Swallowing disorder or dysphagia can be persistent and cause aspiration and weight loss due to the lack of proper nutrition in the body. So this needs to be treated without much delay. The treatment of an individual should be based on the outcome of a comprehensive assessment. There are various swallowing problem treatment approaches and exercises that are performed by an expert speech pathologist. But treatment is pursued only after acknowledging the particular cause of a swallowing disorder.
1. Physiological feedback-
Physiological or biofeedback suggests a kind of treatment in which a speech and language therapist makes use of a patient’s cognitive skills such as his ability to sense changes. A person with swallowing difficulty is taught to explain the visual information that is imparted to the former through necessary subjective or objective assessments. This aids in making biological changes while swallowing.
2. Dietary alterations-
A small transformation in regular diet and living habits can cure a certain gastro-esophageal reflux. The SLPs always advise patients on the alterations of texture of the food. It enables patients to eat and swallow food or drink safely. Softening solids or changing the fluidity of liquids as well as modifying the taste and temperature of food may also influence the sensory intake capacity bolus. If such modifications are required for patients with swallowing disorders, the SLPs always team up with dieticians and take consideration of the patient’s nutritional needs along with his/her preference and cultural or religious values.
3. Exercises for oral muscles-
For patients with the problem of nerves, brain or muscles, speech therapists always recommend some exercises. These enhance the capability of oral muscles and make them work together to help a person swallow. The purpose of oral-motor therapy or exercises is to stimulate lips, tongue, jaw, respiratory muscles, larynx and pharynx and build coordination between nerves and swallowing muscles. Exercises also help control the oral-pharyngeal mechanism and improve its functions. Some of these exercises are:-
Mendelsohn Maneuver: This exercise is very simple for practicing at home. A patient has to elevate his/her larynx for a few seconds while swallowing and keep repeating several times every day to control swallowing muscles.
Tongue Hold: The patient has to hold the tongue and keep it between the teeth while swallowing. This exercise improves strength and movement of the rear pharyngeal muscles and wall. However, it should be done without food or drink in mouth to avert chocking or coughing.
Shaker exercise: In this exercise, the patient lies flat on the back and raises his head to see the toes. This is done to increase the opening of esophageal sphincter and to help strengthen the oral muscles.
The right knowledge about positioning the body and putting food into the mouth properly changes a patient’s ability to swallow solids and liquids. Now, those who have trouble feeding themselves can visit a professional speech-language therapist who can teach some feeding techniques to patients and their family.
What are the roles and responsibilities of speech-language pathologists?
Swallowing and feeding disorders are connected with various structural, neurological and cognitive deficits. It affects the patient’s communicating abilities. So the intervention of an expert speech therapist is very important here. The primary role of a speech-language specialist is to diagnose, evaluate and determine the course of treatment by observing different symptoms of the patient. Appropriate treatment begins with correct diagnosis and leads to interdisciplinary management by the team of speech therapists. Due to the complications of diagnosis and treatment, therapists often collaborate with other expert professionals, caregivers and families. However, the skill and knowledge of an SLP about physiology and oral anatomy along with swallowing and speech disorder is extensive and assuring for successful outcomes.
The extended roles of a speech and language pathologist are-
1. Determining different signs and symptoms of swallowing and feeding disorders
2. Monitoring a complete assessment, both subjective and objective as per the conditions of patients
3. Recognizing normal and abnormal swallowing mechanism with the symptoms of possible disorder on the upper part of the aero-digestive passage
4. Conducting various secure and effectual treatment procedures on patients with swallowing disorders
5. Determining and implementing suitable measures for functional outcomes
6. Comprehending the vast usages of technical and medical diagnoses and their possible impacts on swallowing problem treatment 7. Conducting assessments and treatment based on past medical history of the patient
8. Providing different therapeutic treatments and others, including diet modifications, oral-motor exercises, biological feedback, etc
9. Spreading awareness about some changes in swallowing functions that are different for people of different ages
10. Making giant advancements in treatment procedures and maintaining holistic charm of the therapeutic approaches through vast research work and activities
A speech-language pathologist, certified with graduate and/or postgraduate degrees along with specialized skills, knowledge and acquired experience is qualified to offer assessments and treatments for dysphagia and feeding problems. They are also need to be certified by the Rehabilitation Council of India (RCI). Diagnosis and therapies for swallowing problems need proper training and competence.
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