{"id":453324,"date":"2025-12-25T00:38:46","date_gmt":"2025-12-24T23:38:46","guid":{"rendered":"https:\/\/www.dynseo.com\/?p=453324"},"modified":"2025-12-28T17:59:00","modified_gmt":"2025-12-28T16:59:00","slug":"swallowing-and-dysphagia-complete-guide-for-speech-therapists","status":"publish","type":"post","link":"https:\/\/www.dynseo.com\/en\/swallowing-and-dysphagia-complete-guide-for-speech-therapists\/","title":{"rendered":"Swallowing and Dysphagia: Complete Guide for Speech Therapists"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Article HTML&#8221; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;Contenu&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; 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text-decoration: none; font-weight: 500; }\n.dbi-art-070734 .warning-box { background: #fef2f2; border: 1px solid #fecaca; border-left: 4px solid #ef4444; padding: 20px; margin: 25px 0; border-radius: 0 10px 10px 0; }\n.dbi-art-070734 .tip-box { background: #fef3c7; border-left: 4px solid var(--secondary); padding: 20px; margin: 25px 0; border-radius: 0 10px 10px 0; }\n.dbi-art-070734 .phase-card { background: white; border: 2px solid var(--primary); border-radius: 12px; padding: 25px; margin: 20px 0; }\n.dbi-art-070734 .phase-card h4 { color: var(--primary); margin-bottom: 10px; }\n.dbi-art-070734 .faq-item { border: 1px solid var(--border); border-radius: 10px; margin-bottom: 15px; }\n.dbi-art-070734 .faq-question { background: var(--bg-light); padding: 18px 20px; font-weight: 600; color: var(--primary-dark); }\n.dbi-art-070734 .faq-answer { padding: 20px; }\n@media (max-width: 768px) {\n.dbi-art-070734 .toc ul { columns: 1; }\n}<\/p>\n<\/style>\n<div class=\"dbi-art-070734\">\n<div class=\"container\">\n<h1>Swallowing and Dysphagia: A Comprehensive Guide for Speech Therapists<\/h1>\n<div class=\"intro-box\">\n    <pee>Swallowing is the act of transporting food and liquids from the mouth to the stomach. Dysphagia refers to swallowing disorders, which can have serious consequences (aspiration, malnutrition, pneumonia). The speech therapist plays a central role in the assessment and management of these disorders, in collaboration with the medical team.<\/pee>\n<\/div>\n<div class=\"download-hero\">\n<h2>\ud83c\udf7d\ufe0f Download our swallowing tools<\/h2>\n<pee>Texture chart, meal supports, oro-facial praxia exercises<\/pee>\n    Access the tools \u2192\n<\/div>\n<div class=\"toc\">\n<h3>\ud83d\udccb Table of Contents<\/h3>\n<ul>\n<li><a href=\"#physiologie\">1. Physiology of Swallowing<\/a><\/li>\n<li><a href=\"#dysphagie\">2. What is Dysphagia?<\/a><\/li>\n<li><a href=\"#causes\">3. Causes and Populations<\/a><\/li>\n<li><a href=\"#signes\">4. Warning Signs<\/a><\/li>\n<li><a href=\"#evaluation\">5. Assessment<\/a><\/li>\n<li><a href=\"#prise-en-charge\">6. Management<\/a><\/li>\n<li><a href=\"#outils\">7. Our Downloadable Tools<\/a><\/li>\n<li><a href=\"#faq\">8. FAQ<\/a><\/li>\n<\/ul>\n<\/div>\n<h2 id=\"physiologie\">Physiology of Swallowing<\/h2>\n<pee>Normal swallowing is a complex process involving more than 30 muscles and 6 cranial nerves. It is divided into three main phases, each of which can be the site of difficulties.<\/pee>\n<div class=\"phase-card\">\n<h4>1\ufe0f\u20e3 Oral Phase (Voluntary)<\/h4>\n<pee><strong>Oral Preparation<\/strong>: chewing, salivation, formation of the food bolus. The tongue gathers the food and positions it.<\/pee>\n    <pee><strong>Oral Transport<\/strong>: the tongue propels the bolus to the back of the mouth. This phase is under voluntary control.