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Swallowing evaluation services

Clinical swallowing evaluation

This evaluation includes a detailed case history, an assessment of the oral motor skills involved in swallowing, and an observational assessment of the child’s eating and drinking. It provides the clinician vital information that helps guide treatment and recommendations and/or need for instrumental swallowing assessment.

This evaluation will help to determine if the nature of the feeding concerns stem from a dysphagia or more of a restricted eating picture. In the case of a clinical picture fitting more of a restricted eater, we can collaborate with the university clinic for management options.��

Videofluoroscopic Swallowing Study��

A Videofluoroscopic Swallowing Study (VFSS) is a moving x-ray of swallowing. It enables the speech-language therapist to assess the biomechanics of the child’s swallowing, swallowing safety, and guides management and treatment of the swallowing disorder. No special preparation is required prior to the procedure.

We are the only private clinic in the South Island to offer VFSS. We have our own Fluorostar system on-site and our therapists are trained in Radiation Safety and have Radiation Use licences. In addition, Dr Anthony Lim is available as a consulting radiologist when required. A detailed diagnostic report is provided and if applicable treatment options discussed based on the findings of this assessment.

Please note: Specialist approval is required for this procedure. Caregiver request and/or GP consent is not adequate. This is because radiation exposure risk needs to be considered.��

Flexible Endoscopic Evaluation of Swallowing

Flexible Endoscopic Evaluation of Swallowing (FEES) uses a flexible nasendoscope to assess swallowing. The nasendoscope is passed through the nose until the throat is in view. Food or fluid is given, dyed with food colouring, to eat and drink whilst the nasendoscope is in place. This helps to visualise the throat and enable assessment of swallowing.

This type of assessment can be difficult to administer for many young paediatric patients due to the potential discomfort of having a scope in situ. It is available for children over the age of ten who are able to tolerate it.��

Treatment services

Clinical consultation

The child may just need a one-off consultation session to help improve the safety and efficiency of their swallowing. This may include provision of education, practice of compensatory swallowing strategies, or follow-up after the completion of a home therapy programme.

Intensive therapy treatment programmes can also be provided where we see the child multiple times each week to maximise outcomes.��

Swallowing treatment

Swallowing treatment is individualised for each child based on their swallowing physiology and biomechanics. We have access to a variety of different therapy and instrumental techniques to maximise habilitation or rehabilitation potential. We see infants through to 16-year-olds and will tailor the treatment to meet your child’s individual needs.

Feeding difficulties in children can be difficult to tease apart. We specialise in assessment and treatment of dysphagia (swallowing disorder). If the child has difficulties eating and drinking but the nature of the challenges appears to be more sensory or behavioural, we may recommend a referral to the Feeding Clinic at the UC Speech and Hearing Clinics.

Given the complexity of dysphagia in paediatrics, with your consent, we commonly work together with the wider team members for a multidisciplinary approach around your child’s feeding difficulties this may include paediatrician, Ear Nose and Throat Specialist and dietitian. ��

Some treatments may include:

• Biofeedback – uses the principles of motor learning and neural plasticity to enhance skill training in swallowing. We use biofeedback software such as the BiSSKiT (Biofeedback in Strength and Skill Training) software that was developed in our lab. Children will need to be at a level they can attend to the task and follow the instructions.
• Therapy exercises – targeting a permanent change to swallowing physiology.
• Compensatory strategies – adaptive behaviours that are used when eating and drinking that provide an immediate but short-term change to swallowing physiology and efficiency.

Treatment delivery options

Following a full diagnostic evaluation, we will develop an appropriate treatment plan together to suit your child’s needs.

Swallowing sessions

We provide single swallowing therapy sessions according to the treatment recommendations or you and your child’s availability. Some children with more mild dysphagia may only require a few sessions over several weeks to achieve the goals.

Swallowing intensive��

1-2x/day for one or more weeks.��Intensive swallowing treatment is provided once or twice daily for 5 days/week. You may require one or two weeks depending on your progress. Some people have a two-week block, then a break, then come back for another block after a break.

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