HOME > ASSESSMENTS > SWALLOWING ASSESSMENT
SwallowingAssessments
A swallowing assessment is a Speech Pathologist’s assessment of how safely a person eats, drinks and manages saliva and medicines.
It covers the person’s history, a physical examination of the mouth and the muscles used to swallow, and watching them eat and drink across different food and fluid consistencies. It happens in the places where they usually have their meals.
The result is a written mealtime management plan written for anyone assisting the person at mealtimes to read and follow.
It sets out the food textures and fluid consistencies chosen to minimise risk for the person, how the person should be positioned, what help they need, and what to do if something goes wrong.
The plan is designed to minimise risk. It doesn’t claim to remove every difficulty, and it says so, which is what makes it something a support worker can actually use day to day.
Participants, family members and carers
For Support Coordinators, plan managers and SIL providers
Our Speech Pathologists run swallowing assessments across New South Wales and Tasmania, in the places where the person usually eats, because a kitchen table and a day program dining room tell you things a clinic room can’t. Every assessment starts with a swallowing assessment service checklist at intake, so the right information is gathered before the first visit.
How do I fund a swallowing assessment?
For most people, the NDIS funds a swallowing assessment.
NDIS: the assessment, the mealtime management plan and any training are usually funded from the Capacity Building part of a plan; our intake team confirms the category in your plan.
Medicare: pays a rebate toward each session with a GP chronic condition management plan, and we’ll tell you the fee and any gap before you book.
Privately funded: you’ll get a clear picture of the costs before you book.
If you are not sure which funding applies to you, call us on 1800 678 647 or email hello@opt.net.au. We will sort it out before your first appointment.
Not Sure What Fits Your Plan?
1800 678 647
Don't want to call? Click here to
Fill in an enquiry form.
We Can't Wait to Meet You
What a swallowing assessment involves
01
How do you assess swallowing?
A swallowing assessment runs in three parts.
FIRST, your Speech Pathologist takes a clinical history: the person’s diagnosis, what they eat and drink now, any coughing or chest infections, how long meals take, and what the people around them have noticed.
SECOND, comes a physical examination of the mouth and throat, looking at the structures involved in swallowing and at muscle strength, range of movement and coordination.
THIRD is the functional part, which is the person actually eating and drinking. Your Speech Pathologist watches them across different consistencies, from thin fluids through to regular foods.
They look for signs that something is going down the wrong way, such as coughing, throat clearing or a wet-sounding voice.
We do this in the places where the person usually eats, with their usual cutlery, chair and company, because that’s where the plan has to work.
02
What are the signs of swallowing difficulty?
Common signs include:
- gagging or choking when eating or drinking
- food or drink feeling stuck or going down the wrong way
- Coughing or clearing the throat during or after eating
- being short of breath while eating
- avoiding foods that are hard to swallow
- regular chest infections
The mealtime management plan we write also lists the signs of aspiration that a support worker watches for at the table: coughing, gagging, throat clearing, shortness of breath, a wet-sounding voice, a raised temperature or a chest infection. If they appear, the plan says to contact the GP or the Speech Pathologist for a swallow review.
03
How long does a swallow assessment take?
The assessment starts with a case history conversation by phone, which runs about an hour.
The swallowing assessment itself, at home, takes about an hour, and where the person also eats out, at a day program or in the community, a second observation in that setting takes about another hour.
From those visits your Speech Pathologist writes the swallowing assessment report and the mealtime management plan, with a one-page summary that goes on the fridge or the shift folder.
Then there’s a training session for the person, their carers and support workers, which runs about an hour.
On the day of the assessment, if the person needs something to follow straight away, your Speech Pathologist can leave an interim mealtime management plan with a stated date for the full plan.
We aim to have the report to you within seven business days of the final assessment session.
04
What happens if you fail your swallow test?
There’s no pass or fail.
A swallowing assessment works out which textures and consistencies carry the least risk for the person and which ones need to change, and that goes into the plan.
If thin fluids are a problem, the plan may specify thicker fluids; if regular foods are, it may specify a softer or minced texture. Each requirement is written against the IDDSI framework, the international scale for food textures and drink thickness.
