Problem-Solving with Catherine: Video Swallow Studies
Question: Do you find that sippy cups with spouts used during swallow study do not give the results you are looking for. . The swallow you get has a different pattern than open cup drinking and are you seeing a more immature oral phase. If the child is of the age that they should be drinking from an open cup do you find a more immature swallow with poor collecting. How do you report this and do you recommend open cup drinking to improve swallow maturity. If you are looking for aspiration do you think the immature pattern may be affecting this. I am looking more for your experience and information than answering your questions.
Answer: Good questions!
Looking at what the child is currently utilizing is a good place to start so we see a baseline that reflects the everyday feeding environment. A spouted sippy cup does typically promote different oral-motor patterns than an open cup, both for cheek/lip and tongue activity. It may also alter bolus size and flow rate, positively or negatively for that particular child.
Depending on the swallowing physiology observed, a spouted cup may actually promote a safer swallow for that child. The spout may provide more oral stability and/or promote more effective channeling of fluid through the oral cavity for that child. It is true that an open cup promotes more mature oral-motor patterns, but in the study we need to weigh intake, physiology, safety and developmental goals for that child with his history and co-morbidities. So on an interim basis, a sippy cup might be recommended, with the ultimate goal to work in therapy to provide oral-sensory-motor experiences and therapeutic trials with an open cup, if the study suggested that was appropriate and safe.
Delayed development of oral-motor patterns that support the emergence of more mature swallowing patterns can indeed affect physiology. During the swallow study, we are looking at the child’s swallowing physiology within the context of current level of development, his history and co-morbidities. While we may or may not capture aspiration events during the procedure, the nature of the physiology we observe should guide us to objectify potential interventions during the study. From there, the range of interventions useful for mealtime and those for focus in therapy, can be recommended.
I hope this is helpful.
Catherine S. Shaker, MS/CCC-SLP, BCS-S Board Certified Specialist – Swallowing and Swallowing Disorders