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Understanding dysphagia: a parent''s guide.

Article Excerpt
This is the first of a monthly series written for EP Magazine by members of the American Association on Mental Retardation (AAMR).

Most of us never consider that we might not be able to eat or drink safely; in fact, most people take swallowing for granted. Swallowing, however, is quite complicated. Normal swallowing of food and liquid requires great coordination of a large number of muscles in the mouth, throat, and esophagus (the tube that leads from the throat to the stomach).

It involves many different systems working together quickly, effortlessly, and repeatedly. Normal swallowing is a very quick process, taking less than two seconds to move from mouth through the throat and into the esophagus. We swallow more than 1,000 times in a day. Most of those 1,000 swallows are involuntary, so we never really think about them.

When an individual has a problem swallowing it's called dysphagia. Some of the factors that may have an impact on a swallowing problem are:

* Neurologic deficits

* GERD (gastroesophageal reflux disease)--backward flow of stomach acid up the esophagus from the stomach

* Environment--furniture, overstimulation, feeder, etc.

* Previously learned behaviors

* Physical disabilities

How we swallow

Swallowing is a combination of purposeful movements and reflexes that normally take no more than several seconds to complete. The entire process can be described in three stages:

* Stage one, oral. This is where the food enters the mouth, is chewed and is mixed with saliva. It is then moved backward toward the throat. At the point where the food enters the throat (pharynx) the swallow begins.

* Stage two, pharyngeal. This is where the swallow is actually initiated. The food enters the pharynx (throat) at those large arches (facial arches) in the back of...