Explore every episode of the podcast Dysphagia Research Bites

Is it a case of trouble with swallowing or trouble with eating? In this episode, Dr Megan Parsons, medical speech-language pathologist, unpacks a framework that changed how she thinks about swallowing problems. Chantelle and Megan explore why “dysphagia” isn’t always a problem of the swallow itself, and why working out what is driving the difficulty might be the most important clinical question we ask.

If you’ve ever documented “dysphagia” without being sure what was driving it, this episode is for you.

In this episode we cover:

• What cognitive dysphagia is, and what it looks like at mealtimes
• Why a patient can have intact swallowing anatomy and physiology and still not eat
• Whether “cognitive dysphagia” belongs across populations, including adults with developmental and intellectual disability
• A systems-based framework for dysphagia and how it shifts assessment, chart review and documentation
• When the swallow isn’t the problem, and how to flag concerns outside our scope without handballing the patient
• How to look for respiratory contributors to dysphagia during a clinical swallow evaluation
• How to see natural eating behaviour in a hospital setting, and why involving family matters
• The role of clinical reasoning in what makes us pathologists, not just therapists

The publication this episode is based on:
Winchester, J & Winchester, C (2015). Cognitive dysphagia and effectively managing the five systems. Perspectives on Gerontology, 20(3), 116–132.

You can access the article here: http://dysphagiamanagement.com/wp-content/uploads/2015/03/CognitiveDysphagia_Winchester_2015.pdf

For more clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

Safety, nutrition, enjoyment and the dining experience all need to be part of the conversation when we are talking about texture modified meals in aged care. In this episode of Dysphagia Research Bites, Chantelle sits down with Vanessa Chan to unpack a mixed methods study looking into these very things. They explore the whole journey of a meal, from the kitchen to the dining room, and what speech pathologists can do to influence it.

In this episode we cover:

• Why the whole mealtime workflow matters, from preparation and labelling through to serving and feeding assistance
• Whether texture modified diets are being over-prescribed, and what happens when recommendations are changed without an SLP review
• Why an instrumental assessment isn't always feasible in the community and aged care, and what that means for practice
• The problem with texture modified menus: limited variety, inconsistent quality and nutritional gaps
• How access to drinks, thickening practices and staff training can affect residents' hydration and safety
• Why some residents choose to avoid the dining room, and how our own assumptions as clinicians can get in the way
• How well IDDSI has been implemented in practice, and what needs to improve
• Why choking risk deserves more attention in our profession

The publication this episode is based on:
Wu, X., Yousif, L., Miles, A., & Braakhuis, A. (2022). Exploring meal provision and mealtime challenges for aged care residents consuming texture-modified diets: A mixed methods study. Geriatrics, 7(3), 67. https://doi.org/10.3390/geriatrics7030067. PMID: 35735772.

Additional resources for aged care providers can be found at Swallowing and Dysphagia Support: https://www.swallowinganddysphagiasupport.com.au

For more community-based clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

How many times does your patient swallow in a minute? It sounds like a simple question but the answer might tell you more than you'd expect. In this episode of Dysphagia Research Bites, Chantelle sits down with Dr Sonal Pathak to explore spontaneous swallowing frequency: what it is, how it's measured, and why it could become one of the most practical objective tools in your clinical toolkit, both at the bedside in hospital and out in the community.

In this episode we cover:

• The difference between spontaneous and volitional swallows, and why this distinction matters for how you measure them
• Why the measurement environment needs to be carefully controlled — and what can accidentally inflate your data
• How long you actually need to record (the answer may surprise you)
• The role of spontaneous swallowing frequency as a screening tool in acute care, and what makes it accessible to non-SLP staff
• Why Sonal's doctoral research focused on this measure as an outcome measure in a post-acute setting and what that means for how we evaluate treatment effectiveness
• Why this measure may be particularly useful for clients with mild or subclinical dysphagia where other clinical signs are absent

One of the publications this episode is based on:

Crary, Carnaby & Sia (2013): https://pubmed.ncbi.nlm.nih.gov/25088166/

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

What if you could interpret a video fluoroscopy report the way a doctor reads a blood test, with clear reference ranges, and the ability to say with confidence whether a value is within or outside what's expected for a healthy adult? That's exactly what Dr Catriona Steele and her team at the University of Toronto have been working on, and in this episode she walks us through what they've found.

