SpeechPathology.com Phone: 800-242-5183


Epic Special Education Staffing - April 2023

Distinguishing the Normal Aging Swallow from Dysphagia

Angela Mansolillo, MA, CCC-SLP, BCS-S

March 15, 2016

Share:

Question

How can normal swallow variability in aging be distinguished from a truly disordered swallow?

Answer

The aging swallow is not disordered.  There are very typical changes that occur as we get older, and we should not mistake them for true dysphagia.  However, aging does make a person more susceptible to dysphagia.

Laryngeal penetration is normal, particularly in the aging population.  Normal laryngeal penetration is not consistent, so if you are doing a swallow study with a patient and see laryngeal penetration consistently across trials, then that is more likely to be disordered compared to the patient who has only intermittent laryngeal penetration.

Another important way to distinguish normal laryngeal penetration from disordered penetration is depth. If you are seeing laryngeal penetration that is reaching the level of the vocal folds, research suggests that is much more likely to be disordered, and much more likely to be predictive of actual aspiration. Shallow penetration - penetration that enters the laryngeal vestibule and never really gets to the level of the vocal folds, and generally clears spontaneously - is typically not considered disordered.

Another thing to pay attention to, in terms of pharyngeal swallow physiology, is pooling of secretions in the laryngeal vestibule.  Even if you do not actually see aspiration during a swallow study, if that material sits in the vestibule and does not clear spontaneously, then that is much more likely to be predictive of aspiration and more likely to be related to a true dysphagia. Again, normal laryngeal penetration happens inconsistently, is shallow, and is cleared spontaneously.

Angela Mansolillo, MA/CCC-SLP,BCS-S is a Speech-Language Pathologist and Board Certified Specialist in Swallowing Disorders with over 25 years of experience. She is currently a senior Speech-Language Pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts where she provides evaluation and treatment services for adults and children with dysphagia and is involved in program planning and development for inpatient and outpatient programming including quality improvement initiatives, patient education, and clinical policies and protocols. 


angela mansolillo

Angela Mansolillo, MA, CCC-SLP, BCS-S

Angela Mansolillo, MA/CCC-SLP,BCS-S is a Speech-Language Pathologist and Board Certified Specialist in Swallowing Disorders with over 25 years of experience. She is currently a senior Speech-Language Pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts where she provides evaluation and treatment services for adults and children with dysphagia and is involved in program planning and development for inpatient and outpatient programming including quality improvement initiatives, patient education, and clinical policies and protocols.  In addition, she is an adjunct faculty member at Elms College Department of Communication Sciences and Disorders in Chicopee, Massachusetts.  Over the course of her career, she has worked in a variety of clinical settings, provided numerous regional and national presentations, and lectured at several colleges and universities throughout Massachusetts. 

Ms. Mansolillo received her Bachelor of Arts degree in communication from Rhode Island College in 1983 and earned her Master of Arts in Speech-Language Pathology in 1985 from the University of Connecticut. She is a member of the American Speech-Language-Hearing association and is a member of Special Interest Division 13, which focuses on swallowing and swallowing disorders.


Related Courses

Thickened Liquids in Clinical Practice: The Plot “Thickens”
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #10497Level: Intermediate1 Hour
  'Excellent as always!'   Read Reviews
Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.

Back to Basics: Swallow Screening: How, When, and Who
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #8969Level: Introductory1 Hour
  'It provided a great overview of the screening tools and the classifications for each one'   Read Reviews
Screening of swallow function is a well-regarded tool to identify individuals who are potentially at risk of dysphagia and in need of full swallow assessment, but the options are many and varied. This "back to basics" course teaches participants to make informed, evidence-based choices regarding appropriate screening tools specific to their particular patient populations and settings.

Aging in Place: It Takes a Team
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S, Kathleen T. Foley, PhD, OTR/L, FAOTA
Video

Presenters

Angela Mansolillo, MA, CCC-SLP, BCS-SKathleen T. Foley, PhD, OTR/L, FAOTA
Course: #10522Level: Advanced4 Hours
  'The course was very thorough and covered many medical conditions and also the psychosocial aspect of the aging population'   Read Reviews
Aging in place is the goal of most elders, but it may require a great deal of support. The impact of normal aging on various systems and the differences between frail and well elders are described in this course. Information and interventions are discussed that allow interprofessional team members to support functional mobility, nutrition and hydration, and health management in their geriatric clients, in order to promote successful aging.

Clinical Topics in Dysphagia Management
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #10019Level: Advanced4 Hours
  'This is a very comprehensive course and would be excellent for newer SLPs and even for those of us who are "well seasoned"'   Read Reviews
Master skills to implement in your practice immediately with continued Master Class. This 4-hour master class discusses how to differentiate between types of pneumonia and identify which patients are at risk for aspiration pneumonia. It describes how to make informed decisions about dietary modifications and exercise interventions, as well as how to manage the special needs of patients at end of life.

Back to Basics: Applying Clinical Reasoning to the Clinical Swallow Assessment
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #9000Level: Introductory1.5 Hours
  'Discussed importance of assessing someone’s tolerance across meal'   Read Reviews
The clinical swallow evaluation, or bedside swallow evaluation, is sometimes a maligned component of dysphagia assessment because of its inability to definitively assess for aspiration. This course provides participants with an understanding of the applications of clinical assessment, appropriate components for inclusion, and direction for forming conclusions and making recommendations based on clinical observations.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.