Why we may choke
by Erin Chelsea Kelly, speech/language pathologist
BA in Speech Pathology & Audiology
MA in Communication Disorders
Certified in Swallowing Disorders, Cognitive Therapy & Family Counseling

• Ineffective rotary chewing permits large chunks of food to approach the airway
• Weak tongue muscles fail to move food backward in preparation for swallowing
• Decreased sensation allows residual food or liquids to fall into the airway
• Weak vocal cords fail to close completely to protect the airway
• Delayed swallowing response interrupts the timing sequence
• Swallowing and breathing are not coordinated properly
• Decreased sensation allows saliva to accumulate, spilling into the airway
• Weakness and decreased sensation in the throat may allow food to accumulate in recesses
• Weak or poorly coordinated esophageal muscles allow regurgitation into the airway after swallowing
What We Can Do:
• Use temperature and texture to stimulate sensation
• Develop patterned breathing (breathe in, hold, swallow and breathe out)
• Alternate liquids and solids
• Swallow twice after each sip or bite
• Try using a straw for liquids
• Keep chin tilted down toward chest when ready to swallow
• Stay away from known problem foods (thin liquids, peanut butter, etc.)
• Thicken liquids with unflavored gelatin
• Chew food well and use tongue to check for bits of food left in mouth after swallowing
• Remain upright for at least 45 minutes after a meal
• Limit distractions while eating
• Swallow saliva frequently throughout the day