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Diagnostic Tests

The following tests may be performed to determine the cause of your child's feeding or swallowing disorder.

Videofluoroscopic Swallow Studies/Oral Pharyngeal Motility Studies:
The videofluoroscopic swallow study (VFSS), also called an oral-pharyngeal motility study, is a diagnostic procedure done under a moving X-ray (fluoroscopy) that is used to evaluate the swallowing mechanism.  It analyzes the oral and pharyngeal structures and motility in relation to each other during eating, breathing and swallowing.  Events before, during and after the swallow can be viewed during a VFSS, helping the clinician to determine which food textures under which circumstances a child may eat or drink safely. During the exam, your child simply needs to eat and/or drink while a "video X-ray" (videofluoroscopy) is taken so that his/her swallow can be assessed. your child's food and/or drink will be combined with contrast so that it can be viewed with X-rays.The actual exam usually ranges from 5 to 15 minutes.

Who is a candidate?
A videofluoroscopic swallow study may be recommended if your child:

  • Coughs or chokes during feeding.
  • Takes longer than 30 minutes to drink a bottle.
  • Has difficulty consuming the volume or type of food recommended for his/her age.
  • Has a history of poor weight gain, or is diagnosed failure to thrive.
  • Has a history of unexplained respiratory congestion or illness.
  • Is tube-fed, has a history of swallowing problems, and you are considering introducing food by mouth.
  • Gags excessively with feeding.
  • Forgets to breathe, experiences skin-color changes or sweats during feeding.
  • Describes a sensation of something in his/her throat.
  • Experiences difficulty swallowing large bites or certain textures.

Clinical Feeding Evaluation
A clinical feeding evaluation involves observing your child while feeding or eating a meal to assess current feeding skill level and any areas of difficulty. You will be provided recommendations to implement at home in order to treat any feeding difficulties noted during the evaluation.  Depending on the nature of your child's difficulty, the clinician may also recommend that your child receive feeding and swallowing therapy and/or other services to facilitate progress.

Who is a candidate?
Your child may be recommended for a clinical feeding evaluation if:

  • She/he has already demonstrated a safe swallow in the videofluoroscopic swallow study.
  • The referring physician does not have concerns regarding the anatomy or physiology of your child's swallow

Or if your child:

  • Is experiencing difficulty transitioning to an age-appropriate diet.
  • Refuses all or many attempts at feeding.
  • Has difficulty chewing food adequately.
  • Has difficulty gaining weight.
  • Is a noisy bottle feeder.
  • Takes longer than 30 minutes to take a bottle.
  • Has a very limited diet.
  • Has difficulty gaining weight, or is diagnosed "failure to thrive."
  • Refuses to eat certain food textures.
  • Is medically ready for weaning from tube-feeds.

Feeding and Swallowing Therapy
Feeding and swallowing therapy varies depending on the causes and symptoms of your child's feeding and swallowing problems. Treatment may include oral motor strengthening and range of motion, chewing and biting skill development, cup drinking, oral motor stimulation and desensitization, oral sensory skills, positioning changes, alteration of mealtime schedule, utensil and/or bottle modifications. Ongoing treatment programs may range from 6 to 18 months.