<\/pee>\n    <pee><strong>Duration<\/strong>: variable depending on the texture (1-2 seconds for liquids, longer for solids).<\/pee>\n<\/div>\n<div class=\"phase-card\">\n<h4>2\ufe0f\u20e3 Pharyngeal Phase (Reflex)<\/h4>\n<pee>Automatically triggered when the bolus reaches the pillars of the soft palate. The swallowing reflex causes:<\/pee>\n<ul>\n<li>Closure of the soft palate (prevents nasal reflux)<\/li>\n<li>Elevation of the larynx and tilting of the epiglottis (protection of the airways)<\/li>\n<li>Closure of the vocal cords<\/li>\n<li>Contraction of the pharyngeal muscles (propulsion to the esophagus)<\/li>\n<li>Opening of the upper esophageal sphincter<\/li>\n<\/ul>\n<pee><strong>Duration<\/strong>: about 1 second. Critical phase for safety.<\/pee>\n<\/div>\n<div class=\"phase-card\">\n<h4>3\ufe0f\u20e3 Esophageal Phase (Reflex)<\/h4>\n<pee>Transport of the bolus by peristaltic waves from the esophagus to the stomach. Opening of the lower esophageal sphincter.<\/pee>\n    <pee><strong>Duration<\/strong>: approximately 8-10 seconds.<\/pee>\n<\/div>\n<h2 id=\"dysphagie\">What is Dysphagia?<\/h2>\n<pee>Dysphagia is a swallowing disorder that can affect one or more phases. It can involve solids, liquids, or both. The consequences can be serious:<\/pee>\n<ul>\n<li><strong>Aspiration<\/strong>: passage of food or liquids into the airways<\/li>\n<li><strong>Inhalation Pneumonia<\/strong>: lung infections related to repeated aspiration<\/li>\n<li><strong>Malnutrition<\/strong>: insufficient intake due to fear or difficulty eating<\/li>\n<li><strong>Dehydration<\/strong>: insufficient fluid intake<\/li>\n<li><strong>Impact on Quality of Life<\/strong>: social isolation, anxiety at mealtimes<\/li>\n<\/ul>\n<div class=\"warning-box\">\n<h4>\u26a0\ufe0f Medical Emergency<\/h4>\n<pee>Aspiration with choking, repeated pneumonias, or severe malnutrition requires urgent medical management. The speech therapist always works in collaboration with the medical team.<\/pee>\n<\/div>\n<h2 id=\"causes\">Causes and Affected Populations<\/h2>\n<table>\n<thead>\n<tr>\n<th>Population<\/th>\n<th>Common Causes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Newborns\/Infants<\/strong><\/td>\n<td>Prematurity, sucking disorders, malformations (cleft), neurological impairments<\/td>\n<\/tr>\n<tr>\n<td><strong>Children<\/strong><\/td>\n<td>Cerebral palsy, neuromuscular diseases, oral disorders, malformations<\/td>\n<\/tr>\n<tr>\n<td><strong>Adults<\/strong><\/td>\n<td>Stroke, traumatic brain injury, ENT cancers, Parkinson&#8217;s, ALS, MS, surgeries<\/td>\n<\/tr>\n<tr>\n<td><strong>Older Adults<\/strong><\/td>\n<td>Presbyphagia (aging), dementias, strokes, medication effects<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Types of Dysphagia by Location<\/h3>\n<ul>\n<li><strong>Oral Dysphagia<\/strong>: difficulties in chewing, preparation, or propulsion of the bolus<\/li>\n<li><strong>Pharyngeal Dysphagia<\/strong>: delay or absence of reflex triggering, aspiration<\/li>\n<li><strong>Esophageal Dysphagia<\/strong>: sensation of blockage, regurgitation<\/li>\n<\/ul>\n<h2 id=\"signes\">Warning Signs<\/h2>\n<h3>During Meals<\/h3>\n<ul>\n<li><strong>Coughing<\/strong> during or just after meals<\/li>\n<li><strong>Wet<\/strong> or &#8220;gurgly&#8221; voice after swallowing<\/li>\n<li><strong>Blockages<\/strong> or sensation of &#8220;it won&#8217;t go down&#8221;<\/li>\n<li><strong>Drooling<\/strong> or difficulty holding food in the mouth<\/li>\n<li><strong>Prolonged<\/strong> or