In this episode we cover:

• What prompted the development of VFSS reference values.
• How the ASPEKT method differs from ordinal rating tools like MBSImP and what it means to measure swallowing rather than describe it
• What the reference data tells us about residue, and why ASPEKT's approach to measuring residue is conceptually different from the Bolus Clearance Ratio and DIGEST
• The 2D vs 3D measurement problem: the validity challenges of pixel-based area measures and what Catriona's team is doing about it
• How many thin fluid swallows you actually need before you can confidently rule out aspiration and whether consecutive sips count
• Why bolus position at swallow onset was dropped from the reference value framework  and what replaced it
• What emerging ASPEKT data is showing across clinical populations including Parkinson's disease and COPD
• ASPEKT Academy and the clinical workshop coming to Australia

The publications this episode is based on:

Steele, C. M., Peladeau-Pigeon, M., Barbon, C. A. E., Guida, B. T., Tapson, M. S., Valenzano, T. J., & Waito, A. A. (2023). Reference values for videofluoroscopic measures of swallowing: An update. Journal of Speech, Language, and Hearing Research, 66(8), 2758–2773. https://doi.org/10.1044/2023_JSLHR-22-00608

Updated 2026 Reference Values available here: https://figshare.com/s/428ddbd2d1d009abcd01

Register for upcoming ASPEKT VFSS Workshops Here:

https://steeleswallowinglab.ca/srrl/education/aspekt-academy/#:~:text=ASPEKT%20Academy%20is%20a%202%2Dday,be%20offered%204%20times.%20The

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Aspiration and aspiration pneumonia are not the same thing. We know this theoretically. In this episode of Dysphagia Research Bites, Chantelle sits down with Melissa Kane to unpack a 2022 tutorial paper that illustrates the case for looking beyond aspiration itself and toward the individual: their host defences, their medical complexity, their oral health, their lifestyle, when determining the real risk of an adverse event.

This episode covers:

• Why the presence of aspiration does not have a linear relationship with adverse outcomes
• The BOLUS Framework: a clinical tool that consolidates existing evidence into a practical set of risk-assessment questions spanning Bolus variables, Oral care, Lifestyle and ADLs, Unintended (Iatrogenic) risks, and System Health

• How oral health, feeding dependence, mobility, tube presence, and medical co-morbidities each factor into aspiration risk

• The importance of person-centred language when discussing risk with clients and families
• How using this framework in a real-world case enabled a client who was nil by mouth to significantly increase their oral intake and improve quality of life

The publication this episode is based on:

Palmer, P. M., & Padilla, A. H. (2022). Risk of an adverse event in individuals who aspirate: A review of current literature on host defenses and individual differences. American Journal of Speech-Language Pathology, 31(1), 148–162. https://doi.org/10.1044/2021_AJSLP-20-00375

Some of the tools & articles mentioned in this episode:

• EAT-10 (Eating Assessment Tool-10):https://www.nhsexpertcorner.com/sites/default/files/2021-04/eat10toolenglish_form.pdf

• Drooling Frequency and Severity Scale (DFSS): https://www.movementdisorders.org/MDS-Files1/PDFs/Task-Force-Papers/sm004.doc
• Functional Oral Intake Scale (FOIS): https://www.archives-pmr.org/article/S0003-9993(05)00196-6/abstract
• Oral Health Assessment Tool (OHAT):https://www.dental.sa.gov.au/assets/downloads/Care-for-older-people-toolkit/Residential-care/3.-Oral_Health_Assessment_Tool-OHAT.PDF

• Langmore, S. E., Terpenning, M. S., Schork, A., Chen, Y., Murray, J. T., Lopatin, D., & Loesche, W. J. (1998). Predictors of aspiration pneumonia: How important is dysphagia? Dysphagia, 13(2), 69–81. https://doi.org/10.1007/PL00009559 — available via: https://pubmed.ncbi.nlm.nih.gov/9513300/
• Ashford, J. R. (2005). Pneumonia: Factors beyond aspiration. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 14(1), 10–16. https://doi.org/10.1044/sasd14.1.10 — the Three Pillars framework is also summarised at: https://www.sasspllc.com/three-pillars-of-pneumonia
• O'Keeffe, S., Murray, A., Leslie, P., Collins, L., Lazenby-Paterson, T., McCurtin, A., Mulkerrin, S., & Smith, A. (2021). Aspiration, risk and risk feeding: A critique of the Royal College of Physicians guidance on care of people with eating and drinking difficulties. Advances in Communication and Swallowing, 24(1), 1–10. https://doi.org/10.3233/ACS-210031

