Assessment and treatment approaches for dysphagia | Baamboozle - Baamboozle

A delay in jaw grading (controlled opening/closing) MOST often impacts:

Textural transitions & chewing development

Feeder–infant bonding

Maintaining upright sitting and show tongue lateralization

Compression without suction

Mastication skills begin emerging when infants can:

Maintain upright sitting & show tongue lateralization

Do up–down tongue movement with stronger intraoral suction

Accept purees only

Reflexive pharyngeal contractions

Suckle patterns are characterized by:

Circular rotary motion

Primarily vertical tongue movement

Up–down tongue movement with stronger intraoral suction

In–out tongue motion only

The ability to transition from suckle to true suck is usually seen around:

4–6 months

9 months

1 month

3 months

A persistent tonic bite reflex MOST interferes with:

Spoon-feeding due to strong, involuntary jaw closure

Suck–swallow–breathe coordination

Bottle feeding

Strengthening tongue base retraction

The phasic bite reflex is elicited by:

Touching the lateral gum ridge

Stroking the cheek

Self feeding with forks and spoons

Placing the infant supine

The extrusion (tongue-thrust) reflex must disappear before:

Introduction of spoon-feeding

Drinking thin liquids

Initiating cup drinking

Self feeding with forks and spoons

The primary purpose of the sucking reflex is to:

Support early nutrition & regulate pressure during feeding

Strengthen tongue base retraction

Develop chewing

Teach breathing coordination

The rooting reflex typically disappears around:

3–4 months

9–10 months

1–2 months

6–7 months

In bottle-feeding intervention, external pacing is MOST appropriate when the infant:

Sucks continuously without pausing to breathe

Fatigues after solids

Has reduced hunger cues

Consumes too little volume

A major goal for infants with dysphagia in the NICU is to:

Maintain physiologic stability during feeding

Maximize oral stimulation only

Sucking continuously without pausing to breathe

Reduce crying behaviors

Thickening formula for infants should be used cautiously because:

It may increase caloric density and GI burden

It does not affect gastrointestinal motility

It reduces aspiration risk consistently

It improves breathing rate

The BEST feeding position for an infant with poor SSB coordination is:

Neutral head with slight chin flexion

Fully supine

Upright 90°

Prone

A preterm infant demonstrating “arching, pulling away, and grimacing” during feeding is showing signs of:

Stress cues indicating autonomic instability

Generating negative intraoral pressure for sucking

Aspiration without distress

Disorganized suck–swallow pattern

A baby with cleft palate is MOST likely to experience difficulty with:

Generating negative intraoral pressure for sucking

Chewing solid foods

Managing thickened liquids

Color changes, bradycardia, or oxygen desaturation

Infants with poor state regulation during feeding (e.g., falling asleep quickly, irritability) often have difficulty because:

Feeding requires high energy & coordinated resp. effort

They cannot tolerate puree textures

They have immature esophageal motility only

Their oral reflexes are absent

A hallmark sign of aspiration in infants that is different from adults is:

Color changes, bradycardia, or oxygen desaturation

Audible wheezing

Immediate coughing

Wet vocal quality

The suck–swallow–breathe (SSB) pattern typically emerges around:

32–34 weeks gestation

After birth only

28 weeks gestation

36–38 weeks gestation

When recommending non-oral feeding, the SLP’s primary consideration must be:

Airway protection & adequate nutrition/hydration

Patient and family preference

Ease of caregiver implementation

Reducing pharyngeal contraction & prolonged oral transit

A key advantage of VFSS over FEES is that VFSS:

Provides a dynamic view of all the swallowing stages

Allows direct viewing of vocal folds

Does not require radiation

Can be done at bedside

In adults with Parkinson’s disease, the MOST consistent swallowing impairment is:

Reduced pharyngeal contraction & prolonged oral transit

Hyperactive gag reflex

Excessive tongue base pressure

Xerostomia contributing to reduced bolus formation

The MOST appropriate initial treatment for infants with reflux-related feeding stress is:

Upright or semi-upright feeding & frequent burping

Increasing bolus viscosity

Thermal-tactile stimulation

Monitoring muscle effort during swallow exercises

A patient undergoing radiation therapy complains of increasing dryness and difficulty clearing food. The SLP should suspect:

Xerostomia contributing to reduced bolus formation

Early UES over-relaxation

Hyperfunctional laryngeal closure

Upright or semi-upright feeding and frequent burping

The Logemann “chin-down while drinking thin liquids” strategy is MOST effective for patients with:

Delayed airway closure or premature spillage

Poor esophageal motility

Upright or semi-upright feeding & frequent burping

Cricopharyngeal hypertrophy

Surface electromyography (sEMG) biofeedback is MOST helpful for:

Monitoring muscle effort during swallow exercises

Measuring UES opening diameter

Xerostomia contributing to reduced bolus formation

Weak mastication

A patient demonstrates repeated coughing after swallowing thin liquids. The MOST likely physiological impairment is:

Reduced UES clearance leading to residue spilling in airway

Poor initiation of the pharyngeal swallow

Monitoring muscle effort during swallow exercises

Weak jaw closure

The primary purpose of the Yale Swallow Protocol is to:

Screen for asp. risk using a standardized water swallow

Confirm esophageal motility problems

Reduce UES clearance leading to residue spilling in airway

Determine diet consistency

Which patient would benefit MOST from a FEES rather than a VFSS?

