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Altered Gag Reflex in Down Syndrome

Persons with Down syndrome often demonstrate anatomical differences in the structure of both the oral cavity and/or pharynx. The tongue and/or tonsillar tissue are often enlarged. Tongue enlargement may result in the presence of an exaggerated gag and/or swallow reflex in affected individuals. The gag reflex in particularly sensitive individuals may be strong enough to precipitate coughing or emesis. Conversely, the gag reflex may at times be diminished in persons with Down syndrome due to neurological differences which may also coexist. It is important for healthcare practitioners to realize the potential for these alterations when performing oropharyngeal assessment on individuals with Down syndrome and accommodate accordingly.