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Yvonne talks about the parts of dysphagia care that rarely make it into our clinical training, as a qualified chef, winemaker, and head and neck cancer survivor living with chronic dysphagia. In this episode she shares her experience of going from eating her way through back alleys in Vietnam to not being able to swallow thickened water. I can honestly say that I learnt so much from Yvonne and realised that I need to do better to support clients living at home with dysphagia.

In this episode we cover:

• Why Yvonne says the real fight began after treatment ended not during surgery or chemoradiotherapy
• The concept of commensality and why the deeply human need to eat socially is one of the most overlooked dimensions of chronic dysphagia
• What Yvonne was actually told at discharge, and the gap between that and what she needed to know
• How caregiver involvement in meal preparation, however well-intentioned, can gradually sever a person's connection to food
• Why "just eat soft food" is not a plan, and what asking "what is your favourite food?" could change about the way we approach management

• What the mealtime environment at home actually looks like and why it matters more than we think
• The psychosocial and emotional dimensions of chronic dysphagia that our clinical frameworks tend to leave behind

Resources mentioned in this episode:

• Yvonne's book GULP: yvonnemcclaren.com
• The No Feeding Tubes Podcast
• The Commensality Comeback Movement and the Back at the Table Framework — details via Yvonne's website

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

What if one of the most overlooked aspects of dysphagia management isn't about swallowing at all — it's about chewing? In this episode of Dysphagia Research Bites, Chantelle sits down with Carol, an oral health therapist who works with adults with disability and complex needs, to unpack the Functional Chewing Training (FuCT) protocol.

Yes, the article they discuss was written for children with cerebral palsy. But don't let that put you off. As Chantelle and Carol discuss in this episode, the principles can translate meaningfully to adults — particularly those with intellectual disability, developmental disability, or acquired neurological conditions. There is little chewing rehabilitation literature for adults, and this article is one of the most structured, clinically applicable frameworks available.

Yes we know... the acronym is an interesting choice.

In this episode we cover:

• The four components of the FuCT protocol: postural alignment, food positioning on the molars, sensory stimulation, and food consistency grading
• Why assessing posture and trunk control is the non-negotiable first step before any chewing intervention
• The role of the chew tube and tools like the Gnosh Sidebiter in stimulating the chewing muscles and encouraging lateralisation
• How tongue thrusting relates to chewing dysfunction, and why addressing the thrust may need to come before oral hygiene can even happen

• The link between chewing, saliva, sensory input, and nutrient absorption (including the GLP-1 connection you probably didn't learn in university)
• How reduced mastication may be associated with cognitive decline — and what the research suggests about blood flow and the hippocampus
• Why a dietitian referral should be on your radar for clients with significant chewing dysfunction, even in the absence of obvious weight loss

The publication this episode is based on:

Serel Arslan S, Demir N, Kılınç HE, Karaduman AA. Effect of a new treatment protocol called Functional Chewing Training on chewing function in children with cerebral palsy: a double-blind randomised controlled trial. J Oral Rehabil. 2017;44(1):46–52. doi: 10.1111/joor.12459

You can find more information on the Gnosh Sidebiter here: https://www.sidebiter.com

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Let's unpack the evidence on cough reflex testing: what it tells us, what it doesn't, and whether clinicians are making a dangerous assumption when Cough Reflex Testing (CRT) results aren't available.

