Communication and swallowing

We offer services to adults (over 16 years) who have acquired communication and swallowing problems.

Communication difficulties

These are some examples of the communication difficulties that we assess and treat:

  • Dysphasia/aphasia – a language disorder which may affect a person’s ability to speak, write and understand spoken or written words, possibly following a head injury or stroke
  • Dysarthria – an articulation disorder due to disturbed or weak control of the muscles for speech, eg lips, tongue, jaw, palate, vocal folds and muscles which control breathing. This could be as a result of Parkinson’s disease or other progressive neurological conditions, such as motor neurone disease
  • Dyspraxia (verbal) – an articulation disorder which affects a person’s ability to plan and execute speech movements in the absence of muscle weakness, paralysis, sensory loss, comprehension deficit or ataxia, for example after a stroke
  • Dysphonia – altered voice production as a result of organic, physical or functional changes, for example as a result of head and neck surgery or progressive neurological disease.

Swallowing disorders

Speech and language therapists assess, diagnose and manage swallowing disorders (known as dysphagia) associated with acquired neurological disorders, stroke, head and neck surgery, palliative care and respiratory complications (eg tracheostomy).

Our aim is to identify those individuals who are at risk of aspiration (the inhalation of food/fluid into the airway) and to ensure that eating and drinking is safe and sufficient. Some patients may require their food or fluid to be modified to make swallowing as easy and safe as possible. The IDDSI Framework is a useful resource for patients with dysphagia and/or who have been advised to follow a modified food or fluid intake. It is helpful for us to be involved in care at an early stage as we contribute to the diagnosis and management of swallowing difficulties.

We will provide information about the results of assessments, agreed oral intake and any appropriate swallowing strategies. Further investigation, eg videofluoroscopy, may be required (a videofluoroscopy is a moving x-ray image of swallowing which can be an important diagnostic tool for the assessment and management of people with swallowing difficulties), or FEES (Fiberoptic Endoscopic Evaluation of Swallowing, which is a procedure used to examine the nose and upper airways).

During a FEES assessment, an endoscope (a thin, flexible tube with a light and a camera at one end) is inserted into your nose so that the specialist can look down into your throat and upper airways and identify any blockages or problem areas.

FEES can also be used to test for oropharyngeal dysphagia after you swallow a small amount of test liquid (usually coloured water or milk). You may be given a local anaesthetic spray into your nose, but because the camera doesn’t go as far as your throat, it doesn’t cause retching. The procedure is very safe and usually only takes a few minutes.