Dysphagia

Part of my job as a Speech-Language Pathologist is working with people who  have difficulty eating and swallowing.  I work with children so many of their swallowing difficulties are because they are unable to chew the food, have difficulty moving the food  around in the mouth, or difficulty with the swallow mechanism.  The causes of these difficulties varies but in my caseload dysphagia (the technical term for difficulty swallowing) is related to thing such as Down Syndrome, Cerebral Palsy, or Autism Spectrum Disorders.  Some of the children have had difficulty eating/swallowing since birth.  For others, difficulties begin when they should be transitioning to more complex foods/drinks.

So, part of my job is to do bedside assessments on clients.  During a bedside assessment, I watch the client eat and drink as they normally would.  I look for signs of aspiration such as their face getting pale, eyes reddening, eyes watering, wet vocalizations, wet coughing while eating/drinking or shortly thereafter.  Sometimes have other signs of distress as well.  So, I observe them and then put my fingers on the clients larynx and below the client’s chin so that I can feel the laryngeal elevation of the swallow as well as feel tongue base movement.  I then assess the client’s risk of aspiration (food/liquid going into the airway).

If I think a client is having difficulty swallowing and/or has a history of pneumonia, I will sometimes refer for a video swallow study.  A video swallow study is an xray test where we can watch the person chew and swallow food/liquids.  It is the only definative way to see if a client is aspirating.  It also shows the amount of food/liqud that is left in the mouth/pharynx after the client has swallowed.  This is important because if food is in the pharynx after swallowing, the client is at risk of aspirating after the swallow.