Rehabilitation Services

Videofluoroscopic Swallow Study (VFSS)

What is a Videofluoroscopic Swallow Study (VFSS)?

A videofluoroscopic swallow study (VFSS) is a video X-ray taken while your child is drinking and/or eating. One of the primary reasons your child’s doctor may order a VFSS is to evaluate for aspiration.

What is aspiration?

Aspiration occurs when food and/or liquid enters the airway and/or lungs. This is commonly referred to as “going down the wrong pipe.”

Why is aspiration a problem?

Aspiration may lead to serious health concerns such as:

  • frequent respiratory illness such as pneumonia
  • apnea (pauses in breathing) during feedings
  • refusing to eat, often resulting in difficulty gaining weight

When is a videofluoroscopic swallow study (VFSS) recommended?

Your child’s medical provider may recommend a VFSS if your child is presenting with one or more of the following concerns during or right after meals:

  • coughing, choking or gagging
  • wet or “gurgly” voice
  • increased congestion or noisy breathing
  • runny nose or watery eyes during feedings (when your child does not have a cold)
  • dusky, bluish, or red color changes in the face, on or under the eyes, or around the mouth – these color changes may occur quickly or slowly.

What to expect during a videofluoroscopic swallow study (VFSS)

During the evaluation, your child will be asked to swallow liquids and foods containing barium, a type of contrast fluid that allows the food/liquid to be seen on the X-ray. Most likely your child will be seated during the evaluation and asked to be as still as possible to ensure the best image. You may be in the room with your child, unless you are pregnant. The entire procedure typically takes 10-15 minutes.

Results and recommendations will be discussed at the end of the evaluation. Depending on the results of your child’s study, the therapist may recommend feeding plan changes (ex. thickening liquids), feeding therapy, or possibly VitalStim therapy (link to VitalStim page). Handouts will be provided and home activities may be discussed and demonstrated.

Where can my child have a videofluoroscopic swallow study (VFSS)?

Speech-language pathologists and occupational therapists provide swallow studies at the following locations:

Please check in at the radiology department, not the Developmental & Rehabilitation Services Department, for your child’s VFSS.

What to bring to a videofluoroscopic swallow study:

To ensure the most accurate and complete evaluation, it is recommended that parents/caregivers bring the following items to the evaluation:

  • A hungry child: Typically it is recommended that your child have nothing to eat or drink for 3-4 hours prior to the study. However, if your child is having other exams at the same time, these guidelines change. Please check with the scheduler for specific information about all of your child’s procedures.
  • Special foods: We typically have pudding, applesauce and baby food available as well as a selection of dissolvable solids (such as saltine crackers or cookies). If your child has food allergies or is having difficulty with a specific food we request that you bring these items from home.
  • Bottles and/or sippy cup: If your child is bottle fed or using a sippy cup, please bring the bottle/nipple and/or cup used for most feedings.

Patient/Family Education Handouts

The following education handouts may help you prepare for your child’s videofluoroscopic swallow study: