Swallowing Solutions Newsletter February 2026


Swallowing Spotlight: Understanding Pharyngeal Hypoplasia

And the exercises that help—at any age

Pharyngeal hypoplasia is a term that sounds intimidating, but at its core, it simply describes reduced size, strength, or depth of the pharynx (the throat space that plays a key role in swallowing). When the pharynx is underdeveloped or weakened, the swallow may be less efficient, requiring extra effort, multiple swallows, or specific strategies to clear food and liquids safely.

This condition can be seen in infants, children, and adults, often associated with:

  • Congenital differences

  • Neuromuscular conditions

  • Prolonged tube feeding

  • Reduced oral experiences early in life

  • Deconditioning from illness or medical complexity

The good news?
The swallow is adaptable.
With the right exercises and strategies, we can often improve coordination, strength, and safety—no matter the age.


Children with Pharyngeal Hypoplasia

In young children, signs may include:

  • Difficulty transitioning textures

  • Gagging, coughing, or pocketing food

  • Reliance on purees or thickened liquids

  • Fatigue during meals

Helpful Therapy Focus Areas

Suck–Swallow Coordination
Using straws, syringes, or thick liquids encourages a more organized swallow and better pharyngeal engagement.

Resistance Through Thickness
Thicker liquids (smoothies, milkshakes, yogurt drinks, pudding) provide sensory input and resistance, which can wake up the swallow.

Small Lumen Straws
These slow the flow and promote stronger, more controlled suction and pharyngeal contraction.

Play-Based Oral Motor Work
Blowing bubbles, party blowouts, kazoo play, and whistles strengthen breath support and oral coordination that directly supports swallowing.

Audible Swallows & Repetition
Encouraging repeated swallows helps clear residue and builds endurance.


Adults & Older Individuals

In teens, adults, and seniors, pharyngeal hypoplasia may present as:

  • Needing multiple swallows per bite

  • Feeling food “stuck”

  • Coughing with thin liquids

  • Fatigue while eating

Therapeutic Strategies That Help

Suck–Swallow Exercises
Using applesauce, pudding, or thick liquids through a straw can improve pharyngeal contraction and clearance.

Bolus Control Techniques
Small, intentional sips or bites paired with focused swallows improve efficiency.

Expiratory & Breath Support Exercises
Kazoo, blowing exercises, and controlled exhalation strengthen airway protection.

Sensory-Motor Input
Cold, flavorful, or slightly thicker consistencies can improve swallow timing.

Neuromuscular Electrical Stimulation (When Appropriate)
For some individuals, VitalStim or similar modalities may support muscle activation when paired with active swallowing.


The Big Takeaway

Pharyngeal hypoplasia does not mean swallowing cannot improve.

With:

  • The right textures

  • Intentional exercises

  • Consistent practice

  • Individualized therapy

Swallowing can become safer, stronger, and more efficient.

Every swallow is a learned movement—and learning can happen at any age.

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Swallowing Solutions Newsletter January 2026