ineffective chewing<\/li>\n<li><strong>Food<\/strong> residues in the mouth after swallowing<\/li>\n<li><strong>Nasal reflux<\/strong><\/li>\n<\/ul>\n<h3>General Signs<\/h3>\n<ul>\n<li><strong>Unexplained weight loss<\/strong><\/li>\n<li><strong>Repeated lung infections<\/strong><\/li>\n<li><strong>Avoidance<\/strong> of certain textures or food refusals<\/li>\n<li><strong>Very long meals<\/strong> (fatigue, slowness)<\/li>\n<li><strong>Anxiety<\/strong> or stress around meals<\/li>\n<\/ul>\n<div class=\"tip-box\">\n<h4>\ud83d\udca1 Silent Aspirations<\/h4>\n<pee>Warning: some aspirations are &#8220;silent&#8221; (without coughing) and therefore difficult to detect. They are common in people with neurological impairments and are particularly dangerous. A changed voice after swallowing may be the only sign.<\/pee>\n<\/div>\n<h2 id=\"evaluation\">Swallowing Assessment<\/h2>\n<h3>Speech Therapy Assessment<\/h3>\n<ul>\n<li><strong>Anamnesis<\/strong>: medical history, complaints, problematic textures<\/li>\n<li><strong>Examination of Structures<\/strong>: lip, tongue, velar mobility, sensitivity<\/li>\n<li><strong>Meal Observation<\/strong>: behavior, posture, duration, textures<\/li>\n<li><strong>Food Trials<\/strong>: different textures and volumes, with monitoring<\/li>\n<li><strong>Functional Capacity Test<\/strong>: water glass test<\/li>\n<\/ul>\n<h3>Complementary Examinations (Medical)<\/h3>\n<ul>\n<li><strong>Videofluoroscopy<\/strong> (radiocinema): real-time visualization of swallowing<\/li>\n<li><strong>Nasofibroscopy<\/strong>: direct examination of the pharynx and larynx<\/li>\n<li><strong>Manometry<\/strong>: measurement of esophageal pressures<\/li>\n<\/ul>\n<h2 id=\"prise-en-charge\">Speech Therapy Management<\/h2>\n<h3>Environmental and Positional Adaptations<\/h3>\n<ul>\n<li><strong>Position<\/strong>: sitting upright, chin slightly tucked<\/li>\n<li><strong>Environment<\/strong>: calm, without distractions, no conversation during ingestion<\/li>\n<li><strong>Small Quantities<\/strong>: adapted spoon, small bites<\/li>\n<li><strong>No Straw<\/strong> (difficult to control the flow)<\/li>\n<\/ul>\n<h3>Texture Adaptation<\/h3>\n<table>\n<thead>\n<tr>\n<th>Texture<\/th>\n<th>Description<\/th>\n<th>Examples<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Thickened Liquid<\/strong><\/td>\n<td>Syrup, honey, or cream consistency<\/td>\n<td>Gelatinous water, thick soup, smoothie<\/td>\n<\/tr>\n<tr>\n<td><strong>Smooth Puree<\/strong><\/td>\n<td>Homogeneous, without chunks<\/td>\n<td>Fine puree, applesauce, velout\u00e9<\/td>\n<\/tr>\n<tr>\n<td><strong>Chopped<\/strong><\/td>\n<td>Small soft pieces<\/td>\n<td>Ground meat, mashed vegetables<\/td>\n<\/tr>\n<tr>\n<td><strong>Soft<\/strong><\/td>\n<td>Melt-in-your-mouth pieces, easy to crush<\/td>\n<td>Fish, eggs, ripe fruits<\/td>\n<\/tr>\n<tr>\n<td><strong>Normal<\/strong><\/td>\n<td>All textures<\/td>\n<td>Standard diet<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Rehabilitation<\/h3>\n<ul>\n<li><strong>Strengthening Exercises<\/strong>: lips, tongue, soft palate<\/li>\n<li><strong>Sensitivity Work<\/strong>: thermal, tactile stimulations<\/li>\n<li><strong>Protection Maneuvers<\/strong>: supraglottic swallowing, effort<\/li>\n<li><strong>Coordination Work for Breathing and Swallowing<\/strong><\/li>\n<\/ul>\n<h2 id=\"outils\">Our Downloadable Swallowing Tools<\/h2>\n<div class=\"tools-grid\">\n<div class=\"tool-card\">\n<h4>\ud83d\udcca Texture Chart<\/h4>\n<pee>Classification of food textures with examples. Guide to adapt meals.