Many children experience feeding and swallowing difficulties and they present in a variety of different ways. In order to provide the most effective and appropriate therapy, it is often that physical or physiological abnormalities of the swallowing mechanism must first be ruled out. In order to do this, a video swallow study – Videofluoroscopic Swallow Study (VFSS) or Modified Barium Swallow (MBS)- must be ordered by a physician. These are extravagant, complicated sounding words that can be intimidating to parents; they may sound even more intimidating to children. In order to explain this procedure to your child, it is vital that you must first understand it yourself.
What is a VFSS?
In the simplest of terms, a VFSS is a moving x-ray that examines the process of swallowing food or drink from the mouth and down through the esophagus. A Speech-Language Pathologist and a Radiologist will be in the room to operate the x-ray machine, offer barium-based food and drink items and to decipher the results. The x-ray machine often resembles a large, robotic arm that is aimed at the side of a patient’s body. Patients are placed between this machine and a raised table that serves as the ideal back-drop to capture the best view of the swallowing mechanism.
The barium food products are white in color and taste slightly chalky, but they are typically flavored sweetly. An SLP will watch the path of food (of varying consistencies) and drinks (of varying thicknesses)in order to see that each swallow is effectively moved through the swallowing path without any residue (left-overs) or infiltration into the respiratory system. If food or drink is entering the airway during swallows, this is called aspiration. Aspiration can lead to a host of issues, including pneumonia.
What is the Speech-Language Pathologist Looking For with a VFSS?
Throughout this observation of swallowing, an SLP will identify difficulties and trial strategies in order to increase the safety and efficiency of swallowing. This includes posturing (i.e. head tilts or chin tucks), manipulating the consistency of foods and trial maneuvers (i.e. multiple swallows, liquid washes). This information is all captured on video and is typically recorded for review. After the video is completed, the SLP will provide immediate feedback regarding the safety of a patient’s swallow and provide suggestions that may include dietary changes and/or swallowing therapy. Oftentimes, a VFSS is completed in order to “rule out” physiological basis for feeding difficulty in order to create an appropriate treatment plan. At other times, it serves to illuminate the basis for a child’s feeding difficulty. Regardless, this technology is invaluable to clinicians that are working in the field of feeding and swallowing disorders.