Integrated Physiotherapy and Speech Pathology Dysphagia Assessment and Treatment: A Single Pediatric Case Study

Abstract

Purpose The purpose of this study was to explore the effectiveness of an integrated physiotherapy, and speech pathology approach to pediatric dysphagia assessment and treatment. Method A single retrospective case study design was used for a 3:2 year old child (Y) with a dysphagia only diagnosis over a 2:8 year period. An integrated feeding and postural assessment was completed. Treatment for Y then included the use of speech pathology techniques, core stability and adapted Shaker et al. (2002) exercises, and elastic therapeutic taping (ETT). Results Reassessment suggested that due to the exercises Y had improved core stability and supra-hyoid muscle strength. Videofluoroscopy (VFSS) results indicated that there was increased anterior tilt during hyolaryngeal excursion leading to reduced valleculae post swallow residue, with residue remaining at the level of the cricopharyngeus and pyriform sinuses. Elastic therapeutic taping (ETT) was then used with the aim of supporting an increase in superior hyolaryngeal movement. Results showed that in the absence of being able to create change in superior hyo-laryngeal excursion, ETT potentially altered Y's swallow pattern positively. It was hypothesized this was due to improved sensory awareness. Conclusion In summary, an integrated approach allowed holistic assessment and treatment of the varied aspects of Y's dysphagia.