Treatment of the Pediatric-Dysphagia 2

Maneuvers

Maneuvers are specific strategies used to change the timing or strength of particular movements of swallowing (Logemann, 2000). Some maneuvers require following multi-step directions and may not be appropriate for young children and/or older children with cognitive impairments. Examples of maneuvers include

:

Effortful swallow-increases posterior tongue base movement to facilitate bolus clearance.

Masako or tongue hold-tongue is held forward between the teeth while swallowing; this is performed without food or liquid in the mouth to prevent coughing or choking.

Mendelsohn maneuver-designed to elevate the larynx and open the esophagus during the swallow to prevent food/liquid from falling into the airway.

Supraglottic swallow-vocal folds are usually closed by voluntarily holding breath before and during swallow in order to protect the airway.

Super-supraglottic swallow-effortful breath hold tilts the arytenoid forward which closes the airway entrance before and during the swallow.

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