Dysphagia Service

The Dysphagia Service provides specialist expertise in the assessment and management of complex feeding and swallowing problems in children.

The clinic aims to work with local services to support these children and their families within the community.

Who we see

The Dysphagia Service accepts children up to the age 16, most of whom have some degree of neurological impairment, resulting in severe and specific difficulties with eating and drinking. Children may be orally fed and/or fed by tube.

Referrals

Referrals are usually initiated by a child’s local medical or therapy team, but must be accompanied by a written letter of consent from the child’s consultant paediatrician.

Referrals should be addressed to Dr Neil Wimalasundera Consultant in Neurodisability, and sent to our main address.

The majority of children referred to this clinic are already involved with a local medical and therapy team, and it is helpful if referrals include recent reports from team members.

On receipt of a referral a questionnaire will be sent out to the referrer to gather further information regarding the child's current feeding management and the questions that they have for the dysphagia team.

Assessment

First appointments usually last for half a day. The first part of the assessment involves history taking; this is likely to include all members of the team who are seeing the child on that day. In conjunction with taking a feeding history, the team may also look at other areas, such as overall development and medical history.

The second part of the assessment involves an evaluation of the child’s current feeding and swallowing skills. This may involve taking a video for record purposes, which is discussed with the family during the appointment.

During the feeding assessment, the team also looks at positioning and communication as appropriate. It can also be useful to conduct a brief physical examination including anthropometry (height and weight). Families are requested to bring familiar food, drink and utensils along to the appointment in order to create a familiar environment.

Once the assessment is complete, there is usually a short break for the child and family, whilst the team finalises recommendations. These recommendations are then discussed with the family. A handwritten summary is provided on the day of the appointment, followed by a full report within five weeks.

Children may be referred within the hospital for further investigations such as videofluoroscopy, to take place at a later date.

Liaison with local services is an integral part of the assessment process.

Team

The Dysphagia Service team is usually comprised of a consultant paediatric neurologist and/or specialist registrar, a specialist speech and language therapist with expertise in dysphagia, and a senior occupational therapist.

Other professionals may be invited to take part in the assessment process where specific questions have been asked.

Please click on the links listed below to access several relevant and helpful pages linking to the Dysphagia Service across Great Ormond Street Hospital website:

Contact us

You can contact the Dysphagia Clinic on 020 7405 9200 ext 5293.