Swallowing Difficulties

Swallowing difficulties (also known as dysphagia) occur when an individual has difficulties at any stage of their swallow. This could be from preparing the food in their mouth to the function of the actual swallow in the oesophagus.

Our speech and language therapists can work with children with swallowing difficulties to ensure they have a safe and effective swallow in order to protect their health and safety.

The swallow takes place in three stages:

The oral stage

This is where the child prepares the food in the mouth. Oral motor movements involved in chewing are used here. Some children may have weak oral motor movements and struggle to swallow at this stage.

The pharyngeal stage

This is where the food is pushed to the back of the throat and the swallow is initiated as the back of the throat (pharynx) is opened up and prepared for the food and drink to be propelled down the throat. As the pharynx moves it protects the airway (trachea) here. Difficulties can occur here if the muscles involved in this stage are not working effectively.

The oesophageal stage

Here the food is pushed down the oesophagus. Problems may occur here if the airway is not protected sufficiently enough and the food may be pushed down into the lungs instead of the stomach - this is called aspiration and has many health risks such as pneumonia and recurrent chest infections.

Swallowing difficulties can occur during in any of these stages.

Swallowing difficulties can be caused by a variety of factors. Swallowing difficulties may occur because of reduced or increased muscle tone, food aversions and allergies. The causes of swallowing difficulties is not exhaustive and many different things can cause dysphagia. It is common that the cause of swallowing difficulties is due to a primary neurological condition or physical disability.

Children with swallowing difficulties may experience many problems with their day-to-day lives that speech and language therapy can help with, including:

• Increased stress and anxiety for child and families.
• Risk of aspiration causing pneumonia and recurrent chest infections.
• Lack of confidence when feeding.
• Gagging and vomiting.
• Reflux.
• Food aversions.
• Excessive dribbling.
• Poor weight gain.
• Reduced ability to thrive.
• Uncomfortable feeding or painful feeding.

Speech and language therapy has several benefits for a child with swallowing difficulties and their family, including:

• Increased confidence and reduced anxiety for the child and families during and around meal times.
• Promotion of weight gain.
• Reduced pain when eating and discomfort.
• Reduced and prevented risk of aspiration.

Speech and language therapists use various treatment and assessments to treat a child with swallowing difficulties, including:

• Assessment of the swallowing difficulties and identification of the underlying cause.
• Individualised goal setting with the parents and child in order to gain the best benefits for the child.
• Discussion and support for parents.
• Therapy techniques to help strengthen the swallow and overcome the difficulty.
• Continuously monitoring the child’s progress through reviews to ensure the treatment programme is well suited to them.
• Providing advice and education to the parents (potentially through training).
• Implementing compensatory strategies or alternative methods to ensure the swallow is safe and effective for the child as possible.
• Continuously monitoring risks and preventing the potential risks.
• Referral to other relevant health professionals if this is appropriate and beneficial to the child.

To arrange a speech and language therapy assessment for swallowing difficulties with one our speech and language therapists please call 0330 088 2298.

Swallowing difficulties can occur during any stage of a swallow, from preparing food to propelling the food down the oesophagus. There are many causes of swallowing difficulties, including neurological conditions or physical disabilities. Speech and language therapy can help children with swallowing difficulties to help promote the most safe and effective swallow for the child.

If your child has swallowing difficulties and you think they would benefit from seeing one of our specialist paediatric speech and language therapists, email office@sltforkids.co.uk or call 0330 088 2298.