A patient who cannot be transported to radiology

A patient needing evaluation of esophageal motility

A patient with concern for cricopharyngeal dysfunction

A patient with suspected reduced tongue base contact

Diet modifications are MOST appropriate when:

Immediate airway safety is a concern

Strengthening exercises are ineffective

The patient refuses all other therapy

The disorder is rapidly improving

Adaptive utensils, modified cups, and environmental changes are part of:

Compensation

Strength-based therapy

Rehabilitation

Sensory training

Neuromuscular electrical stimulation (NMES) is used to:

Facilitate muscle contraction in weak swallowing musculature

Improve sensory reflexes only

Replace traditional therapy

Airway closure at the level of the true & false vocal folds

In dementia, the PRIMARY goal of dysphagia management is:

Ensure safe intake and maintain quality of life

Use muscle-strengthening exercises exclusively

Cure the swallowing disorder

Restore normal diet levels

Appropriate therapy for infants with poor suck–swallow–breathe coordination includes:

Pacing & controlled flow nipple systems

Side-lying bottle hold

Thickened solids

Facilitate muscle contraction in weak swallowing musculature

A total laryngectomy patient requires:

No airway protection strategies

Airway protection strategies

Voice therapy only

Supraglottic swallow

Super-supraglottic swallow improves:

Airway closure at the level of the true & false vocal folds

Anterior hyoid movement

UES opening by strengthening suprahyoids

Reduced mastication

Supraglottic swallow compensates for:

Delayed airway closure

Reduced mastication

Poor UES function

Reduced tongue strength

Thickened liquids help reduce aspiration risk by:

Slowing bolus flow

Increasing airway opening

Increasing pharyngeal pressure

Eliminating residue

Thermal-tactile stimulation is designed to:

Increase sensory input to improve swallow initiation

Sustained laryngeal elevation and UES opening

Narrowing the airway entrance and reducing aspiration

Reduce vallecular residue

The Shaker (head-lift) exercise promotes improved:

UES opening by strengthening suprahyoids

Esophageal clearance

Tongue base retraction and pharyngeal pressure

Pharyngeal wall contraction

The Masako maneuver is used to strengthen:

Pharyngeal wall contraction

UES opening by strengthening suprahyoids

Laryngeal closure

Esophageal peristalsis

The Effortful Swallow primarily increases:

Tongue base retraction and pharyngeal pressure

Narrowing the airway entrance and reducing aspiration

Nasal closure

Jaw opening

The Mendelsohn maneuver targets improvement in:

Sustained laryngeal elevation and UES opening

Narrowing the airway entrance and reducing aspiration

Increase sensory input to improve swallow initiation

Oral bolus formation

A technique used to manage dysphagia by changing head and neck posture is what treatment approach:

The chin tuck posture

The Mendelsohn maneuver

The Effortful Swallow

The Masako maneuver

Videofluoroscopic Swallow Study (VFSS) allows the clinician to evaluate:

Timing, pressure, & transit of the bolus

Peripheral nerve pathways

Aspiration with no effort to eject material

Excessive residue or spillage before the swallow

During FEES, the “white-out” period corresponds to:

Epiglottic inversion

Premature spillage

Bolus transport

Upper Esophageal Sphincter opening

Aspiration after the swallow is MOST often associated with:

Residue spilling into the airway

Delayed reflex

Vocal fold paralysis

Cricopharyngeal spasms

Aspiration during the swallow typically results from:

Incomplete laryngeal closure

Reduced Upper Esophageal Sphincter opening

Premature bolus loss to pharynx

Backflow from esophagus

Aspiration that occurs before the swallow is usually due to:

Delayed swallow initiation

Weak vocal fold adduction

Poor esophageal motility

Reduced epiglottic inversion

The BEST procedure for assessing secretion management is:

Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Ultrasound

Scintigraphy

Videofluoroscopic Swallow Study (VFSS)

Videofluoroscopic Swallow Study (VFSS) is the gold-standard test for evaluating:

Oral, pharyngeal, & some esophageal phases

Trismus

Aspiration with no effort to eject material

Excessive residue or spillage before the swallow

An SLP observes prolonged chewing time and fatigue. A likely contributing factor is:

Lingual discoordination and weak mastication

Reduced laryngeal elevation

Oral apraxia

Reduced labial sensation

A water swallow test is MOST useful for:

Identifying patients at high risk who need instrumental eval

Determining Upper Esophageal Sphincter dysfunction

Evaluating epiglottic inversion

Confirming silent aspiration

Excessive anterior spillage during the oral phase is commonly due to:

Poor lip seal

Weak jaw closure

Reduced vocal fold closure

Impaired timing of swallow reflex

Poor mastication during the clinical exam MOST likely results from dysfunction of:

CN V (trigeminal)

CN XII (hypoglossal)

CN IX (glossopharyngeal)

CN X (vagus)

A clinician suspects esophageal dysphagia. The MOST appropriate next step is:

Referral for GI consultation

FEES

Oral motor exam only

Mandible ROM testing

In infants, the BEST indicator of dysphagia during feeding is:

Coughing, oxygen desaturation, or color changes

Severity level of gag reflex

Increased drooling

Slow oral transit

A key limitation of a bedside swallow exam is:

It cannot directly visualize pharyngeal physiology

It requires specialized equipment

It is invasive

It overestimates aspiration

During a bedside swallow evaluation, the MOST important safety component is assessing:

Secretion management & airway protection

Diadochokinesis

Maximum phonation time

Tongue strength

A wet or gurgly vocal quality after swallowing MOST strongly suggests:

Laryngeal penetration or possible aspiration

Esophageal reflux

Cranial nerve IX (glossopharyngeal) lesion

Vocal fold nodules

The primary purpose of a dysphagia screening is to:

Identify indiv. who require a full swallowing evaluation

Diagnose the swallowing disorder

Identifying patients at high risk who need instrumental eval

Determine aspiration severity