This is Lucy. A unique thing about her is she has cerebral palsy. She uses a walker to help her walk.

Cerebral palsy sometimes makes things a little harder for Lucy. For example, she doesn’t have the best balance and walking is a little difficult. That is why she uses her walker. Another thing that is hard for her is chewing and swallowing her food and drinks.

Lucy has a doctor’s appointment on Friday to have her swallowing tested. She is a little nervous because sometimes she chokes when she eats which scares her. “I wish I could be like all the other kids and eat whatever I want.”, she thought.

This is Kevin. He has Down syndrome. Down syndrome is a genetic disorder. He can do most things everyone else can do, but sometimes he has a hard time eating and drinking. 

Kevin has a doctors appointment on Friday to check out his swallowing. He is feeling worried about his appointment because eating is sometimes hard for him. He is feeling sad because he thinks that nobody else has a hard time eating and drinking like he does.

Today is appointment day for Lucy and Kevin. Both of them got ready this morning with butterflies in their stomachs. They both arrive with their mom’s at 9:30am. Most people in the waiting room are adults so Kevin and Lucy are surprised to see another kid their age!

Kevin and Lucy sit next to each other in the waiting room. Kevin is too shy to say hello but Lucy is so excited to see another kid so she introduces herself, “Hi, I’m Lucy, what's your name?” “I’m Kevin!”, he replies, “What are you here for?” Lucy is a little nervous to tell Kevin why she is there because sometimes kids at school don’t get it. “Sometimes I have a hard time eating and drinking.”, Lucy says sheepishly. “NO WAY!”, Kevin exclaims, “Me too!” Lucy and Kevin feel so much better knowing someone else understands.

After Kevin and Lucy tell each other about their favorite things to do, Kevin says “Hey, why do you use that walker?” “I have something called cerebral palsy”, replies Lucy. “Sometimes I have a hard time getting around, so I use this walker to keep me balanced.” “Cool! I like that it’s orange. That’s my favorite color!”, said Kevin. Then Kevin says “We’re not so different! I have Down syndrome.” 

Suddenly, the speech therapist calls Lucy’s name. It is time for her appointment. Even though she is nervous, having Kevin there makes her feel better. She takes a deep breath, stands up, and says, “I am brave. I can do this!” A different speech therapist calls Kevin’s name.

"Hi Lucy!", says the speech therapist. "I'm Carly, I am your speech therapist. It is my job to look at how you swallow and make sure you can eat and drink safely."

During their appointments the speech therapists ask Lucy, Kevin and their parents some questions. For example, "What brings you here?", "How long does it take you to eat a meal?", "Do you cough or choke when you eat?", "Does this happen with foods, drinks, or both?".

Then, Kevin and Lucy have to answer some easy questions about what day it is, where they are, and why they are there. Next, they follow some simple directions like "pat your head and then clap your hands". The speech therapist says that they do these things to make sure the brain is working just right.

Then the speech therapists takes a look inside their mouths at their lips, tongue, and teeth and checks for any weakness or differences that might make swallowing hard.

Next the kids try some foods and drinks. They try different types of water. Some is thin and some is really thick and gooey. The speech therapist explains that something called thickener makes the water gooey. The first drink is regular water, the second is a little gooier, the third is even gooier, and the fourth is the gooiest! Next, they try applesauce, rice with gravy, pieces of banana, and finish with a cookie!

At the end of Lucy's appointment, her speech therapist says that she isn’t chewing up her foods all the way and that she noticed that Lucy coughed after drinking regular water.

At the end of Kevin’s appointment, his speech therapist says that he has leftover food in his mouth after chewing his banana and she noticed that he choked after drinking the first thickened water.

Both of the speech therapists tell Kevin and Lucy that they have dysphagia which is something that makes chewing and swallowing foods and drinks hard. 

Lucy’s speech therapist sets up a new appointment for her to get a special x-ray and take a video that will look at her swallowing. This is called a Modified Barium Swallow Study (MBSS). The speech therapist explains that this special x-ray will help her figure out why Lucy has difficulty swallowing. The speech therapist tells Lucy and her mom that there are three possible areas of difficulty when swallowing. The first is in the mouth and is called the oral phase. There might be problems with the mouth, lips, and tongue holding the food. The second phase is in the throat and is called the pharyngeal phase. Problems in the pharyngeal phase might cause food to go into the windpipe rather than the stomach. The last phase is the esophageal phase, where there might be issues as the food travels to the stomach.