Dysphagia

Dysphagia refers to a person’s difficulties with eating, drinking, and swallowing. Swallowing is a complex process which involves transporting food and liquids from the mouth to the stomach while keeping the airway protected.

Swallowing difficulties can occur at any stage of the swallow. This includes from the time a child starts chewing their food to the time the food is carried to the stomach through the oesophagus. The stages of swallowing are:

• Oral Stage: This stage involves the child preparing the food in the mouth in order to make it safe to swallow. This includes chewing and using the tongue to move and manipulate food and liquid around the mouth.
• Pharyngeal Stage: This stage is when the food is moved towards the back of the mouth and the swallow begins. The pharynx (back of the throat) opens up to allow the food and liquid to be propelled through by the muscles of the pharynx.
• Oesophageal Stage: This stage involves the food traveling down the oesophagus into the stomach. 

Signs and symptoms of dysphagia may vary based on the child’s age and developmental level. Some signs may include (but not be limited to):

• Back arching in infants
• Breathing difficulties when feeding (eg: increased respiratory rate)
• Coughing and/or choking during or after swallowing
• Difficulty chewing foods that are texturally appropriate for a child’s age
• Difficulty managing their saliva (non-teething related)
• Wet vocal quality (“gurgly”) during or after eating
• Frequent congestion, particularly after meals
• Gagging
• Refusing foods of certain textures

Dysphagia can result in aspiration, which is when food, liquid, or saliva enters the airway.

Children with dysphagia may develop food aversion or oral aversion. Food aversion is when a child refuses all foods that are presented to them, despite the foods being developmentally appropriate. Oral aversion is the reluctance and avoidance of sensation in or around the mouth.

Children with dysphagia may also experience undernutrition, malnutrition, or dehydration. This can happen as a child that has difficulty with their swallowing may not be getting the correct nutrients and fluids from their diet. 

Children with dysphagia may also experience aspiration pneumonia. This is a type of lung infection that is due to a large amount of food and liquid entering the lungs.

Dysphagia can also cause meal-times to become a stressful time for a child and their family members.

Your ChatterBug SLT will complete an assessment to evaluate your child’s swallowing whilst eating and drinking. The assessment may also include evaluation of your child’s secretion (saliva) management and the management of any oral medications.

Once the assessment is complete, our SLT will use the information from the assessment to devise a treatment plan with you and your child’s input that is tailored to your child’s areas of need and priorities.

Our primary goal will be to support safe and adequate eating and drinking for your child, determine the optimum feeding methods and techniques to maximize swallowing safety and feeding efficiency, and minimize any potential risks.

If you child have a limited range of foods they eat but not difficulties with eating and drinking, our ChatterBug SLTs can also support you to develop the range of foods your child currently eats. This may be as part of a group.

Your SLT will also be able to provide advice on suitable textures for food and fluids using IDDSI texture and fluid descriptors as appropriate.

Please note that our Leeds service can only support children who have had their swallow previously assessed and found to have a safe swallow.