Take a good look at this video before you keep reading… get some thoughts in your head about what is going on with this patient. Impulsive? Inadequate mastication? “Premature spillage”? Do they need strategies to “fix” them? What strategies would be potentially helpful?
Got your thoughts ready?
This is actually a video clip of one of our Cleveland area SLPs, Angela. I asked her to eat a bit of her lunch under fluoroscopy… and here are the results. Angela is a perfectly normal, healthy person. She eats a bit quickly, doesn’t chew a whole lot… but she definitely does not need interventions. We don’t get the chance to see normal swallowing on fluoro a whole lot, which can give us the perspective that variations of normal swallowing are, in fact, disordered. There is a wide variety of what is normal with regard to mastication in terms of timing, number of strokes, etc. There is also a wide variety with regard to where (and how low) the bolus collects prior to the initiation of the swallow.
(Links with info below) Since we don’t get to see a lot of normal, and most of us probably can’t talk our coworkers into eating under Xray, we need to keep up with the literature, and to take courses on normal swallowing when we can. Otherwise, we risk breaking that age old caveat…if it ain’t broke, don’t fix it.