"Seeking Personal Experience and Opinions on Dysphagia (Swallowing Disorder)"

I am an RN and in all the hospitals that I worked the speech therapist are the swallowing experts. If a patient has trouble swallowing the speech therapist is called and he/she does an evaluation.

The speech therapist will feed your son food of different consistency and textures and monitor it from the minute it goes in his mouth, while he chews and then swallows. She will use a special camera to watch the food move down the esophagus. It is called an FEV evaluation and it is painless. The speech therapist should beable to determine the cause of the dysphasia. It could be many things, perhaps muscular? If it is muscular the therapist can help him strengthen his swallowing muscles. If it is something else, she will be the expert to know what intervention works best for your son. It would be irresponsible of me to guess what could cause your son's dysphasia without more info and further testing.

Dysphasia is just a word that means difficulty swallowing, it does not give a cause or reason for your son's difficulty swallowing.

I suggest that you call your pediatrician and tell him that you want your son evaluated by a speech therapist ASAP. Why wait??? Trust your instinct, if you think it is more than just being a "picky eater" it probably is. If the test come back normal, then you know and you have peace of mind. If something is wrong - it can be managed and your son can start enjoying his food.

Good Luck

They couldn't just test him then because a swallow study is done by a radiologist and a speech pathologist. It has to be scheduled in either an outpatient radiology center or usually a hospital radiology department. They basically takes x-rays while he is sitting upright drinking the contrast so they can see exactly what happens when he eats, drinks or just handles his own secretions.

He could have some swallowing/physical issues, he could have sensory issues. Depending on what they find he might be referred to a speech pathologist or an occupational therapist to address any sensory issues or he might work with both.

My son got checked for this at around 1 year old in the children's hospital by a pediatric ENT. I just had to keep him calm and make sure he ate the food with the contrast agent so they could see how he handles chewing and swallowing. As your son is older, I guess it will not be a problem. They will just look at him through a screen which is similar to having an x-ray vision in real time, while he is eating. There is a white solid/liquid that they put on the food (cookie in your case) which is pretty much tasteless. You may also consider taking with you whatever he likes to eat, so they can put it on that food and it will be easier to make him eat it. If you actually schedule this test, they should give you more information on what to do/what to bring.

In our case, it turned out everything looked just fine so I do not have any personal experience on what might happen next if they see a problem.

I would suggest to make a list of all the questions you have and ask them to the doctor(s) either on the phone or at your next visit.

Sounds like you have gotten some good information already! I am a speech therapist, although I work with the elderly and I do treat a lot of swallowing disorders. I think the reason your doc suggested you wait a few days it that sometimes kids just have a hypersensitive gag reflex and not a true dysphagia. They were probably thinking that if the problem persists they would schedule the Modified Barium Swallow (also referred to as a Cookie Swallow.) Sometimes when a child has a cold, and increased mucous production, this can cause the coughing/gagging to occur. It sounds like you are pretty concerned and that this has happened several times. I would call your doctor and ask for the test to be scheduled. Some children do have difficulties tolerating various textures of food and this can be addressed by speech therapy and occupational therapy. It might be a good idea to ask for a multidisciplinary therapy evaluation.

Try not to worry yourself too much. Yes, it could be just that he is a picky eater, or has a hypersensitive gag, or difficulty with new textures. Ask him what he thinks it is. Then let the experts advise you. Hang in there!

Hi, Renee:

There is a book, "To Listen To A Child," by T. Berry Brazelton, M.D.
In it, there is information on fears of a child at this age.

Check out the book and see if you can relate to anything written.
Good luck. D.

You may want to take him to an allergist.. Maybe it's something he's allergic to causing his throat to close up... Good luck!

My daughter had this test when she was around a year old. It turned out there was nothing physically or mechanically wrong. She has sensory issues. She had speech and feeding therapy which helped. I would get the test to be sure.