Pediatric Dysphagia 

Patient will independently maintain an upright posture to establish central alignment and stability for safe feeding and swallowing 90% of the time during snacks and lunch by mid-year as observed by SLP data.

Postural modification may help in the treatment of dysphagia by affecting bolus flow to improve the speed and safety of swallowing by the closure of airways to prevent aspiration (Alghadir et al., 2017).

• Chin down posture- chin is tucked down toward the neck to contain and control the bolus before initiating the swallow to potentially reduce penetration/aspiration

→Clients are instructed to ‘bring their chin down to their chest” and maintain this posture during swallowing. You do this by:

1. Instructing the client to take a mouthful of food/drink

2. Tuck their chin towards their chest

3. Swallow with their chin tucked

• Head tilt- The head is tilted toward the stronger side to keep the food on the chewing surface

→Clients may be instructed to "turn/tilt your head to the side (as if you are looking over your shoulder).” Either right or left

1. Instruct the client to take a sip/bite of food

2. Turn/tilt the head towards the _____ shoulder while keeping the rest of their body facing forward.

3. Instruct the client to swallow in this position

• Chin up posture- slightly tilting the chin up; to facilitate bolus movement to the pharynx

• Head rotation- The head is turned to either the left or the right side to direct the bolus toward the stronger side of the lateral channels of the pharynx 

• Upright positioning- 90° angle at the hips and knees, feet on the floor, with supports as needed

• Head stabilization- Supported so as to present in a chin-neutral position

• Cheek and jaw assist

• Reclining position- using pillow support or a reclined infant seat with trunk and head support

• Side-lying positioning- For infants

No single posture will guarantee improvement to all patients, and postural changes will differ between infants and older children. The SLP must document which positioning technique demonstrates central alignment and stability for safe feeding.