video fluoroscopy swallow study (VFSS): This test provides information about swallowing function. It requires a low dose of radiation. It allows for the recording of videos/images of the patient swallowing liquids of multiple consistencies. It is done while awake and under the guidance of a feeding specialist.

Flexible Endoscopic Evaluation of Swallowing (FEES): This test involves a small, flexible endoscope used to assess swallowing function. The scope is passed through the nose, and the SLP can visualize parts of your throat (oropharynx and larynx) as you swallow.

Chest radiograph (X-ray): This is a radiographic image of the chest that allows us to evaluate for lung or airway disease.

Chest computed tomography (CT): This is a study that reports a more detailed evaluation of the chest. It provides information about the lungs, heart, airways, bones and soft tissues of the chest.

Why choose us?

  • Multidisciplinary programs, such as the UF ADP, are known to improve the quality of patient care. They play an instrumental role for patients with complex disorders followed by multiple providers.
  • Consolidating subspecialty care can improve access to specialized studies and procedures. When indicated, surgical procedures can be coordinated the same day to reduce anesthetic exposure.
  • Our team is dedicated to advancing the medical and surgical care of current and future patients enrolled in our program. This is achieved through frequent meetings to discuss patient cases and coordinate ongoing care.
  • Our pediatric ADP providers are passionate about maintaining the knowledge and skills required to treat aerodigestive disorders. During our meetings, we also periodically host educational sessions to share the latest knowledge about diagnostic and treatment techniques for our patient population.
  • Our program is also involved in clinical research projects to advance the care involved in treating pediatric aerodigestive disorders.

Resources

National resources

UF Health resources

Information about thickening liquids

Q: My child’s Speech and Language Pathologist (SLP) recommended that I thicken their liquids? Do you have recipes or products that I can use?

A: Liquids should be thickened to an appropriate consistency as recommended by your SLP and in conjunction with your medical team. Each child will be different.

Your SLP will provide guidance on recipes and products for your child’s specific needs and in accordance with their age. You will be provided instruction on thickening guidelines in alignment with the IDDSI (International Dysphagia Diet Standardization Initiative) guidelines.

Products for infants include Gelmix, ground infant rice cereal or oatmeal, or food-based thickeners like green beans. Xantham gum based thickening products are only appropriate for older children. For example, Thick&Easy is suitable for children 3 years of age and older. Recommended thickening products for your child can typically be purchased through major national retail chains such as Amazon, CVS, Walgreens, Walmart, etc.

Here are some instructions for thickening liquids (PDF).

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