Adult swallowing assessment and therapy
Swallowing Therapy in Sydney
Coughing with drinks, food sticking or meals becoming difficult can be signs that swallowing needs a closer look. Nikki Martin assesses adults with swallowing concerns in Edgecliff, Sydney, and develops an individual plan based on the findings.
Eating and drinking should not feel like a repeated test. A swallowing assessment can help identify where the difficulty occurs, what additional testing may be useful and what can make meals safer and more manageable.
What Are Signs of a Swallowing Difficulty?
Swallowing problems, also called dysphagia, do not always feel the same. You might cough or splutter with drinks, feel that food is sticking, take longer to finish a meal, avoid particular textures or notice a wet-sounding voice after swallowing. Some people have trouble managing saliva or pills.
These signs can have different causes. A cough does not by itself prove that a drink entered the airway, and aspiration can sometimes happen without an obvious cough. If the problem is recurring, it deserves assessment rather than guesswork. Nikki’s article on coughing when drinking water looks more closely at one common question.
What Happens in a Swallowing Assessment?
A speech pathologist asks about your symptoms, medical history, the foods and drinks that cause difficulty, and any recent changes in weight, chest health or eating habits. They may examine the mouth and observe eating or drinking when it is safe and appropriate to do so.
A clinical assessment cannot show every part of the swallow. If more detail is needed, an instrumental examination may be recommended. A videofluoroscopic swallow study (VFSS) uses moving X-ray images. A fibreoptic endoscopic evaluation of swallowing (FEES) uses a small camera passed through the nose. These tests answer different questions and are chosen when clinically indicated; they are not automatically part of every appointment.
Assessment guides the plan. It helps distinguish a problem that may respond to swallowing strategies from one that needs further medical investigation or care from several clinicians.
What Might Swallowing Therapy Involve?
Management depends on why swallowing is difficult. It may involve targeted exercises, changes to the way a person eats or drinks, positioning or pacing strategies, education for family or carers, and coordination with a GP, ENT specialist, dietitian or other clinician.
Changes to food texture or drink thickness can affect hydration, nutrition and quality of life. They should be recommended for a particular person after assessment, then reviewed. It is not sensible to copy a strategy from someone else simply because the symptoms sound similar.
The practical goal may be to make meals safer, less effortful and more comfortable while preserving as much choice and enjoyment as possible. Some conditions improve; others need ongoing management as health changes.
When Is Medical Advice Urgent?
Seek medical assessment for persistent or worsening swallowing trouble, painful swallowing, unexplained weight loss, food repeatedly sticking, or recurrent chest infections. If food is lodged and you cannot swallow or breathe normally, or if there is severe choking or breathing difficulty, seek emergency help immediately.
Sudden swallowing difficulty together with new weakness, facial droop or speech change can be a sign of stroke. Call 000. Speech pathology supports swallowing care but does not replace investigation of an underlying medical condition.
Swallowing Therapy in Edgecliff, Sydney
Nikki works with adults who have swallowing difficulties, including changes after illness or surgery. Appointments are available at her Edgecliff clinic; whether telehealth is suitable depends on the assessment needed. Many people come after seeing a GP or specialist, but you can contact the practice to discuss the right first step.
See the Sydney speech pathology service overview for Nikki’s broader adult practice or contact Nikki about an assessment.
Frequently Asked Questions
Is swallowing therapy the same as speech therapy?
Swallowing care is part of speech pathology. A speech pathologist can assess swallowing and recommend therapy or management suited to the cause.
Does coughing with water mean it went into my lungs?
Not necessarily. Coughing is a sign worth investigating, but it does not establish the cause or show exactly where the water went.
Will everyone need a swallow X-ray or camera test?
No. VFSS or FEES may be recommended when a clinical assessment cannot answer an important question about swallowing safety or physiology.
Can I book without a referral?
You can contact the practice directly. A GP or specialist referral can provide useful medical context and may be relevant to funding eligibility.
Are meals or drinks becoming difficult?
Describe what happens and when. Nikki can advise whether a swallowing assessment is an appropriate next step.
Further Reading
Clinical background: ASHA: Adult Dysphagia healthdirect: Dysphagia.
