Dysphagia in the adult population:

Occupational therapists, traditionally concerned with activities of daily living, are now addressing the problems of eating caused by dysphagia. Adult-onset dysphagia results from either neurological or mechanical, i.e., structural, causes. Following a description of the normal swallowing process, this paper reviews the various disorders that cause dysphagia. General evaluation principles are offered with treatment methods appropriate to the category of disorders. Although specific treatment methods have been used clinically, many remain untested. More recently, a growing number of studies have been published which measure the effectiveness of rehabilitation for dysphagics. Active intervention in the problem of adult-onset dysphagia consists largely of detailed evaluation of oral structures, manipulation of diet, techniques to elicit normal swallowing mechanisms, and assistive devices to compensate for lost structures. In addition, cognitive status, nutrition, posture, and position are addressed in a comprehensive therapy program. The goal of treatment is to promote a safe and nutritional oral diet to the fullest extent possible.