Text Box: VIDEO-FLUOROSCOPIC STUDY OF SWALLOWING (VFSS) IN CHILDREN WITH NEUROLOGICAL DISORDERS Fung CW1, Khong PL1, To R2, Wong V1 1Queen Mary Hospital, Hong Kong 2Duchess of Kent Children’s Hospital, Hong Kong Objective: To evaluate the usefulness of VFSS in the diagnosis as part of the multi-disciplinary management of feeding and swallowing problems in children with neurological disorders. Methods: VFSS was performed in four children with different neurological disorders (Olivo-ponto-cerebellar atrophy, Down syndrome, spastic quadriplegic cerebral palsy and acute myeloid leukaemia with intracerebral haemorrhage). Results: Severe aspiration was noted in our patients with olivo-ponto-cerebellar atrophy and intracerebral haemorrhage. Oral feeding was discontinued. For the Down syndrome patient, silent aspiration of thin liquid was noted. Thickened formula was introduced with improvement. Aspiration was noted in the patient with cerebral palsy when fed in the sitting position with the neck extended. This was markedly improved when he was fed in the left lateral-oblique position with the neck flexed. Conclusion: We recommend VFSS as a tool for child neurologists, who manage children with neurological disabilities, to completely evaluate the underlying feeding problems. The formation of a feeding team is essential in order to provide a multi-disciplinary approach to the management of children with dysphagia. 1991