;Thickening agents Food thickeners can be used to improve swallowing in pediatric populations. ;Postural techniques. * Head back (extension) – used when movement of the bolus from the front of the mouth to the back is inefficient; this allows gravity to help move the food. * Chin down (flexion) – used when there is a delay in initiating the swallow; this allows the valleculae to widen, the airway to narrow, and the epiglottis to be pushed towards the back of the throat to better protect the airway from food. * Chin down (flexion) – used when the back of the tongue is too weak to push the food towards the pharynx; this causes the back of the tongue to be closer to the pharyngeal wall. * Head rotation (turning head to look over shoulder) to damaged or weaker side with chin down – used when the airway is not protected adequately causing food to be aspirated; this causes the epiglottis to be put in a more protective position, it narrows the entrance of the airway, and it increases vocal fold closure. * Lying down on one side – used when there is reduced contraction of the pharynx causing excess residue in the pharynx; this eliminates the pull of gravity that may cause the residue to be aspirated when the patient resumes breathing. * Head rotation to damaged or weaker side – used when there is paralysis or paresis on one side of the pharyngeal wall; this causes the bolus to go down the stronger side. * Head tilt (ear to shoulder) to stronger side – used when there is weakness on one side of the oral cavity and pharyngeal wall; this causes the bolus to go down the stronger side. ;Swallowing maneuvers. * Supraglottic swallow - The patient is asked to take a deep breath and hold their breath. While still holding their breath they are to swallow and then immediately cough after swallowing. This technique can be used when there is reduced or late vocal fold closure or there is a delayed pharyngeal swallow. * Super-supraglottic swallow - The patient is asked to take a breath, hold their breath tightly while bearing down, swallow while still holding the breath hold, and then coughing immediately after the swallow. This technique can be used when there is reduced closure of the airway. * Effortful swallow - The patient is instructed to squeeze their muscles tightly while swallowing. This may be used when there is reduced posterior movement of the tongue base. * Mendelsohn maneuver - The patient is taught how to hold their adam's apple up during a swallow. This technique may be used when there is reduced laryngeal movement or a discoordinated swallow. ;Medical device In order to strengthen muscles in the mouth and throat areas, researchers at the University of Wisconsin–Madison, led by Dr. JoAnne Robbins, developed a device in which patients perform isometric exercises with the tongue. ;Diet modifications Diet modification may be warranted. Some patients require a soft diet that is easily chewed, and some require liquids of a thinned or thickened consistency. The effectiveness of modifying food and fluid in preventing aspiration pneumonia has been questioned and these can be associated with poorer nutrition, hydration and quality of life. There has been considerable variability in national approaches to describing different degrees of thickened fluids and food textures. However, the International<unk>  Diet Standardisation Initiative (IDDSI) group produced an agreed IDDSI framework consisting of a continuum of 8 levels (0-7), where drinks are measured from Levels 0 – 4, while foods are measured from Levels 3 – 7. ;Environmental modifications Environmental modification can be suggested to assist and reduce risk factors for aspiration. For example, removing distractions like too many people in the room or turning off the TV during feeding, etc. ;Oral sensory awareness techniques Oral sensory awareness techniques can be used with patients who have a swallow apraxia, tactile agnosia for food, delayed onset of the oral swallow, reduced oral sensation, or delayed onset of the pharyngeal swallow. * pressure of a spoon against tongue * using a sour bolus * using a cold bolus * using a bolus that requires chewing * using a bolus larger than 3mL * thermal-tactile stimulation (controversial) ;Prosthetics * Palatal lift or Palatal obturator * Maxillary denture Surgery These are usually only recommended as a last resort. * Tracheotomy * Tracheostomy * Vocal fold augmentation/injection * Thryoplasty medialization * Arytenoid adduction * Partial or total laryngectomy * Laryngotracheal separation * Supralaryngectomy * Palatoplasty * Cricopharyngeal myotomy * Zenker's diverticulectomy * Percutaneous endoscopic gastrostomy * Feeding tube
Oropharyngeal dysphagia
Cricopharyngeal spasm
Velopharyngeal insufficiency
Vocal cord paresis
Alaryngeal speech
Muscle tension dysphonia
Ankyloglossia
Crenated tongue