Understanding dysphagia: Swallowing changes after an acquired brain injury (ABI)

At MSWA, we support people living with dysphagia to safely eat and drink. If you or a loved one has noticed changes in swallowing after an ABI, we’re here to help. With the right support, including individualised dysphagia management, many people can find safer, more comfortable ways to manage swallowing difficulties and continue to enjoy mealtimes with greater confidence. 

Dysphagia is any difficulty associated with swallowing. Swallowing is more complex than most of us realise – it relies on more than 26 muscles and 5 cranial nerves working in perfect coordination.  After an ABI, damage can occur to these muscles and cranial nerves leading to muscle weakness, incoordination and/or cognitive changes leading to food or drink going ‘down the wrong way’ or feeling like food is stuck in the throat. If dysphagia isn’t managed appropriately, it can lead to, dehydration, poor nutrition or choking and chest infections such as pneumonia.  

Dysphagia can appear immediately after the injury or develop later if there are complications or changing needs. Some people might notice only mild changes, like taking longer to finish meals support from a speech pathologist can make mealtimes easier and safer.  

If you or a loved one has had an acquired brain injury, keep an eye out for signs of changes to swallowing. Common signs of dysphagia include: 

• Coughing or choking while eating or drinking
• Food or drink going down the wrong way
• A wet or gurgly sounding voice during or after meals
• Taking much longer to finish a meal
• Food remaining in the mouth after swallowing
• Frequent chest infections or unexplained weight loss 

If you or your loved one experience any of these symptoms, please reach out to a  MSWA Speech Pathologist.

At MSWA, our Speech Pathologists specialise in supporting people living with neurological conditions, including ABI, in managing their communication and swallowing needs. We understand how swallowing difficulties can affect wellbeing, safety and independence.  

Your journey with speech therapy starts with a thorough dysphagia assessment. This includes a detailed history of your eating and drinking, an OME (oromotor examination) and observing you swallow different foods and drinks.  In some cases, using special diagnostic tools, like a video fluoroscopy (a live X-ray), to understand exactly how your throat muscles are working. 

Once we understand your unique needs, your MSWA Speech Pathologist will develop a personalised management plan. This may include: 

• Techniques and positioning to make swallowing safer
• Advice on food and drink textures that are easier to manage
• Exercises to strengthen the muscles involved in swallowing
• Education for family and carers so everyone feels well-prepared and informed
• Complex swallowing therapy personalised strategies and exercises, to improve muscle strength, coordination, and safety for swallowing
• Support transition from PEG (enteral feeds) to oral diet

At MSWA, we believe in working as a team to deliver the best possible support. Alongside our Speech Pathologists, you may also work with MSWA Dietitians, Occupational Therapists, Physiotherapists and Support Workers to make daily life safer and easier. 

• Dietitians help plan meals that meet your nutritional needs and adjust for any texture recommendations.
• Occupational Therapists can suggest adaptive equipment, seating and positioning to make eating and drinking safer and more comfortable.
• Physiotherapists work with you to build strength and maintain good posture and head control, all of which help with safe swallowing.
• Support Workers help put your safe swallowing plan into action at home, assisting with meal prep, feeding and daily routines. 

Your swallowing needs may change over time, so regular reviews with your MSWA Speech Pathologist and the wider allied health team will help keep you safe, comfortable and well-supported at every stage. 

If you’re caring for someone experiencing dysphagia, small changes can make a big difference: 

• Make sure they’re sitting upright while eating or drinking
• Allow plenty of time for eating and drinking, don’t rush
• Offer smaller bites and encourage thorough chewing
• Follow the texture and fluid recommendations from your speech pathologist 
• Keep an eye out for signs of coughing or a wet voice 

For many families and carers, understanding how to support someone with dysphagia safely can feel overwhelming. That’s why MSWA offers Dysphagia Training for carers and support workers, giving them the knowledge to support safe mealtimes. Delivered by experienced MSWA Certified Practicing Speech Pathologists, these sessions provide practical skills and confidence to prepare meals to the right texture, assist with safe feeding and recognise any signs that need extra support.  

This training aligns with the NDIS High Intensity Support Skills Descriptors for Dysphagia Support and is suitable for support workers who provide high intensity dysphagia care. 

Managing swallowing difficulties is an important part of staying healthy and independent. Many people living with an ABI can access funding for speech pathology and dietitian support through the National Disability Insurance Scheme (NDIS), Chronic Disease Management Plans (CDMP) or other funding options like private health insurance. MSWA can help you understand your funding options, provide supporting reports and guide you through the application process if needed. 

Swallowing difficulties can be life threatening, but they can be managed well with early intervention and the right support. With a clear plan, the right team and regular reviews, many people living with an ABI can continue to enjoy mealtimes safely and comfortably. 

MSWA’s experienced Speech Pathologists support people right across Western Australia whether you live in Perth or regional WA. Our team can work with you at home, via telehealth or at one of our MSWA Hubs, depending on what suits you best. 

If you’ve noticed swallowing changes after an ABI or you’re concerned about a loved one, please reach out. We’re here to help you stay safe, well-nourished and supported at every step.  

Get in touch today to find out how MSWA’s Speech Pathology team can help you or a loved one live well and eat safely after an ABI.