How is Dysphagia Diagnosed?
If the child has a feeding or swallowing problem, talk with the primary care doctor. Depending on the severity of the problem, the child may be referred to a doctor that specializes in the evaluation of feeding problems, a speech-language pathologist, an occupational therapist, a registered dietician, and/or a lactation consultant.
A speech-language pathologist can perform a clinical oral-motor and feeding evaluation. This will help identify the problem and see if there is a need for treatment or further assessment first.
A VSS (video fluoroscopic swallowing study), also known as a modified barium swallow, may be suggested. A VSS is done by a speech-language pathologist and a radiologist. An X-ray video is taken of the child’s throat while they are eating and drinking. The examiners evaluate the safety and efficiency of swallow. They can also detect aspiration and other problems with swallowing function. Techniques to modify the way the child swallows can be introduced during the VSS to see what may help with swallowing issues.
A FEES (Fiberoptic Endoscopic Evaluation of the Swallow) study may also be suggested. This study is done with an ear, nose and throat (ENT) doctor and a speech-language pathologist. It involves putting a small tube (scope) through the child’s nose to the back of the throat so that the structures and muscle function can be watched directly during swallowing. This study allows observation of the child’s ability to protect the airway from secretions, liquids and solids during swallowing.
Impact of Dysphagia
Dysphagia may result in inadequate airway protection during swallowing. This can cause food or liquid to get into the lungs (aspiration). Aspiration into the airway can cause upper respiratory infections and pneumonia. The child may not be able to manage food or liquid well or accept an age-appropriate diet. Dehydration and malnutrition may occur if the feeding problem goes untreated. If the dysphagia is severe, another source of nutrition and hydration, such as a feeding tube, may be needed. A child with dysphagia may develop anxiety about eating or drinking.
