To most of us, swallowing is automatic. We never think about it, because swallowing is considered a reflex. Difficulty swallowing or an inability to swallow is called dysphagia. Dysphagia can occur for a number of reasons, in our case it is the brain damage that causes a lack of a swallow reflex or a weak suck and swallow. One article state that when a feeding tube is placed immediately following birth, the baby might “forget” how to suck and swallow and may relearn it.
There are actually three stages of swallowing and the specific difficulty can be at any or all of those stages. An excellent overview of dysphagia, including the phases of swallowing, can be found at the website of the American Speech-Language-Hearing Association. http://www.asha.org/speech/swallowing/Sw... Here is another good overview page from National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/pubs_vsl...
Swallow Studies
If you are not sure about your child’s ability to swallow and feed orally, your child will need a swallow study, also called an upper GI series. A swallow study can also be done in order to be sure that a child is ready for oral feeding or to find out if a child is aspirating. Dr. Evans Morris’ article When A Child Aspirates tells about swallow studies and what they can show about the child’s ability to swallow. It also gives questions for the parent to ask and tells when a child should have a swallow study. http://www.new-vis.com/fym/papers/p-feed... Here is a link to a description of an Upper GI series (barium swallow study test). This site tells exactly what to expect and tells any risks to this test. http://www.nlm.nih.gov/cgi/medlineplus/l...
Oral Motor Therapy
Although some articles state that surgery or medication may help with dysphagia, I don’t think that is true of our brain injured children. Therapy appears to be the way to go. Oral motor therapy is provided by a speech therapist or occupational therapist who is trained in oral therapy. The goal of an oral motor treatment program should be to develop positive and enjoyable use of the mouth. Objectives include sensory awareness, perception and discrimination with the mouth. This is a comprehensive article about oral motor therapy http://www.new-vis.com/fym/papers/p-feed...
Oral Defensiveness
Oral defensiveness is common with our kids. They have learned that the anything done in the area of the face and mouth will be unpleasant: placement of ng or og tube, suctioning, and intubation, for example. Babies and children can fear that anything having to do with the mouth will result in their discomfort. They learn that the mouth is a place to be guarded. Therefore, the child needs to have many, many positive experiences in the mouth and face area to counteract these feelings. The following is a list of some sensory experiences you can use to “desensitize” the area. As you will see the ideas range from activities for babies who make no purposeful movement to babies or children who do move and explore on their own. The list was culled from a variety of sources on the web.
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