Dysphagia: an evaluation and treatment program for the adult.

Dysphagia, or difficulty swallowing, can interfere with independent feeding in the physically disabled adult. The physiology of normal swallowing and neuromuscular pathology of dysphagia applicable to the occupational therapist are reviewed in this paper. Pertinent nursing care of the respiratory and gastrointestinal tracts are described. Normal and pathological reflexes involved in swallowing include gag, bite, and suck-swallow. Head, neck, and jaw stability are necessary for swallowing. Methods for evaluating the appropriate reflexes, sensation, and orofacial movement of the adult neurologically impaired patient are presented. Proper positioning is described and treatment suggestions are offered and applied to four case studies.