Swallowing Therapy (Dysphagia) & Modified Barium Swallow Studies

Swallowing is something most of us never think about — until it stops working smoothly. Dysphagia (difficulty swallowing) can affect nutrition, hydration, social enjoyment of meals, and respiratory safety.

Dysphagia can occur at any stage of life. In adults, it often follows stroke, Parkinson's disease, ALS, dementia, or head and neck cancer treatment. In children, it may present as feeding challenges, oral motor weakness, or sensory aversions to certain textures. The approach to therapy is different for each population, but the goal is the same: safe, efficient, and enjoyable swallowing.

How we evaluate

Modified barium swallow studies (MBS)

Aspiration doesn't always look like coughing or choking. In fact, over half of all patients who experience aspiration do so silently, showing no outward warning signs. That hidden danger is why advanced imaging is the perfect partner to our bedside evaluation — the bedside exam looks at the whole person and builds your immediate mealtime plan, while the scan provides the final piece of internal clarity.

A modified barium swallow study may be ordered to be completed in coordination with local medical facilities. An MBS is a moving X-ray of the swallow that lets the speech-language pathologist see exactly how the swallow is functioning — where the impairment is, whether food or liquid is entering the airway (aspiration), and which strategies or textures improve safety. The results inform a precise therapy plan and diet recommendations.

Advanced training

NMES is most effective for adults with pharyngeal-phase weakness — typically post-stroke or oncology patients. It's rarely a first-line option for pediatric feeding, where sensory and behavioral factors dominate.

eSwallow NMES

Chelsea holds advanced training in eSwallow NMES (neuromuscular electrical stimulation) — a therapy that uses small electrical currents to retrain the swallowing muscles. It is appropriate for many adult patients with pharyngeal dysphagia and is used alongside traditional swallowing exercises.

Advanced training

Beckman Oral Motor Protocol

As part of our comprehensive approach to pediatric care, Chelsea utilizes her certification in Beckman Oral Motor training to target underlying mechanical deficits in the oral musculature. Rather than treating oral motor issues or dysphagia in a vacuum, she integrates Beckman techniques alongside functional swallowing and feeding therapies. This method utilizes targeted pressure and assisted movement to activate muscle contraction, normalize sensory response, and increase oral control. This combined approach is highly effective for infants and children struggling with complex feeding issues, poor bolus control, or structural weakness.

Pediatric feeding & swallowing

For infants and children, feeding and swallowing challenges can show up as refusal of textures, gagging, prolonged meals, poor weight gain, or aversion to certain food groups. We work closely with parents to identify the underlying cause — oral motor weakness, sensory differences, swallow safety — and build a plan that makes mealtimes safer and less stressful for the whole family.

For families

Refusal of textures or gagging
Prolonged meals or poor weight gain
Aversion to certain food groups
Oral motor weakness or swallow safety

First step

A swallow evaluation starts with a conversation.

Tell us what's happening at mealtimes. We'll explain whether a bedside evaluation, an MBS, or direct therapy is the right starting point — and what each step looks like.

Consultation — by phone
MBS coordination — with local medical facilities
Infant to adult — every age supported

Signs Dysphagia (Swallowing Disorder) therapy may help

Coughing or choking during or after meals
A feeling of food "sticking" in the throat or chest
Repeated pneumonia or respiratory infections (aspiration)
Unexplained weight loss or dehydration
Avoiding certain foods or taking much longer to eat
A wet or gurgly voice after eating
Drooling or difficulty managing secretions

How ReImagine treats dysphagia (swallowing disorder)

Evaluation may include a clinical bedside swallow evaluation and a modified barium swallow study (MBS) performed in coordination with a local medical facility. Based on findings, therapy may include swallowing exercises, diet texture modifications following the IDDSI framework (International Dysphagia Diet Standardisation Initiative), compensatory strategies, and caregiver training. We use evidence-based approaches including eSwallow NMES (neuromuscular electrical stimulation) when appropriate.