Speech and Language Therapists assess, diagnose and treat swallowing difficulties as part of a multidisciplinary team, including the person themselves, and their family or carers
Swallowing disorders, known as dysphagia (pronounced dis-fay-dya) affects a person’s ability to safely swallow drinks, food and medication. It can impact people across the lifespan. Swallowing disorders can have a significant impact on health and on quality of life. Occasionally you may also hear the term FEDS this stands for Feeding, Eating, Drinking and Swallowing.
Speech and Language Therapists may have many roles and responsibilities in the management of dysphagia such as clinician, researcher, team manager and educator. The IASLT has developed a number of clinical guidelines for members to support their practice in this clinical area. This can be found in the learning centre and members' area.
The ability to eat, drink, and swallow safely requires motor, sensory, and cognitive skills. These can be affected across the lifespan
The ability to eat, drink, and swallow safely requires motor, sensory, and cognitive skills. These can be affected across the lifespan.
The ability to eat, drink, and swallow safely requires motor, sensory, and cognitive skills. These can be affected across the lifespan. It can involve the pre-oral stage, before the food reaches the mouth (involving the pace of eating and drinking). It can be the oral phase: this is the ability to contain the food or drinks in the mouth, chew and manipulate the food with the tongue, propel it backwards toward the throat to the pharyngeal phase: this involves the propulsion of the foods and drinks from the mouth to the oesophagus, typically the larynx or voice box moves forward, the epiglottis closes over the airway and prevents the food entering into the lungs (aspiration), weakness of the pharyngeal muscles can result in residue. While a sensory difficulty can reduce a person's ability to feel the food or drinks at the various stages of the swallowing process.
A speech and language therapist may carry out a clinical dysphagia assessment.
This might include asking questions to gain a better understanding of the person’s background history including any previous medical reports or assessments.
They will observe the person’s general status such as their respiratory status, their alertness, their oral motor skills and communication status. If appropriate they might trial and assess various foods and fluid consistencies, this may also be carried out through a mealtime observation, based on this assessment and background information, and they may make recommendations.
An instrumental assessment may also be indicated, this may be a Videofluoroscopic Swallowing Study (VFSS) or a Fibreoptic Endoscopic Evaluation of Swallowing (FEES) exam.
Yes. The treatment for dysphagia will depend on multiple factors, including the underlying cause of the swallowing difficulty. Dysphagia can range from a very mild problem, to a very significant problem. Some people will experience dysphagia temporarily, while others might have swallowing difficulties for a longer period of time, and maybe even permanently
The risk factors associated with Dysphagia that is not treated in a timely and/or appropriately include:
In order to minimise the risks associated with Dysphagia, and to promote the best outcomes it is important that Dysphagia is treated in the context of a multidisciplinary team who are skilled in the area of Dysphagia.
The speech and language therapist works as part of the multidisciplinary team to support people with swallowing difficulties. This may include but is not limited to the dietitian, the occupational therapist, the physiotherapist, the medical team and nursing staff, carers, chefs and catering staff
In Ireland we use the IDDSI framework to classify modified foods and fluids.
The IDDSI is the international dysphagia diet standardisation initiative, it is a common framework used to describe the different foods and fluids and their consistency.
Foods are classified from level 0 (normal fluids) to Level 4 (Extremely thickened liquids). Foods are classified from level 4 (puree) to Level 7 (normal diet) Read more
You should see your GP if you, or someone you care for, have difficulty swallowing or any other signs of dysphagia so you can get treatment to help with your symptoms.