Dysphagia therapy and management

At Swallow Science Melbourne, dysphagia therapy focuses on individualised, evidence-based treatment to improve swallowing safety, comfort, and quality of life. Therapy is always guided by instrumental assessment findings (FEES or VFSS) wherever possible, ensuring treatment targets the specific physiological cause of swallowing difficulty rather than surface symptoms alone. Instrumental assessment reports from local speech pathology providers and hospitals are accepted.

Swallowing difficulties can occur for many reasons - neurological disease, head and neck cancer, respiratory compromise, surgery, or general deconditioning. Treatment is tailored to each person’s underlying cause, goals, and overall health.

Compensatory Strategies

Compensatory therapy focuses on immediate techniques to improve safety and efficiency during swallowing, helping people eat and drink more comfortably. These strategies do not change physiology directly but optimise how an individual swallows within their current ability.

They may include:

Adjusting head or body position during swallowing
Modifying bolus size, rate, or utensil use
Changing food and fluid textures in line with IDDSI standards
Using environmental or behavioural cues to support attention and pacing
Coordinating swallowing with breathing to reduce coughing or breathlessness

Swallow Rehabilitation

Rehabilitative therapy targets the muscles and timing involved in swallowing to restore or enhance function over time. These approaches are based on principles of exercise physiology, repetition, and progressive load.

Depending on the assessment findings, therapy may include:

Exercises/manoeuvres which involve resistance or high effort (may or may not use tools)
Expiratory Muscle Strength Training (EMST) to support cough strength and airway protection
BiSSkApp for development of swallow skill and strength (coming soon - Jan 2026)

Therapy frequency and duration depend on the individual’s diagnosis, goals, and fatigue tolerance. Some benefit from a few focused sessions with home practice; others need ongoing support as the condition evolves.

Sessions can be conducted in the clinic, via telehealth, or in aged care or community settings, depending on the type of program, medical status and mobility. Each program includes education for patients, families, and carers to encourage confident daily management.