Fact Sheet

Occupational Therapy:
A Vital Role in Dysphagia Care
Dysphagia is “dysfunction in any stage or process of eating. It includes any
difficulty in the passage of food, liquid, or medicine, during any stage of
swallowing that impairs the client’s ability to swallow independently or safely.”1

Dysphagia affects quality of life in at-risk pediatric populations,2 rehabilitation

populations,3 and the well elderly.4 Swallowing is an essential activity of daily
living: the inability to swallow negatively affects nutrition, overall health, and
quality of life. Dysphagia is within the scope of occupational therapy practice as
supported by educational curriculum and a history of application in practice.

Occupational therapists and occupational therapy assistants provide

skilled care to clients of all ages with dysphagia.

Working individually and/or as members of a collaborative team, occupational

therapy practitioners provide dysphagia interventions in a variety of areas,
including hospitals, rehabilitation centers, outpatient clinics, long-term-care facilities, schools, and in the home or
community settings. Both occupational therapists and occupational therapy assistants can provide comprehensive
rehabilitative, habilitative, and palliative care to clients with a variety of dysphagia diagnoses through the life course.
Occupational therapists provide screening and in-depth clinical assessment. As part of this process, they may assist with
instrumental dysphagia assessments including videofluoroscopy (the modified barium swallow). Occupational therapists
work together with clients and caregivers to determine mutual goals and optimal outcomes for swallowing skills. They
provide focused interventions addressing a range of swallowing components.

These interventions include collaboration with clients to provide:

• Individualized compensatory swallowing strategies.
• Modified diet textures to ensure safe swallowing and eliminate or minimize the risk of aspiration.
• Adapted mealtime environments including visual presentation of the meal to encourage eating, and creation of a
setting that encourages attention to the meal.
• Enhanced feeding skills including strategies to create feeding independence and provision of appropriate
adapted utensils.
• Preparatory exercises prior to a meal to facilitate the
oral and pharyngeal motions required for eating.
• Positioning of the body to facilitate optimal
digestion and arm use for independent and safe
eating.
• Reinforcement of strategies for clients to enhance
and improve swallowing safety to prevent
aspiration, including adapted swallowing
techniques.
• Training for caregivers in individualized feeding
and swallowing strategies to enhance eating and
feeding performance.

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In addition, occupational therapy practitioners offer
input to other dysphagia team members regarding client
performance at mealtime and goal accomplishment.
Occupational therapy practitioners use environmental and
behavioral strategies to optimize swallowing performance
and provide culturally sensitive interventions to clients
with dysphagia.

The American Occupational Therapy Association defines

occupational therapy’s role in dysphagia care through
its documents, including Specialized Knowledge and
Skills in Feeding, Eating, and Swallowing for Occupational
Therapy Practice,1 which delineates entry and advanced
competencies in this practice area for both occupational
therapists and occupational therapy assistants. In
addition, AOTA provides resources and advances
competency in practice through a variety of continuing
education products. AOTA also offers occupational
therapy practitioners specialty certification in feeding, eating, and swallowing. Occupational therapy practitioners play an
important role in addressing dysphagia needs throughout the life course.

References
1. American Occupational Therapy Association. (2007). Specialized knowledge and skills in feeding, eating, and swallowing for
occupational therapy practice. American Journal of Occupational Therapy, 61, 686–700.
2. Prasse, J. E., & Kikano, G. E. (2009). An overview of pediatric dysphagia. Clinical Pediatrics, 48, 247–251.
3. Avery, W. , DuBose, C. M., Ernst-Nguyen, L., Gibbes, F. W., Holm, S. E., Latella, D., & Meriano, C. (2010.) Dysphagia care and related feeding
concerns for adults (2nd ed.). Bethesda MD: AOTA Press.
4. Serra-Prat, M., Hinojosa, G., Lopez, D., Juan, M., Fabre, E., Voss, D. S., et al. (2011). Prevalence of oropharyngeal dysphagia and impaired
safety and efficacy of swallow in independently living older persons. Journal of the American Geriatrics Society, 59, 186–187. DOI:
10.1111/j.1532-5415.2010.03227.x

Developed by Wendy Avery, MS, OTR/L, for the American Occupational Therapy Association. Copyright © 2011 by the American
Occupational Therapy Association. This material may be copied and distributed for personal or educational uses without written consent.
For all other uses, contact copyright@aota.org.

Occupational therapy enables people of all ages live life to its fullest by helping them to promote health, make lifestyle or
environmental changes, and prevent—or live better with—injury, illness, or disability. By looking at the whole picture—a client’s
psychological, physical, emotional, and social make-up—occupational therapy assists people to achieve their goals, function at
the highest possible level, maintain or rebuild their independence, and participate in the everyday activities of life.