5 Levels Difficulty In Swallowing
Movement Disorder Medicines
Anxiety-Antidepressant Medications
Antidepressant Adverse Effects
Warnings~Adolescents Under 25
Sertraline ~Zoloft
Anti-psychotic Medications
Prozac, Luvox, Paxil, Zoloft & Celexa
Olanzipine & Risperidone and blood tests
Cutting Prescriptions
Sites That Help the Medicine Go Down
Vitamins & Minerals
Why Certain Symptoms Occur In HD
Tests Commonly Used -Neuropsychological Examination
Symptom vs Medication
Speech & Swallowing Difficulties~Lynn Rhodes
Swallowing Problem Warning Signs
Swallowing Tests
Nutrition and HD~Anna Gaba (Recipes)
HD & Diet~HSA Fact Sheet 7
HD~Swallowing & Nutrition
Weight Gain
5 Levels Difficulty In Swallowing
Feeding Tube~Advanced Stages of HD
Feeding Tube~Jean Miller
One more word on feeding tubes
PEG Tubes and baby foods
Feeding Tubes-More Info
HD~Falling/Safety Issues
HD~Cognitive/Decision Making/Impulsivity
Cognitive-Short Tips
Denial of HD
HD~Irritability/Temper Outbursts
Managing behavioral problems
Depression - Treatment Resistant Patient
HD~Mania, Obsessive Disorders
HD~Hallucinations & Psychosis
HD~Rigidity, Spasticity, and Dystonia
Adaptive Products
Teen Suicide~Let's Talk Facts
Stress Explained-Easy/Fun Format
How To Help Someone Chronically Ill
Legal Planning for Incapacity
Out-of-Home Care Options FAQ
Preparing for Emergencies
This seems to describe different levels which might be beneficial in
the various stages of HD.

Dysphagia Diet 5 Levels Difficulty In Swallowing Diet
including  sample menu's and provides  the names and phone numbers for
manufacturer's for Commercial Thickening Agents

Level 1 - Puréed Foods
Foods in this group are puréed to a smooth, mashed potato-like consistency. If necessary, the puréed foods can keep their shape with the addition of a thickening agent. Meat is puréed to a smooth pasty consistency. Hot broth or hot gravy may be added to the puréed meat, approximately 1 oz of liquid per 3 oz serving of meat.

CAUTION: If any food does not purée into a smooth consistency, it may make eating or swallowing more difficult. For example, zucchini seeds sometimes do not blend well.

Level 2 - Minced Foods
Foods in this group should be minced/chopped into very small pieces (1/8 inch). The flecks of food are similar in size to sesame seeds.

Level 3 - Ground Foods
Foods in this group should be ground/diced into 1/4-inch pieces. These pieces of food are similar in size to rice.

Level 4 - Chopped Foods
Foods in this group should be chopped into 1/2-inch pieces. These pieces of food are similar in size to uncooked elbow macaroni or croutons (small bread cubes).

Level 5 - Modified Regular Foods
Foods in this group are soft, moist, regularly textured foods

Explanation of some Swallowing Programs

Self-Feeding and Swallowing Treatment Programs
When your feeding and swallowing difficulties require therapy, your speech- language pathologist and occupational therapist will work together to design and implement a program specific to your needs. Our goal is to help you reach your highest potential for safe swallowing.

Several treatment approaches which may be included in your swallowing program are:

Oral Motor Methods - These may include an exercise program for your chewing and swallowing muscles, as well as training specific swallowing techniques.

Therapeutic Feeding - Small amounts of food are given to increase the patient's ability to eventually tolerate a complete meal safely.

Posture - Recommendations are made to assure that your head and body is positioned for safe and efficient swallowing.

Adaptive Equipment - Equipment may be recommended to help you with positioning and feeding yourself. Some devices that may be recommended include arm and lapboards, wheelchair cushions and adaptive cups and plates.

Changes in Eating Style - Changes may be recommended by your swallowing therapists to assure safer swallowing. A written list of recommendations will be provided and may include suggestions such as eating more slowly, swallowing more frequently, eating in a quiet area with few distractions, eating only certain food consistencies, etc. The
reason for each recommendation will be explained to you by your swallowing therapists.

