Swallow assessment older child

[Cupcake695]

DD previously had reflux and had the barium swallow/videofluroscppy done as a baby.
She suffers from recurrent chest infections and we have noticed recently that when on antibiotics (3 weeks of every month and a prophylactic x3 a week) she gets reflux. One of her consultants has referred her to SALT for assessment- they are wondering if she is aspirating - but what tests will they do for swallow / reflux / aspiration in a 5 year old?

SALT can get her to drink different liquids from a cup, through a straw etc and listen with a stethoscope on her neck while she drinks. This alone tells them quite a lot.
If SALT are still concerned they can refer her for a videofluroscopy where she will drink the variety of liquids again but with the barium in - this will show if she is aspirating.
My DC had this last year - but via a baby bottle - was quick and painless - apart from the aspiration with the barium which caused pneumonia!
hope that helps!

What did the video fluoroscopy show when s

What did the video fluoroscopy show when she was little? Was she aspirating then?

The swallow assessment I presume will be looking for signs of aspiration or if proved before when little to see if signs have improved.

My child shows no signs but silently aspirates seen on the video fluoroscopy and is resource thicken up which thickens all drinks, alongside preventative antibiotics like your daughter three times a week.

When she was little she had silent reflux, you could hear it come up and she would scream then gulp as it went back down.
On the video fluoroscopy they said there was mild reflux but not of any significance - although it is just a snap shot of one time whilst sat in a chair, I would have thought when they are crawling/running/playing then are more likely to have reflux?
Have the thickened fluids made much difference? How would they tell if foods were aspirated?

They did different levels of fluids on the fluoroscopy when she was 2, water, then syrup thick then custard thick then purée thick - and she aspirated on water and syrup thick - she has scarring on her lungs so the thickness fluid is not just about preventing the infection but also about the scarring.

Earlier on the SALT assessment we (us and SALT) thought she would not be aspirating as no symptoms.

She has still needed antibiotics, but more about the long term journey. Next for us is a camera down the throat under general to check for any physical causes such as cleft in the flap that is meant to stop fluids going down.

We have to make the fluids custard thick which she then can control and aspirate.

Our daughter also has scarring on her lungs /bronchial wall thickening seen on X-rays. They have done a bronchoscopy under GA which was ok but couldn't do all of it, possibly the bit you mentioned about the cleft in the flap as he said something about needing her to be awake for that bit as is too young to try??
So did they still do your DD video fluoroscopy even though you and SALT thought she was not aspirating or could they hear something when listening to her?

@Cupcake695 because of the barium in the fluid they can see it on the screen going into the lung instead of the stomach.
As it is video recorded they should show you the video of your DD swallowing after the procedure. They film the water, then syrup thick, then custard thick, then puree thick if needed. You can watch and see where the fluid goes - the stomach correctly, or the lungs as an aspiration.
You cannot aspirate foods - you choke and cough them back up. You only aspirate fluids as the fluid just runs down. That is why thickener is given to make syrup, custard or puree thickness as needed - every person is different, but the videofluroscopy shows what thickness is needed.

'So did they still do your DD video fluoroscopy even though you and SALT thought she was not aspirating or could they hear something when listening to her?'

Yes - they said she silently aspirates - no signs to SALT, just guided by consultant because of history and x-ray image.