OBJECTIVE: To describe the participation of speech and hearing therapists in the differential diagnosis of dysphagia and gastro esophageal reflux (GER). CASE REPORT: M.B., a 1-year 7-month-old male, had a medical history of pneumonia requiring hospitalization and the use of a feeding tube. He attended the speech and hearing ambulatory department of a hospital in the city of Porto Alegre at the same time as he was being treated by pediatric and gastro pediatric teams. The patient had undergone speech and hearing therapy during hospitalization when he was 1 year old, the focus of which was to ensure safe and efficient oral feeding. After discharge, he was referred for ambulatory treatment. The patient was exclusively orally fed, but with some food consistency adaptation. In the clinical evaluation performed at the ambulatory clinic, alteration of swallowing with nasal noise during swallowing and proper sucking and labial sealing were observed. Normal swallowing was also found by video fluoroscopy. CONCLUSION: The speech and hearing therapist is responsible for evaluating clinical swallowing and accompanying variables, and so can offer significant insight into the differential diagnosis of gastro esophageal reflux and dysphagia.