Speech Therapy & Difficulty Swallowing: Causes and Symptoms

When people think about speech therapy, they may think about speech, phonation, articulation, even cognition and voice. But what about swallowing? Not only do we as speech-language pathologists address swallowing, but depending on the therapist and the setting, it may actually be a large focus of what we do each day.

Do you ever get that feeling that food or drink is "going down the wrong pipe?" It can actually happen and it's called aspiration. One “pipe” is the esophagus that goes to your stomach and one is the trachea which goes to your lungs. Aspiration is when food, drink, secretions, or any foreign material enters the trachea heading for the lungs.

How do you know if this has happened? The signs and symptoms can include coughing, throat clearing, wet/gurgly voice, choking, etc. while eating and drinking. A speech-language pathologist can typically determine if a person is aspirating and/or having difficulty swallowing. The speech therapist would proceed with a treatment plan and therapeutic exercises to target individual muscles of swallowing.

The individual may also be asked to participate in a Modified Barium Swallow Study, which is an x-ray of your throat while eating and drinking. The plan may include temporary or permanent modification of a person's diet and learning safe swallow strategies.

Modification to one's diet may include chopping up meats, cutting all food into small pieces, blending food to a puree or pudding consistency, thickening liquids, etc. Safe swallow strategies can include alternating small bites/sips, eliminating the use of straws, tucking your chin to chest while swallowing, turning your head towards one side while swallowing, slowing down, chewing thoroughly, avoiding talking with food in mouth, sitting upright 90 degrees for meals, etc.

People who may exhibit difficulty with swallowing include those with a stroke, Parkinson's disease, Alzheimer's disease, dementia, Traumatic Brain Injury, amyotrophic lateral sclerosis (ALS), spinal cord injury, multiple sclerosis, muscular dystrophy, cerebral palsy, cancer in the mouth/throat/esophagus, damage to the head or neck, etc.

Why does this happen? Typically the muscles of swallow have suffered some type of damage and are weak and unable to perform at full capacity. That is why diet modification, safe swallow strategies, and therapeutic exercises are important so that you can safely consume the Southern delicacies we all love.

If you or someone you know is experiencing difficulty swallowing, you should inform your doctor and inquire about visiting a speech-language pathologist for further assessment and/or treatment. Happy hearing and speech month!