Patient with doctor 

Tests or Procedures for Diagnosis

There are several tests and procedures available in the Pediatric Airway, Voice, and Swallowing Center to help with diagnosis. Determining which are most appropriate for your child is a decision to be made after your child has been evaluated by one of our physicians. If you would like to schedule an appointment, you may request one online or call us at 617-573-3190.

Learn more about the most common diagnostic tests or procedures we offer:

Feeding and Speech Evaluation

Depending on your child's condition, we may refer you to one of our speech-language pathologists from the Mass General Hospital for Children to evaluate feeding and speech performance. Our speech-language pathologists are usually available at the Center during clinic hours, so it is probable that you will be able to consult with one of them on your first visit. If one is not available that day, an evaluation will be scheduled for another time. 

The evaluation may include a modified barium swallow or other swallowing studies, a feeding team evaluation, or various speech and language studies.

Flexible Laryngoscopy

Flexible laryngoscopy is an office procedure that allows us to view the structures of your child's upper airway. A small scope with a camera on the end is placed inside the nose and into the upper airway. 

It can be performed on infants or older children, but can be difficult to perform on toddlers, who often become anxious during the procedure. If a toddler requires laryngoscopy, sedation in an operating room setting may be recommended.

Videofluoroscopic Swallow Studies

A videofluoroscopic swallow study (VFSS) is a radiographic study performed to evaluate swallowing issues in children who exhibit coughing, choking, or congestion during liquid and/or food intake. In particular, this study looks for times when the liquid or food is moving toward or into the airway, instead of down toward the stomach. 

During this study, video and x-ray images are taken as the child drinks and/or eats. The study evaluates swallow safety and determines whether changes in positioning or consistency are necessary to allow safer swallowing.

Bravo Study or pH Probe

A pH probe or Bravo study is used to evaluate acid levels in the upper gastrointestinal (GI) tract and is typically ordered when a diagnosis of reflux is suspected. 

The Bravo study is a procedure done in the operating room, in which a special device that monitors acid is attached to the esophagus. This box is attached to record acid levels over a 24- to 48-hour period, before it falls off. We ask that you keep a log of your child's activities, such as eating, playing, and sleeping during this time and return the device to the Center at the next appointment. 

Another study used for evaluation of acid reflux is a 24-hour esophageal pH monitor. A small probe is passed through the nose into the esophagus. The tube has sensors at various levels that detect acid levels. The tube is attached to a monitor that is worn for 24 hours. It has buttons to record your child’s position and a log is kept recording your child’s activities at certain intervals. 

A gastroenterologist (GI specialist) will use the information recorded on the device to evaluate acid levels in your child's GI tract.

Pulmonary Function Testing

This is a computerized test done in a special lab that measures your child's ability to take air in and out of their lungs. This test is useful in diagnosing disorders of the respiratory tract, such as asthma and restrictive lung diseases. 

During the test, a clip will be placed on your child's nose and they will be asked to breathe into a computerized mouthpiece. The mouthpiece measures airflow as they breath.

Endoscopy (Triple)

We may determine that your child needs further assessment of their symptoms by endoscopy. Endoscopy is a general term that refers to an examination using a small scope that is passed through the mouth while the patient is asleep. For most of our patients, we will perform a triple endoscopy (laryngoscopy, bronchoscopy, and esophagoscopy). 

During these procedures, a flexible or rigid scope with a camera on the end is inserted through the mouth to visualize the throat, voice box (larynx), windpipe (trachea), lungs, swallowing tube (esophagus), and stomach. 

Several laboratory tests, cultures, and biopsies are often performed at the same time to help with diagnosis.

X-Ray, CT Scan, or MRI Scan

These are certain imaging studies that can provide more information that may be helpful for diagnosis. Depending on the complexity of the study ordered, most scans and results can be obtained on the day of your visit. Our Radiology Department is located on the first floor, just off of our main lobby at 243 Charles Street in Boston.