Swallowing/Feeding Therapy
S.L. Hunter SpeechWorks provides swallowing therapy and speech-language pathology services for people experiencing swallowing difficulties, difficulty swallowing, trouble swallowing, feeding concerns, or other swallowing problems. The medical term for difficulty swallowing is dysphagia.
The swallowing process is a complex process involving the mouth, throat, muscles, nerves, and coordination needed to move food or liquid safely. Problems swallowing may affect a person's ability to chew food, manage certain foods, maintain adequate nutrition, or swallow safely.
Our Speech-Language Pathologists assess swallowing and oral function and develop individualized recommendations when speech therapy or dysphagia treatment falls within the speech-language pathology scope of practice.
Understanding Swallowing Disorders
Swallowing disorders can occur for many reasons. Depending on the suspected cause and underlying cause, swallowing issues may involve different stages of swallowing.
Common forms include:
- Oral dysphagia, involving difficulty controlling food or liquid in the mouth
- Oropharyngeal dysphagia, involving difficulty moving material from the mouth through the throat
- Esophageal dysphagia, involving difficulty after food enters the esophagus
Swallowing difficulties may be associated with neurological conditions, cerebral palsy, head and neck cancer, head and neck surgery, neck surgery, muscle weakness, disorders of the nervous system, spinal cord conditions, scar tissue, or other medical conditions and health issues.
Symptoms may include choking, coughing during eating, difficulty managing certain foods, trouble breathing during meals, or the sensation that food is not moving normally.
Swallowing Assessment
An assessment begins with discussion of symptoms and relevant medical history. Depending on the person's needs, a Speech-Language Pathologist may complete a clinical swallowing assessment and oral-motor examination as part of a broader physical exam.
The SLP may assess:
- Ability to chew food
- Movement and strength of structures involved in swallowing
- Management of different food or liquid consistencies
- Signs of difficulty swallowing
- Ability to swallow safely
- Eating habits and mealtime concerns
- Strategies that may make swallowing easier
When more detailed information is required, a Modified Barium Swallow study may be recommended or completed through an appropriate medical service. Other procedures or specialized medical testing may also be required depending on the suspected cause.
Treatment for Swallowing Disorders
Treatment swallowing disorders requires an individualized approach. Dysphagia treatment depends on the type and cause of the swallowing difficulty and the person's overall health.
Treatment may include:
- Specific swallowing exercises
- Strategies to improve swallowing
- Techniques such as an effortful or swallow hard strategy when clinically appropriate
- Changes to positioning or mealtime routines
- Recommendations regarding food texture or softer foods
- Strategies to help prevent food or liquid from entering the airway
- Education for clients and caregivers
Treatment recommendations should follow assessment rather than being applied to every patient in the same way.
Oral Placement Therapy
Oral Placement Therapy is an oral-motor approach used to target particular movements involved in speech clarity and feeding.
Where appropriate, therapy may address oral movement, coordination, strength, and function as part of a broader treatment plan.
Oral Rest Posture Program
Oral Rest Posture Program addresses oral rest posture and related oral-motor patterns. Oral posture can influence speech and oral function, and recommendations are individualized according to assessment findings.
Medical Conditions That Can Affect Swallowing
Not every swallowing problem is treated through speech therapy alone.
Conditions involving stomach acid, acid reflux, or gastroesophageal reflux disease may involve the digestive system. Conditions affecting the lower esophageal sphincter, including achalasia, generally require medical evaluation. A Speech-Language Pathologist does not independently treat achalasia or gastrointestinal disease.
Medical providers may use additional testing, including procedures that measure esophageal pressure with a pressure recorder, depending on the suspected problem.
Similarly, muscle spasms, structural changes, or other esophageal conditions may require medical treatment rather than swallowing therapy alone.
Resources from medical organizations, including the American College of Gastroenterology, may also discuss these gastrointestinal causes of dysphagia.
Aspiration and Swallowing Safety
When food or liquid enters the airway instead of moving safely through the swallowing system, this is called aspiration. In some people, aspiration can contribute to respiratory complications, including what is called aspiration pneumonia.
The risk of aspiration pneumonia varies considerably between individuals and depends on many medical and functional factors. People with certain medical conditions may be at higher risk and require coordinated medical care.
Signs such as severe choking or trouble breathing require appropriate medical attention.
Feeding Tubes and Medical Care
Some individuals with severe swallowing difficulties may require another way to provide nutrition, such as tube feeding through a feeding tube or small tube. Decisions about feeding tubes are medical decisions made by the appropriate healthcare team; S.L. Hunter SpeechWorks does not prescribe or insert them.
Swallowing therapy may still form one part of care for some people receiving tube feeding, depending on their assessment and medical status.
Coordinated Dysphagia Care
Treating dysphagia may require collaboration among Speech-Language Pathologists, physicians, dietitians, occupational therapists, and other health professionals. The best treatment approach depends on the person's symptoms, diagnosis, medical history, and ability to swallow.
S.L. Hunter SpeechWorks provides swallowing and feeding services focused on assessment, communication, oral function, and safe participation in eating where appropriate.
If you or someone you care for is experiencing trouble swallowing, choking, or other swallowing issues, contact S.L. Hunter SpeechWorks to ask about swallowing assessment and available treatment services.