In this episode we cover:

• What cough reflex testing is and how it works as a screening tool for silent aspiration risk
• The key finding from Phoebe's research: a failed CRT leads to significantly more restrictive management, but in the absence of any CRT result, clinicians manage patients almost identically to those who passed
• What that pattern reveals about our default assumptions around airway sensation
• How aspiration pneumonia risk factors influenced clinician decision-making in the study
• The sensitivity and specificity of CRT and why it's not a perfect predictor of aspiration
• The complexity of interpreting CRT results across different textures — including patients who silently aspirate on thickened fluids after overtly aspirating on thin
• Why Phoebe frames CRT as one piece of a bigger clinical picture, not a standalone decision-making tool
• What Phoebe would want her own caregivers to know if she ever developed dysphagia

The publication this episode is based on:

Darrock, K., Wallace, E., Guiu Hernandez, E., Huckabee, M.-L., Mills, M., & Macrae, P. (2024). The influence of cough reflex testing on patient management. Journal of Speech, Language, and Hearing Research, 67, 2987–2996. https://doi.org/10.1044/2024_JSLHR-24-00174

Other articles mentioned:

Miles A, Zeng IS, McLauchlan H, Huckabee ML. Cough reflex testing in Dysphagia following stroke: a randomized controlled trial. J Clin Med Res. 2013 Jun;5(3):222-33. doi: 10.4021/jocmr1340w. Epub 2013 Apr 23. PMID: 23671548; PMCID: PMC3651073. https://pubmed.ncbi.nlm.nih.gov/23671548/

Miles A, Moore S, McFarlane M, Lee F, Allen J, Huckabee ML. Comparison of cough reflex test against instrumental assessment of aspiration. Physiol Behav. 2013 Jun 13;118:25-31. doi: 10.1016/j.physbeh.2013.05.004. Epub 2013 May 12. PMID: 23672854. https://pubmed.ncbi.nlm.nih.gov/23672854/

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

If you've ever felt like your dysphagia training just doesn't quite fit when you're sitting at someone's kitchen table, you're not wrong, and this episode is going to explain exactly why. In this solo episode of Dysphagia Research Bites, Chantelle shares the framework at the heart of her clinical practice and the reason she started this podcast and her business: Dysphagia management in the community requires a different approach.

Chantelle breaks down the acute care principles that most of us were trained on, and makes the case for why applying them in a community setting isn't just a poor fit, it's leaving community SLPs underprepared and their clients underserved.

If you've ever wondered whether you're doing something wrong in your community caseload, this episode might just reframe everything.

In this episode we cover:

• Why the acute care model of dysphagia management doesn't translate to community practice — and what to use instead
• The specific populations and practice contexts where this gap is most pronounced
• What the research says about how experienced community SLPs actually approach dysphagia management
• Why quality of life, carer involvement, and shared decision-making have to sit at the centre of community dysphagia care

Publications mentioned in this episode:

Howells, S. R., Cornwell, P. L., Ward, E. C., & Kuipers, P. (2019). Dysphagia care for adults in the community setting commands a different approach: perspectives of speech-language therapists. International Journal of Language & Communication Disorders, 54(6), 971–981. https://doi.org/10.1111/1460-6984.12499

Moloney J, Walshe M. Managing and supporting quality-of-life issues in dysphagia: A survey of clinical practice patterns and perspectives in the UK, Ireland and South Africa. Int J Lang Commun Disord. 2019 Jan;54(1):41-49. doi: 10.1111/1460-6984.12429. Epub 2018 Oct 26. PMID: 30362200.

If you are after a comprehensive self-paced course that teaches you how to conduct a clinical swallow evaluation in a community or post-acute care setting then check out this comprehensive course:

https://www.dysphagiabites.com/clinical-swallow-evaluation-course

What does it actually look like to assess swallowing difficulties in an adult who has eaten a certain way their entire life, and whose "textbook" may look nothing like yours? In this episode of Dysphagia Research Bites, Chantelle sits down with Jen Biener, a speech-language pathologist specialising in adults with developmental disabilities, to dig into a Dutch retrospective study on the prevalence and associated factors of swallowing difficulties in adults with intellectual disabilities aged 50 and over — and to unpack what it really means to assess and support this often-overlooked population.

In this episode we cover:

• Why the terminology we use — dysphagia vs. feeding and swallowing difficulties — matters clinically and in research, and why both terms have a place depending on the setting
• How to conduct a meaningful mealtime assessment, including the value of observing familiar caregivers feeding the person rather than jumping straight to a formal evaluation
• Why mealtime dependency needs to be understood differently in people who have always been dependent for feeding, compared to someone who acquired that dependency after a stroke
• Choking risk assessment in this population, including the limitations of existing tools and the power of instrumental assessment as a biofeedback tool
• How to set people up for success before and during instrumental swallowing studies 
• The importance of clinical language: writing what you observe, not what you assume, and why "did not follow one-step commands" is very different from "cannot follow one-step commands"
• Assessment tools and approaches Jen recommends, including the Dysphagia Disorder Survey, the Choking Risk Assessment, and the Functional Communication Profile - Revised
• Why there is so little research on adults with intellectual disabilities, and why this population is, in many ways, historically new 

