Compensatory Strategies: Swallowing

Speech–language pathologists play a primary role in the evaluation and treatment of dysphagia (difficulty swallowing) in infants, children, and adults. Since the late 1970s, researchers have examined and described compensatory strategies used to improve the safety of swallowing in people with oropharyngeal dysphagia. Even though compensatory strategies—changes in (a) bolus flow during swallowing and (b) duration, extent, and timings of oropharyngeal structural movements—do not promote neural reorganization in the brain, newer technologies, especially transcranial magnetic stimulation (TMS), high-resolution manometry, and functional magnetic resonance imaging (fMRI) support that these strategies change oropharyngeal biomechanics. This entry describes the following compensatory strategies for improving safety in swallowing: postural changes, sensory stimulation, and bolus modifications.