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Speech Pathology

Swallowing Treatment at Wake Forest Baptist

Difficulty swallowing, or dysphagia, can impact your quality of life. We specialize in treating patients who have problems swallowing foods, liquids, medications, or even saliva. Our speech-language pathologists use the latest exams and technology to assess swallowing and aspiration, or the entry of food and liquid into the airway, and then develop an individualized treatment plan for each patient. 

On this page, you can learn about our adult and inpatient rehab swallowing evaluations and treatment at WFBH. Click here to learn about the pediatric feeding and swallowing therapies available at our Brenner Children's Hospital and Medical Plaza Miller.

Swallowing Evaluations

Wake Forest Baptist speech-language pathologists may use one or more of the following tests to examine a patient’s muscles and see how foods and liquids are swallowed.  

Clinical Swallow Evaluation (CSE)CandaceF_ClinicalSwallowEval_125px

During a CSE, a non-invasive swallowing evaluation, a speech-language pathologist looks at the movements of the mouth and face and assesses breathing and secretion (saliva) management. Then, the patient is given various food and liquids so that chewing and swallowing can be observed. The speech-language pathologist will ask the patient and/or family questions about eating habits and any observed eating difficulty.

Flexible Endoscopic Evaluation of Swallowing (FEES)Flexible Endoscopic Eval-Swallowing_125px-crpd

The FEES is a swallowing evaluation where a small endoscope is gently passed through the nose to visualize the throat from above, while swallowing. The patient is given various food and liquids so that swallowing can be viewed in real time. Food and liquid is typically dyed  to allow for greater visualization.

Pharyngeal Function Study (PFS), also known as a Modified Barium SwallowPFS_125px

A PFS is an x-ray of the swallowing process performed in conjunction with a radiologist. This involves a very low dose of radiation exposure. The test is typically done for patients who have difficulty swallowing liquids, solids or medications. The patient is given a variety of food and liquid mixed with barium, a contrast material that shows up on the x-ray when you swallow. 

Comprehensive Swallowing Therapy

We offer a variety of swallowing therapies to help strengthen swallow muscles and improve swallow function and safety. These treatments are customized for each patient and may include:

Oral _Pharyngeal Str..ening Exer._125pxOral and Pharyngeal Strengthening Exercises

These exercises focus on improving strength, timing and coordination of the muscles of the mouth, tongue and throat.


sEMG_125pxSurface Electromyography (sEMG)

Small electrodes are placed under the patient’s chin to measure contraction of the swallowing muscles and the data is displayed on a computer or handheld monitor in real time. This provides visual biofeedback that helps the patient improve swallowing effort.


Lingual Manometry_125pxLingual Manometry

Lingual manometry is used to evaluate and improve tongue strength. Small air-filled bulbs are placed on the tongue. The patient then presses the bulbs against the roof of the mouth while a computer or handheld screen monitors the activity. This provides visual biofeedback during tongue strengthening exercises.


Endoscopic biofeedback-crpd_125pxEndoscopic Biofeedback

An endoscope is placed through the nose to allow visualization of the throat. The patient is able to practice swallowing exercises, maneuvers and strategies. This allows for increased awareness of targeted outcomes.


Swallow _VitalStim_125px

VitalStim® Therapy

Small electrodes are placed on the face or under the chin and deliver an electrical current to stimulate the muscles in that area. This is performed together with traditional swallowing exercises..


Thermal_Taste_125pxThermal/Taste Stimulation

Cold and/or flavored foods (such as lemon flavored swabs, ice chips or popsicles) are given to the patient in effort to create a swallow response. The use of the cold or flavor may help a patient who has decreased sensation, or feeling of foods and liquids, to notice the foods/liquids and swallow them in a more timely fashion.  In such patients, speeding up the response time increases their safety. This is performed with traditional swallowing exercises.

Respiratory Train_Biofeedback_125pxRespiratory Training and Biofeedback

Respiratory training can be provided  to improve breathing methods, improving strength for breathing in and out. This improves swallowing, reduces congestion, and helps clear airways. The patient is taught to use a handheld device to work on better breathing in and out. In addition, biofeedback can be utilized to increase attention to respiration during the swallow. The patient wears a nasal cannula to measure inspiration and exhalation during swallowing, which is captured in conjunction with sEMG. This allows for visual biofeedback of the respiratory pattern to improve the coordination of respiration and swallowing.


Myofascial release_125pxMyofascial Release®

Specially trained speech-language pathologists can provide gentle and sustained stretching to release muscle restriction and improve range of motion. This eases pain and aids in improved swallowing function. 




We use the TheraBite® Jaw Motion Rehabilitation System™ to help patients who have problems with the jaw, like difficulty biting, chewing, speaking and swallowing. We help develop a therapy plan and educate patients about use of the device.


We also offer caregiver education regarding diet and swallowing.

Swallowing therapy takes time and requires your commitment and dedication. We offer both inpatient and outpatient care. We work closely with inpatients during their hospital stay and encourage swallowing therapy two to three times per week for 12 to 16 weeks for outpatients. A self-led and/or home exercise program is also strongly recommended to improve results. We continue to work closely with you after your initial treatment, providing suggestions for follow-up care and evaluating your progress. 

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Last Updated: 08-18-2016
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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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