The publication this episode is based on:

Sanders KJV, Elbers RG, Bastiaanse LP, Echteld MA, Evenhuis HM, Festen DAM. Prevalence of swallowing difficulties and associated factors in older people with intellectual disabilities. J Appl Res Intellectual Disability. 2024 May;37(3):e13209. doi: 10.1111/jar.13209. PMID: 38382915: https://pubmed.ncbi.nlm.nih.gov/38382915/

Other resources mentioned in this episode:

• Dysphagia Disorder Survey (DDS)  & Dysphagia Management & Staging Scale: https://sites.google.com/view/dysphagiaorg/the-dysphagia-disorder-survey
• Choking Risk Assessment & Pneumonia Risk Assessment: https://pubmed.ncbi.nlm.nih.gov/28822297/
• Article on mealtime supports for people with ID: https://pubmed.ncbi.nlm.nih.gov/21988217/
• Functional Communication Profile — Revised: https://www.wpspublish.com/fcp-r-functional-communication-profile-revised

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

If there's one thing that hasn't aged well in dysphagia management, it's the idea that swallowing is only a reflex. Over the past few decades, our understanding of cortical control in swallowing has fundamentally shifted, and so have our approaches to rehabilitation. In this episode, Professor Maggie-Lee Huckabee walks us through that evolution: from reflex-based compensation, to muscle strengthening, to where we are now: skill-based training that targets neural networks and motor planning. We also get into the practical side of surface EMG biofeedback, what it actually is, how it differs from NMES, and how to use it clinically.

In this episode we cover:

• The distinction between sEMG and NMES 
• How our understanding of cortical control in swallowing has evolved, and what that means for how we approach rehabilitation
• The shift from compensation-based approaches to muscle strengthening, and then to skill-based training
• The importance of the cranial nerve examination in directing our rehabilitation approach
• How skill-based swallowing impairments might look on VFSS
• Practical application of sEMG biofeedback
• BiSSkApp: an sEMG biofeedback system that patients can use at home while clinicians can have remote access to data

The publication this episode is based on:

Huckabee, M-L., Mills, M., Flynn, R., & Doeltgen, S. (2023). The evolution of swallowing rehabilitation and emergence of biofeedback modalities. Current Otorhinolaryngology Reports, 11, 144–153. https://doi.org/10.1007/s40136-023-00451-8

Where to find the resources mentioned:

BiSSkApp by Swallowing Technologies (SwalTech): https://swaltech.com/bisskapp/

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

In this episode a panel of speech pathologists talk about risk feeding plans across settings. In this episode I chat with Meredith Lane, Niall Taylor, Anna Coates, and Dr Lillian Krikheli, to unpack one of the most clinically and ethically complex areas in our field: Eating and Drinking with Acknowledged Risk (EDAR).

The panel explores why this practice looks so different across countries, settings, and service systems and follows on from a previous episode on the same topic, but with a guest with a medical background.

In this episode we cover:

• The differences in terminology across countries
• How community and hospital settings approach EDAR differently — and why community SLPs often bear the brunt of overly risk-averse policies

• How supported disability accommodation settings can inadvertently remove client autonomy and de-skill individuals
• Why business decisions — not clinical ones — are often driving restrictive mealtime policies in community organisations
• What coroner's reports actually tell us about SLP accountability in dysphagia-related incidents
• The concept of dignity of risk and how to balance it with duty of care
• Why risk to pleasure, social engagement, and identity deserves as much attention as aspiration risk
• The problem with waivers and how they oversimplify complex clinical decisions
• What patient-centred decision-making actually looks like in practice

Additional Resources:

You can find more information on Eating & Drinking with Acknowledged Risk here:

https://www.rcslt.org/members/clinical-guidance/eating-and-drinking-with-acknowledged-risks-risk-feeding/

https://www.speechpathologyaustralia.org.au/Common/Uploaded%20files/Smart%20Suite/Smart%20Library/1b67af79-1074-4a30-a9a0-61f3eccb7b2d/20200221%20Position%20Statement%20Risk%20Feeding.pdf

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

The guidelines say to manage risk. But what if the guidelines are the problem? In this episode of Dysphagia Research Bites, Dr Shaun O'Keeffe and I unpack his critique of the Royal College of Physicians' guidance on eating and drinking difficulties, and we ask the question that too few clinicians are asking: is our fear of aspiration actually driving good practice, or just driving restriction?

