Swallowing
• Normal vs. Abnormal Abnormal Functioning
• Focus is pri il mar y on the preparatory and oral phase of the swallow
Abnormal Findings
• Mentalis contraction
• Lack of masseter contraction
• Anterior loss of the bolus
• Excessive or forced swallowing
• Tongue Pumping
• Poor bolus formation
• Inappropriate bite size
• Chewing with the mouth open
• Difficulty in isolating the tongue to manipulate the food
• Tongue forward or interdentalized during the
swallow
copyright MLW 2010Teaching the characteristics characteristics of the
“normal” swallow
• Educate patient of appropriate chewing patterns
‐practice gathering food into a bolus.
• Increase awareness of the masseter/“chewing muscles”
– clenching, tension, biting to “pop” the muscle
• Teach correct placement of tongue for swallowing
– sequential positioning of the tip, mid‐portion, and back of the
tongue
copyright MLW 2010Habituate the Normal Swallow
• Establishing habitual awareness and behavior
by following following a hierarchical hierarchical level of skill
development:
– Individual to consecutive swallows
– Crackers to more typical diet
– Sips of l d iqui s to continuous d k rin ing
– Charting meals and monitoring progress of carryover
• Normal vs. Abnormal Abnormal Functioning
• Focus is pri il mar y on the preparatory and oral phase of the swallow
Abnormal Findings
• Mentalis contraction
• Lack of masseter contraction
• Anterior loss of the bolus
• Excessive or forced swallowing
• Tongue Pumping
• Poor bolus formation
• Inappropriate bite size
• Chewing with the mouth open
• Difficulty in isolating the tongue to manipulate the food
• Tongue forward or interdentalized during the
swallow
copyright MLW 2010Teaching the characteristics characteristics of the
“normal” swallow
• Educate patient of appropriate chewing patterns
‐practice gathering food into a bolus.
• Increase awareness of the masseter/“chewing muscles”
– clenching, tension, biting to “pop” the muscle
• Teach correct placement of tongue for swallowing
– sequential positioning of the tip, mid‐portion, and back of the
tongue
copyright MLW 2010Habituate the Normal Swallow
• Establishing habitual awareness and behavior
by following following a hierarchical hierarchical level of skill
development:
– Individual to consecutive swallows
– Crackers to more typical diet
– Sips of l d iqui s to continuous d k rin ing
– Charting meals and monitoring progress of carryover
