What does a Speech and Language Therapist do?
The Speech Therapist is the health professional responsible for the prevention, evaluation, treatment and scientific study of human communication and related disorders.
We talk about all the processes related to the comprehension and production of oral and written language, and the adequate forms of non-verbal communication. These disorders refer to speech and language, auditory, visual, cognitive, oral, respiratory, vocal functioning and, last but not least, swallowing.
Do you also evaluate and identify the muscle function of swallowing?
Yes, this is one of the most important competences of the Speech Therapist: to detect, evaluate and intervene on the swallowing function, in terms of structures, muscles and their functioning.
One of the swallowing disorders is dysphagia. Is it a serious disorder? Why?
Yes, dysphagia is one of the swallowing disorders, characterized by a difficulty in chewing and preparing the bolus, controlling it, transferring it from the mouth to the pharynx, protecting the airways during swallowing and / or transferring the bolus to the esophagus. These changes may involve the oral, pharyngeal or esophageal stage (s). Severity depends on the phase, the structures involved and the type of etiology. In general, if a person has changes in this function, however small, it has affected one of the functionalities necessary for their survival, having difficulty maintaining the nutritional and hydration level, which can be considered a very serious disorder.
Are there any warning signs that people should be aware of or ways to prevent dysphagia?
The warning signs and symptoms are varied: hesitation or inability to swallow, food retention in the oropharynx, nasal regurgitation, reflux, multiple swallowing, frequent throat clearing, wet voice after swallowing, coughing, need to clear the throat after swallowing , weight loss, frequent episodes of respiratory infections, choking, loss of oral sensation, loss of saliva, among others. Prevention also involves paying attention to the clinical conditions that give rise to dysphagia. After the diagnosis, we must minimize its consequences and prevent the continuous appearance of signs and symptoms through specific maneuvers for compensation and stimulation of swallowing, as well as promoting a change in the diet.
Is dysphagia more common in any group of people?
Dysphagia due to natural degeneration of neurophysiological structures increases with advancing age, and is also associated with taking certain medications and inattention. However, it is more common in people with neurological injuries and degenerative diseases. It must be borne in mind that aging is a process of progressive degradation common to all living beings. Even in healthy aging, characterized by gradual and adaptive changes, there is a decrease in skills and loss of neuromuscular and perceptual control. If we think that the increase in average life expectancy is a reality, we can imagine that this aging process is more and more common. Thus, there are greater demands made on society, responsible for its population, and with the task of actively responding to this process.
Is it possible to treat dysphagia?
Treatment depends on the degree of injury and its etiology, just as the expected results are also different. In most cases, it is possible to reduce symptoms and make swallowing more effective, even when there is a continuous need to use certain techniques.
What kind of intervention and procedures can the speech therapist have and apply to the person with dysphagia to make improvements?
Intervention methodologies essentially involve changing behaviors, using compensatory strategies, stimulation techniques, swallowing maneuvers, positioning techniques, strengthening exercises; a different set of technical aids can also be used.
Is the accompaniment by the speech therapist only to the person with dysphagia or also to his family or caregiver?
The follow-up is not limited to the person with dysphagia, it must be carried out to all those involved, through guidance to family members, caregivers, and to everyone who feels they are an integral part of the process. Some people are not able to apply the strategies and depend on the family / caregivers for them to be carried out. If indirect monitoring is not carried out, the work is subject to departure.
In order to achieve positive results in the treatment of this disorder, there is a multidisciplinary work. Do you agree that there is intervention of several health professionals in the whole process?
The feeding training is carried out by the Speech Therapist, however other professionals are fundamental in contributing to the improvements, being essential to highlight the following: Nutritionist, Dietitian, Gastroenterologist and Otorhinolaryngologist. Swallowing changes have brought together professionals from different areas, both in scientific studies and in clinical practice, with a view to safeguarding the essential functions of Quality of Life.
Can malnutrition problems arise from dysphagia? Why?
Yes, due to the impossibility of eating foods of different textures / consistencies, or if the person does not eat properly for social reasons; on this point, I can give as an example the individual who is unable to retain food in his mouth, having the perception that it bothers others, inducing social isolation. It is urgent to emphasize this situation because we are a people who socially gather frequently around the table, valuing and prolonging those moments.
In these cases, should nutritional supplements be used?
If the individual does not eat properly, it is essential to supplement his diet with the necessary supplements to supply the missing nutrients and balance his body. This way we can prevent some consequences that range from malnutrition, to respiratory problems, and in some cases to death. I want to mention the importance, sometimes neglected, of the psychosocial problems that lead to depression, anxiety and isolation.