<\/pee>\n        Download\n    <\/div>\n<div class=\"tool-card\">\n<h4>\ud83d\udc45 Oro-facial Praxia Exercises<\/h4>\n<pee>Movements of the tongue, lips, and cheeks. Strengthening of oral musculature.<\/pee>\n        Download\n    <\/div>\n<div class=\"tool-card\">\n<h4>\ud83c\udf7d\ufe0f Meal Supports<\/h4>\n<pee>Visual guidelines for posture and adaptations during meals.<\/pee>\n        Download\n    <\/div>\n<div class=\"tool-card\">\n<h4>\ud83d\udccb Food Diary<\/h4>\n<pee>Tracking meals, tolerated textures, observed difficulties.<\/pee>\n        Download\n    <\/div>\n<\/div>\n<h2 id=\"faq\">Frequently Asked Questions<\/h2>\n<div class=\"faq-item\">\n<div class=\"faq-question\">\ud83d\udccc Should all liquids be thickened in case of dysphagia?<\/div>\n<div class=\"faq-answer\">\n        <pee><strong>Not necessarily<\/strong>. The adaptation of liquids depends on the type and severity of dysphagia. Some people have difficulties only with clear liquids (water, juice) but tolerate thickened liquids well. Others have difficulties with all consistencies. Speech therapy assessment allows for determining the necessary adaptations for each person.<\/pee>\n    <\/div>\n<\/div>\n<div class=\"faq-item\">\n<div class=\"faq-question\">\ud83d\udccc Can dysphagia be cured?<\/div>\n<div class=\"faq-answer\">\n        <pee>It depends on the <strong>cause<\/strong>. After a stroke, dysphagia often improves significantly in the weeks to months following due to neurological recovery and rehabilitation. In neurodegenerative diseases (Parkinson&#8217;s, ALS), the goal is rather to maintain abilities as long as possible and to adapt. Speech therapy improves safety and comfort in all cases.<\/pee>\n    <\/div>\n<\/div>\n<div class=\"faq-item\">\n<div class=\"faq-question\">\ud83d\udccc Who can prescribe a modified texture diet?<\/div>\n<div class=\"faq-answer\">\n        <pee>The prescription of a modified texture diet is a <strong>medical act<\/strong>. The speech therapist assesses swallowing capabilities and makes recommendations, but it is the physician who officially prescribes the adapted diet. In institutions or hospitals, a multidisciplinary team (physician, speech therapist, dietitian) collaborates to define adaptations.<\/pee>\n    <\/div>\n<\/div>\n<div class=\"download-hero\">\n<h2>\ud83c\udf7d\ufe0f Ready to work on swallowing?<\/h2>\n<pee>Discover all our free tools to support swallowing disorders<\/pee>\n    See all tools \u2192\n<\/div>\n<\/div>\n<\/div>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<p>[et_pb_code]<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"What are the three main phases of normal swallowing?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Normal swallowing is divided into three main phases: 1) The Oral Phase (voluntary), which includes oral preparation (chewing, salivation, food bolus formation) and oral transport (tongue propelling the bolus to the back of the mouth); 2) The Pharyngeal Phase (reflex), which is automatically triggered when the bolus reaches the soft palate pillars and involves closure of the soft palate, larynx elevation, epiglottis tilting, and vocal cord closure; 3) The Esophageal Phase, where the bolus travels to the stomach.\"}},{\"@type\":\"Question\",\"name\":\"What is dysphagia and what are its potential consequences?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Dysphagia refers to swallowing disorders that can affect any of the three phases of swallowing. 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