Objective: 22q11.2-deletion syndrome is a genetic condition that affects 1:3000 births. In addition to cardiac anomalies and immunosuppression, individuals with 22q11.2-deletion syndrome can have feeding difficulties from birth resulting in failure to thrive and infections. This study aims to characterize the dysphagia seen in infants with 22q11.2-deletion syndrome. Methods: This is a retrospective chart review of infants with 22q11.2-deletion syndrome who underwent videofluoroscopic swallow studies (VFSS) from June 1, 2008 to January 1, 2018 at a tertiary children's hospital. Demographic data and VFSS findings were collected. Results: Forty-four patients were identified, 52% were females, and mean age at VFSS was 71 days. In their lifetime, 30% of the patients had at least 1 episode of pneumonia, 66% had NG-tube placement and 41% required G-tube placement. 93% had oral-phase dysphagia, and 89% had pharyngeal-phase dysphagia. Twenty-two patients (50%) demonstrated evidence of penetration. Eighteen patients (41%) showed tracheal aspiration. Of the patients that showed tracheal aspiration, 83% of them aspirated "silently." Three patients (7%) had upper esophageal sphincter (UES) opening dysfunction. Conclusion: Vast majority of the infants with 22q11.2-deletion syndrome referred for swallow studies demonstrated evidence of dysphagia in both oral and pharyngeal phases with deficits in swallow physiology not yet documented in other studies. Importantly, more than 80% of these infants showed evidence of "silent" tracheal aspiration, which can lead to recurrent pneumonia and significant morbidity if overlooked. Prompt recognition is paramount in these infants to intervene early and reduce long-term complications and also develop targeted interventions.

ObjectiveThe goal of the present research was to provide updated normative TTG data for younger athletes and increase understanding of the reliability of the TTG.BackgroundImbalance is a hallmark sign of concussion. The Sport Concussion Assessment Tool (SCAT-3) suggests using the Modified Balance Error Scoring System (mBESS) or Timed Tandem Gait (TTG) to evaluate balance function. TTG instructions indicate that times >14 seconds are abnormal as established in individuals between 16-37 years of age (Schneiders et al., 2010). Currently, there is a lack of normative data for the pediatric population.Design/MethodsPre-season TTG data were collected from 363 male and 20 female athletes with no active concussion complaints. The best TTG time out of 4 trials without errors was recorded. In addition, post-season data were collected for 107 male athletes.ResultsResults demonstrated a significant decrease in TTG time with age. Given this improvement, separate expected values were constructed: 7–8 years (21.4 +/− 7 s), 9–10 years (18.56 +/− 6 s), 11–12 years (18 +/− 5 s), 13–14 years (15.8 +/− 4 s), and 15–16 years (14.0 +/− 3 s). Analysis showed a significant improvement in TTG time over the season. Preliminary analysis shows no difference between baseline and post-concussion scores.ConclusionsThese results suggest that TTG time should be established annually. Future research will need to explore the expected amount of change in individuals with post-concussion imbalance.