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Modified Barium Swallow Study

The Modified Barium Swallow Study (MBSS) is where a speech-language pathologist, radiology doctor, or x-ray technologist determines a patient’s swallow. A swallow is hard to determine directly; therefore, if a child is presenting wet talking noise, poor control of oral secretions, coughing, choking, changes in breathing when eating or drinking, or has frequent respiratory infections, an MBSS is suggested to determine underlying factors. Determining if the patient has an effective swallow or not is important when it comes to successful eating. An abnormal swallow leads to a risk of aspirating foods into the lungs, weight loss, uncontrolled reflux, difficulty with harder to chew foods, or choking.

During the MBSS, the speech-language pathologist will create a series of thin and thick liquids using Barium to visualize the swallowing process with a fluoroscopy (a moving x-ray screening). The fluoroscopy allows the therapist to determine how the patient swallows by viewing the head and neck area. The actual fluoroscopy should not take longer than 15 minutes.

What is being observed (but not limited to):

  • Bolus formation

  • Bolus control

  • Oral transit time

  • Type of chewing

  • Epiglottic movement

  • Aspiration

  • Structural abnormalities


Bousquet, J., & Shonbrun, S. (2015, November 7). Pediatric modified barium swallow studies

[PowerPoint slides]. Tampa Bay Medical Speech Pathology.


Evans, K. K. (n.d.). Five facts about modified barium swallow studies. University of Mississippi

Medical Center.



Fluoroscopy procedure. JHM. (2019, August 14).


Modified barium swallow (cookie swallow): Children’s Pittsburgh. Children’s Hospital of

Pittsburgh. (n.d.).


Modified barium swallow. UM Baltimore Washington Medical Center. (n.d.).


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