Occupational therapy has always been interested in helping an individual to become as independent as possible in performing activities of daily living. Feeding, eating, and swallowing are three basic activities of daily living an individual needs to be able to stay alive and have a healthy life. Feeding is the process of bringing food to the mouth and it is sometimes called self-feeding. While eating is the process of manipulating or breaking down food using the teeth when placed inside the mouth. Swallowing is the movement of food from the mouth to the stomach. When a problem occurs in one of these processes and the individual becomes unable to eat/feed himself independently, the role of  occupational therapy becomes very important. An occupational therapist helps an individual to improve the quality of eating/self-feeding and to perform it independently if possible. Sometimes this is done with the help of a caregiver. 

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Swallowing involves many stages in which food /liquid is moved from the mouth to the stomach:

• Mouth is prepared to receive food or liquid as it starts watering at the sight of food. The individual uses his hands to bring the food to his mouth.

• The food is placed inside the mouth and the individual starts to chew it and mix it with saliva.

• The food / liquid is then moved to the back of the mouth. Many muscles start to work together to close the top of the throat to prevent the food from entering the mouth. The food is then moved deep into the throat.

• The food / liquid passes through the pharynx into the esophagus. The passage that leads into the airway and the vocal cords is closed to prevent the food from entering the lungs.

• The food / liquid passes through the esophagus into the stomach.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dysphagia, which means difficulty in swallowing, happens when there is a dysfunction in one of the swallowing stages that are mentioned above. This dysfunction can occur due to a lot of reasons and these include:

• Medical reasons such as prematurity, central nervous system damage, and gastrointestinal reflex

• Oral motor problems such as poor tongue control and poor chewing

• Sensory motor problems such as hypersensitivity and food refusal

• Behavioral problems such as fear of swallowing

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Occupational therapy uses a holistic approach when treating a person and this means that an occupational therapist would look at the individual from all aspects (sensory skills, motor skills, social and behavioral skills, and emotional skills) in addition to the environment as it has a great impact on an individual’s performance in daily activities. After assessing the individual and the environment, an occupational therapist will identify the difficulties that are interfering with the individual’s performance and these could include inability to hold the food and bring it to the mouth, difficulty chewing the food, difficulty swallowing. Sometime, having a dysfunction in the cognitive abilities might be the reason why an individual is having difficulty in eating.

 

Occupational therapy intervention in dysphagia aims to improve the individual’s ability to participate and perform self-feeding/eating independently. An occupational therapist works with the individual and the caregiver (if available) to identify the goals of the treatment which consist of:

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