Understanding Swallowing Assessments

Eating and drinking are fundamental activities that support health, wellbeing, and social connection throughout life. For some persons, however, swallowing can be challenging. These difficulties, known as dysphagia, may affect a person's ability to suck, swallow, drink, bite, chew, eat, manage saliva, take medication, and protect their airway while swallowing.

Dysphagia can significantly impact a person's mealtime experience, affecting their safety, enjoyment of food, nutritional intake, hydration, and participation in social activities.

What Is a Swallowing Assessment?

A swallowing assessment is a comprehensive evaluation of how a person manages food and fluids during mealtimes. It examines the entire eating and drinking process, from accepting food and chewing to safely swallowing.

There are two main types of swallowing assessments:

Clinical Swallow Examination

A Clinical Swallow Examination is conducted by a Speech Pathologist and involves observing the person's eating and drinking abilities. Standardised assessment tools may be used to evaluate swallowing function and identify any signs of dysphagia. This assessment also helps determine whether further instrumental assessment is required.

Instrumental Swallowing Assessment

Instrumental assessments provide a detailed view of the swallowing process and are typically arranged through a hospital service. These assessments may include:

• Videofluoroscopic Swallowing Study (VFSS) – a specialised X-ray procedure that examines swallowing in real time.

• Flexible Endoscopic Evaluation of Swallowing (FEES) – a procedure that uses a small flexible camera to assess swallowing function.

Who May Benefit from a Swallowing Assessment?

A swallowing assessment may be recommended for persons who experience:

• Coughing or choking during meals

• Difficulty chewing or managing certain food textures

• Prolonged mealtimes

• Fatigue while eating or drinking

• Food refusal or limited food variety

• Frequent throat clearing

• Poor weight gain or nutritional concerns

• Recurrent chest infections or respiratory issues

• A wet or gurgly voice after eating or drinking

What Happens During a Clinical Swallowing Assessment?

1. Gathering Background Information
   Information is collected from the person and/or their family members to identify risk factors for dysphagia and determine the suitability of the assessment.

2. Observing Communication and Cognitive Skills
   The Speech Pathologist evaluates communication abilities, cognition, behaviour, alertness, and overall level of consciousness.

3. Assessing Breathing and Posture
   Respiratory function and postural control are observed, as both can influence swallowing safety and efficiency.

4. Examining Oral Structures and Function
   The Speech Pathologist assesses the face, jaw, lips, tongue, hard and soft palate, teeth, and oral tissues. An oral motor examination may also be completed, depending on the person's abilities and needs.

5. Observing Eating and Drinking
   The person is observed during mealtime, and a variety of food and fluid textures may be trialled to assess swallowing performance.

6. Developing Recommendations
   All assessment findings are integrated to determine the presence and severity of dysphagia, identify potential risks, and develop a personised mealtime management plan with appropriate recommendations.

Frequently Asked Questions

What happens after a swallowing assessment?

Following the assessment, the Speech Pathologist will discuss the findings and provide recommendations tailored to the person's needs. These may include strategies to improve swallowing safety, modifications to food or fluid textures, mealtime support recommendations, or referral for further instrumental assessment if required.

Will a swallowing assessment be uncomfortable?

A Clinical Swallow Examination is non-invasive and typically involves observation, discussion, and assessment of eating and drinking skills. If an instrumental assessment such as a VFSS or FEES is recommended, the Speech Pathologist will explain the procedure and answer any questions beforehand.

How do I arrange a swallowing assessment?

At Thrive Health Therapies, our Speech Pathologists provide comprehensive swallowing assessments for children and adults experiencing feeding or swallowing difficulties. Contact our team to discuss your concerns and determine whether an assessment may be appropriate.

Conclusion

Swallowing difficulties can affect a person's safety, health, nutrition, hydration, and enjoyment of mealtimes. A comprehensive swallowing assessment can help identify concerns, determine potential risks, and guide appropriate management strategies to support safer and more enjoyable eating and drinking experiences.

If you are concerned about swallowing difficulties for yourself, your child, or someone you support, seeking assessment and advice from a qualified Speech Pathologist can provide valuable information and support. Early identification and intervention can play an important role in maintaining health, wellbeing, and quality of life.

Please call Triple Zero (000) immediately if a person is choking, unable to breathe, or experiencing severe respiratory distress.

Reference

Speech Pathology Australia. (2025). Dysphagia guidelines. Speech Pathology Australia. https://www.speechpathologyaustralia.org.au/resource?resource=125

Next Steps

If you have concerns about your swallowing, booking a swallowing assessment is often the most effective place to start.

Our team at Thrive Health Therapies can guide you through the assessment process and help determine the most appropriate next steps for your care.

Get in touch today to speak with our team:
📞 0474 248 081
✉️ enquiries@thrivehealththerapies.com