Food Preparation - Foods may be prepared in different ways to help you swallow safely. Your foods may be pureed, blenderized or soft as ordered by your physician. Liquids also have different consistencies. Thicker liquids may be easier at first to swallow than thinner liquids.

The following list gives examples of diet orders including foods you
may receive at meals.

Physician's Diet Order - Foods may include:

Thick Liquids - Cream soups, hot cereal, custard, puddings, thick frappe, and apricot nectar.

Thin Liquids with Thickener - A powdered additive (cornstarch) may be used to thicken consistencies of thin liquids.

Thin Liquids - Water, soda, fruit juices, hot beverages, milk, jello, melted ice cream.

Puree Diet - Meat, vegetables, fruit will be pureed; mashed potato, whipped squash, applesauce, cream of wheat and oatmeal.

Basic Soft Diet - All meats will be ground and vegetables will be blenderized. Soft chewables are allowed including canned fruits, scrambled eggs, hot cereal, rolls, muffins, bread, pastas, casseroles, stews, quiche, pie, pancakes.

Advanced Soft Diet - Soft cut meats and cooked vegetables, and canned fruit are allowed. All foods allowed for basic soft diet are also available on advanced soft diet .

Dental Soft Diet - For patients who may have difficulty chewing. This diet restricts fresh fruit, raw vegetables and foods containing nuts. Most other foods are included. (Some patients require foods from more than one of the above categories.)

House/Regular Diet - Foods have no modifications of ingredients or textures

Nutrition and Huntington's Disease, A Practical Guide. to order

Ellen van Broekhoven (dietician), Dirk Gaasbeek (nursing home physician),
and Maartje Veninga (speech therapist) work in a nursing home with a special unit for patiens suffering from Huntington's Disease. They discovered that there were no ready answers to questions in relation to, in particular, nutrition for patiens suffering from this disease.

It is for this reason that they decided to pool their knowledge and experience into a very practical guide and to supplement it with information from the skimpy scientific literature on this subject.

The book provides insight into the nutritional problems that exist among patients suffering from this disease from the point of view of various disciplines. With that, it appears time and again that communication, i.e. to understand what the patient wants and to which degree it is possible to discuss problems of vital importance. That is why communication comes up extensively. Another question that is raised is whether or not tube feeding may be a good alternative if regular feeding is no longer possible.

What makes this book so unique is that it serves as a comprehensive guide for medical practitioners and paramedics.

In this recommendation, Prof. Dr. H.P.H Kremer, neurologist, says: "I warmly recommend this book to those who, either in their work or in the family, have to deal with patients suffering from Huntington's Disease. This is the first practical publication in this field and I hope it will inform and inspire many people."
toll-free HELPLINE  1-800-638-8255

Free Consumer Brochures Examine Swallowing Disorders in Children and Adults

(ROCKVILLE, MD-May 1, 2001) Two new brochures focusing on swallowing
disorders are available free of charge to consumers from the American
Speech-Language-Hearing Association (ASHA).

"Feeding and Swallowing Problems in Children" and "Swallowing Problems
in Adults" discuss some of the causes and symptoms of swallowing disorders, or dysphagia, as well as how swallowing problems can lead to poor nutrition, dehydration, or pneumonia in both children and adults.
The brochures also examine the different phases at which problems can occur in the swallowing process, from difficulty chewing or moving food or liquid from the mouth to the throat, to problems in squeezing food through the esophagus.
In addition, the brochures address the role of the speech-language pathologist in evaluating and treating dysphagia.

Consumers can receive the brochures by calling ASHA's toll-free HELPLINE
at 1-800-638-8255. Consumers may also view the brochures online, as well as obtain referrals to qualified speech-language pathologists and access additional  information on speech, language and hearing development and disorders, by visiting the ASHA website at

ASHA is the national professional, scientific, and credentialing association for more than 99,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists.

Resources in Spanish
¿Qué es una evaluación audiológica?

Problemas de la voz

Related Links:

Augmentative Communication: A Glossary

Introduction to Augmentative and Alternative Communication

Augmentative and Alternative Communication Decisions