Swallowing Disorders - North Carolina Eye, Ear, Nose & Throat

How can a Speech Language Pathologist help with swallowing difficulty?


Speech Pathologists are uniquely qualified to assess swallowing and have received special training in dysphagia (a swallowing disorder).

What is a swallowing disorder ?

Swallowing disorders can occur at any of the follow stages:

  • Oral phase - sucking, chewing and moving food/liquid to the throat.
  • Pharyngeal phase - starting the swallow reflex, squeezing the food down the throat, closing the airway to prevent food or liquid from entering the airway.
  • Esophageal phase - relaxing and tightening the openings at the top and bottom of the esophagus and transporting the food into the stomach.

What can I expect during a swallowing evaluation?

A clinical swallowing evaluation will begin with:

  1. Review of the case history, including medical conditions, current medications, and history of your swallowing concern.
  2. Evaluation of strength and movement of structures involved in swallowing.
  3. Observation of eating and drinking.

Following this portion of the assessment, the following tests may be recommended:

Fiberoptic Endoscopic Evaluation  of Swallowing (FEES) and/ or Modified Barium Swallow Study (MBSS)

How are FEES and MBSS Completed?

Fiberoptic Endoscopic Evaluation  of Swallowing (FEES) – Ingestion of food or drink is viewed through a lighted scope inserted through the nose.  This procedure is completed in our clinic.

Modified Barium Swallow Study (MBSS) – Ingestion of food or drink mixed with barium,  viewed and assessed by the SLP  using imaging in a radiology suite.

During both examinations the SLP will observe the swallow and  assess safety of swallow with various consistencies and textures of foods.

The Speech Pathologist may make recommendations that include therapy for your swallowing and/or diet modifications.

Symptoms of Dysphagia:

  • Poor weight gain.
  • Meals that take more than 30 minutes to complete.
  • Wet or gurgly sounding voice during or after eating or drinking.
  • Coughing during feeds.
  • Loss of liquid or food while eating.
  • Food or drink coming out the nose.

Common Causes of Dysphagia in Children:

  • Neurological Problems
  • Anatomical differences
  • Cleft lip/palate
  • Cardiac Defects
  • Gastrointestinal problems, such as reflux

More information about Dysphagia can be found at: