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Purpose: Flexible endoscopic evaluation of swallowing (FEES) in the pediatric population is an important tool for the diagnosis and intervention planning for dysphagia. This clinical focus article highlights special considerations and strategies for optimizing pediatric FEES outcomes. The results of an informal survey completed by American Speech-Language-Hearing Association Special Interest Group 13 (SIG13, Swallowing and Swallowing Disorders) members completing pediatric FEES are also presented to provide context regarding clinical practice patterns across facilities. A pediatric FEES case study is included to highlight use of supportive strategies detailed in this clinical focus article. Conclusions: Based on evidence and author's clinical expertise, special considerations and strategies should be incorporated into the workflow of pediatric FEES for achievement of functional results that diagnose and characterize dysphagia, directly guide dysphagia management, and improve patient/caregiver experience of the exam. Establishing a triage process for FEES candidacy is complex but sets the stage for a successful exam. Teaming of clinical staff with patient/caregiver includes collaborative preparation for the exam, establishing achievable goals and expectations, and determining supportive strategies for best patient participation.

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