Speech Pathologists and Dysphagia

Speech pathologists study, diagnose and treat communication disorders, including speaking, stuttering and using voice. Because they have so much knowledge about the muscles in the mouth, tongue and neck, they are well placed to help people who have difficulty swallowing (dysphagia).

What is dysphagia?

Dysphagia is a broad medical term used to describe difficulty swallowing. People with dysphagia may find chewing, drinking, sucking and managing saliva challenging.

Like breathing, swallowing is a reflex and is essential to everyday life. Humans swallow at least 500 times a day, around three times an hour during sleep, once per minute while awake and more often during meals.

Eating and drinking can be uncomfortable, stressful and even dangerous for a person with swallowing difficulties. If not appropriately managed, swallowing difficulties can result in life-threatening medical conditions, such as choking, poor nutrition, compromised chest health and dehydration.

An individual with dysphagia may not cope with certain types of food and drink. Dysphagia symptoms include coughing, gurgling voice and difficulty managing saliva. These symptoms can make eating and drinking in front of friends and family difficult and sometimes embarrassing, leading to anxiety, depression and social isolation.

The good news is that there are ways of eating and drinking that can reduce or remove these problems. This is when a speech pathologist might get involved.

What is the role of a speech pathologist in treating dysphagia?

Speech pathologists can provide support to ensure that mealtimes are safe and enjoyable for children and adults with dysphagia.

As eating and drinking involve many parts of the body, speech pathologists work as part of a multidisciplinary team to support people with dysphagia. This may include working with general practitioners, occupational therapists, physiotherapists, dietitians and nurses.

When working with a customer with dysphagia, a speech pathologist will tailor their intervention to the unique needs of each individual. These can include the following approaches:

Mealtime observation and assessment

Before a speech pathologist can make recommendations, they will look at their current environment and how they eat and drink. This might include

• how they sit when they consume food and liquids,
• how they are putting food or drink into their mouth (or how they are being fed),
• the consistencies and textures of food and drink they consume,
• and the environment in which they eat (e.g. are they sitting alone in the corner of the kitchen or are mealtimes a social occasion with other people around).

By taking these factors into account, the speech pathologist can see the ‘bigger picture. This helps them choose which treatment strategies to use and what other supports might be required.

Information, advice and strategies for the management of swallowing difficulties

There are several strategies and treatments that a speech pathologist can use to help individuals with dysphagia. One common strategy is to provide texture-modified (e.g. chopped, minced, pureed) foods and liquids of varying thicknesses to reduce the risk of choking or having food/drink entering the airway.

Foods and drinks can vary hugely in terms of texture and consistency. A speech pathologist uses their expert judgement to determine which textures and consistencies are suitable for everyone. Other strategies include developing oral movements such as lip closure or tongue movement and compensatory strategies such as taking a single sip of fluids or using a bottle teat with a slower flow rate.

A speech pathologist develops a Mealtime Management Plan for people with swallowing difficulties following the texture and consistency guidelines from ©The International Dysphagia Diet Standardisation Initiative 2019 (IDDSI) Framework.

Education and training for parents, carers, families and support workers

It is essential that parents, carers, families and support workers are trained and educated about making mealtimes safe and stress-free.

Miscommunication and lack of understanding around how and what to eat can be dangerous, and in some instances fatal, for individuals with dysphagia.

A speech pathologist shares essential information with the individual’s support network regarding how and what they should be eating and drinking. They may demonstrate how foods and drinks vary in texture and consistency so that those involved in the individual’s mealtimes are certain of what is suitable.

Accessing our Speech Pathology services

Our speech pathology services can be accessed through a range of funding options. We can help you find out if you are eligible and provide information about the options available.

Where extra team support is needed, our therapists may refer individuals and families to Therapy Focus’ specialist mealtime management team, MEAHLS.