The testing method for each level goes into the plan too, so a support worker can check a meal before serving it.
Where your Speech Pathologist needs to see what’s happening inside the throat, they may recommend that your doctor arrange an instrumental test, such as a barium swallow which are done in a hospital or radiology setting.
05
What is a mealtime management plan?
A mealtime management plan is the written plan for anyone helping the person at mealtimes to read and follow.
The plan opens with the person’s photograph (for identification purposes, a risk statement and a duty statement, then the choking emergency instruction (call 000 and give first aid) and the signs of aspiration to look out for.
After that it sets out the food texture and fluid consistency requirements against IDDSI, with food-piece sizes for adults and children and the testing method for each level.
Then the plan focuses on the persons allergies, medication, alertness, diet, likes and dislikes.
It covers positioning, including how long to stay upright after a meal, the utensils and equipment needed, and the level of supervision and assistance.
It also records the verbal prompts that help, behaviour and communication at the table, the mealtime environment, and oral care.
The Speech Pathologist signs it, and copies go to the Supported Independent Living manager and the Support Coordinator.
06
Treatment Options for difficulty swallowing?
The most common forms of treatment include:
- changing the textures of food and drinks
- learning new swallowing techniques
- doing exercises to help the muscles work better
- medicines for reflux where it is called for.
For most people we see, the plan is the treatment that runs every day, and it only works if the people supporting the person know it.
For this reason, the plan ends with a support-worker endorsement sheet where each support worker signs that they’ve read and understood the plan and have received the practical training in mealtime management.
This is reinforce their understanding of their duty of care around positioning, support and risk monitoring. Your Speech Pathologist delivers that training and keeps an attendance list.
How our Speech Pathologists run the swallowing assessment
It starts at intake, with a swallowing assessment service checklist and a case history conversation by phone. Your Speech Pathologist will ask about the diagnosis, current textures, any coughing or chest infections, and who helps at mealtimes. Then they’ll visit where the person usually eats, examine the mouth and throat, and watch a meal or a drink across the consistencies that matter for that person.
If something needs to change that day, your Speech Pathologist will leave an interim mealtime management plan with the date the full plan is due. Between the visit and the plan they’ll write the swallowing assessment report, liaise with the GP, the Support Coordinator and any other providers, and, where a dietitian is involved, cross-reference the diet section.
The full plan and its one-page summary then go to the person, the family, the Supported Independent Living manager and the Support Coordinator. Your Speech Pathologist runs the training session, where each support worker signs the endorsement sheet.
Swallowing assessments through the NDIS
Dysphagia is connected to many disabilities the NDIS covers, and the assessment helps establish that the swallowing difficulty is disability-related, so the plan can fund the supports around it. The assessment, the mealtime management plan, the training of support workers and the annual review usually sit under Capacity Building, in Improved Daily Living. The report goes to the participant and, where it’s needed for a plan decision, to the NDIA. Support Coordinators, plan managers and Supported Independent Living providers can refer directly through our Referrers Hub, and we’ll confirm the funding line before the first appointment.
NDIS
Referrals
14 clinics across NSW & Tasmania
Email us
hello@opt.net.au
Speak to us
1800 678 647
Get in Touch.
Where we offer Speech Pathology
Common questions about swallowing assessments
How do you assess swallowing?
What are 5 signs of swallowing difficulty?
How long does a swallow assessment take?
What happens if you fail your swallow test?
What causes you to fail a swallow test?
What treatment helps with difficulty swallowing?
What foods should I avoid with dysphagia?
What is a mealtime management plan?
When should I get urgent help for swallowing?
Reviewed by Sarah-Louise higgins
You May Also Like:
Functional Communication
Maybe a child or adult you support gets frustrated, cries, pushes things away, or shuts down when they cannot get a message across. The gap is rarely about effort. It
Speech and Language Development
Most parents who ask about speech and language development are not worried about a textbook. They are worried about their own child. Should a 2-year-old be putting words together? Is
Gross Motor Skill Development In Your Children
What are gross motor skills? Gross motor skills are the movements that use the big muscle groups: the core, the legs, the arms and the back. They are what let