Who do you need?

Dietitian vs. a Speech & Language Therapist for dysphagia

Speech and Language Therapists:

Speech and Language Therapists tend to specialise in communication and/or dysphagia.  If you suspect a client may have issues with their swallowing, a Speech and Language Therapist (SLT) should be your first port of call. 

• These professionals can actually diagnose whether someone has dysphagia or not. Subjective and objective strategies may be used for this, including mealtime observation, cervical auscultation and/or by requesting a videofluoroscopy or a Fibreoptic Endoscopic Evaluation of Swallowing. 
• Once dysphagia has been diagnosed, the Speech and Language Therapist recommends the texture of food or fluid which would be safest.  They will also make recommendations on posture, positioning and the mealtime environment.
• They will give some meal and snack suggestions and may also prescribe some swallowing exercises to help rehabilitate the muscles in the throat.
• Speech and Language Therapists work with Occupational Therapists to advise on cups and cutlery that would best suit the clients’ needs.

Dietitians:

Once the Speech and Language Therapist has decided which texture of food and fluid is safest for the client to consume (using the International Diet Descriptors such as Level 6 “soft and bite sized”) a dietitian can then work with the client to put these recommendations into practice.  Many people get stuck for meal and snack ideas when following a texture-modified diet, and they may end up losing weight or becoming malnourished, because their diet is overly restricted or unvaried.

• Dietitians help clients come up with meal and snack ideas which balance food preferences, nutrition, other health issues and the Speech and Language Therapist’s texture recommendations.
• Dietitians help clients modify their favourite recipes to follow the Speech and Language Therapist’s texture recommendations and identify which equipment they will need to prepare the food they want to eat.
• They monitor the client’s weight and will make sure they are meeting their needs for energy and nutrients.

For more information, or to refer a client with dysphagia for dietary advice, get in touch at: sheri@specialistnutritionrehab.co.uk.

Thank you to Jo Frost, Speech and Language Therapist from The Speech Therapy Practice, and Tracey Dailly, Speech and Language Therapist from the Neuro Rehab Group for reviewing this article.