In this episode we cover:

• The difference between aspiration and aspiration pneumonia, and why conflating them causes harm
• Why dietary modifications and thickened fluids are not evidence-based strategies for preventing pneumonia
• The BOLUS Framework and why Shaun takes issue with how it frames risk
• Why "unsafe swallow" is a term that needs to go
• The evidence, or lack of it, behind nil by mouth orders for dysphagic patients
• Informed consent, patient choice, and why quality of life has to be part of the conversation
• Why the profession is at a crossroads between risk-averse practice and evidence-based care

The article this episode is based on:

O'Keeffe, Shaun & Murray, Aoife & Leslie, Paula & Collins, Lindsey & Lazenby-Paterson, Tracy & Mccurtin, Arlene & Mulkerrin, Siofra & Smith, Alison. (2021). Aspiration, risk and risk feeding: A critique of the royal college of physicians guidance on care of people with eating and drinking difficulties. Advances in Communication and Swallowing. 1-10. 10.3233/ACS-210031.

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

If you've ever felt uncertain about whether cervical auscultation belongs in your clinical toolkit, this episode is for you. In this episode of Dysphagia Research Bites, Chantelle sits down with Associate Professor Liza Bergstrom to unpack the evidence behind cervical auscultation, why it became so controversial, and why recent high-quality research suggests it deserves a proper place in your clinical swallow evaluation.

In this episode we cover:

·      What cervical auscultation actually is and where to place the stethoscope

·      Why CA became controversial and why that controversy may have been based on a misunderstanding of its intended purpose

·      The five key components to listen for during oral trials using the Respiratory Swallow Assessment Protocol

·      How CA complements the clinical swallow exam rather than replacing instrumental assessment

·      What the research says about validity, accuracy and reliability of CA compared to FEES

·      The role of training in improving reliability and what training options are available

·      Whether CA can detect silent aspiration and what its limitations are

The publication this episode is based on:

Bergström L, Cichero J, Jaghbeer M, Sutt AL. Respiratory-swallow assessment protocol for adult dysphagia management. BMC Res Notes. 2025 Nov 27;19(1):60. doi: 10.1186/s13104-025-07509-4. PMID: 41310723; PMCID: PMC12903235.

If you'd like some further reading on CA, please check out the articles below:

• https://link.springer.com/article/10.1007/s00455-022-10468-8
• https://www.tandfonline.com/doi/full/10.1080/17549507.2021.1953592#abstract
• https://onlinelibrary.wiley.com/doi/full/10.1111/coa.14202?msockid=077fa973c35469500a04bf97c2d968d3
• https://pubmed.ncbi.nlm.nih.gov/30019178/
• https://www.asha.org/siteassets/uploadedfiles/icf-swallowing.pdf

If you’ve been on the fence about CA or you’ve written it off, this episode is for you!

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Tiffani Wallace, is a dysphagia specialist with a passion for rehabilitation. In this chat Tiffani breaks down a 2016 case series study on the Intensive Dysphagia Rehabilitation Approach (IDRA) ™ in patients with neurogenic dysphagia.

In this episode they cover:

• What the IDR approach actually involves and why it's more accessible than it sounds
• The three core components of the program: oropharyngeal exercises, high intensity targeted swallowing practice and adherence-inducing features
• The principles of neuroplasticity underpinning the approach — and how to apply them in everyday practice
• Why focused, targeted exercises beat a long list of unproven techniques every time
• Why 60 bolus swallows per day is less daunting than it sounds — and why it matters

Be sure to check out Tiffani's work at www.dysphagiaramblings.net or find her on Instagram at @dysphagia_ramblings.

The publication this episode is based on: Malandraki GA, Rajappa A, Kantarcigil C, Wagner E, Ivey C, Youse K. The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study. Arch Phys Med Rehabil. 2016 Apr;97(4):567-574. https://doi.org/10.1016/j.apmr.2015.11.019

Note: DPNS stands for Deep Pharyngeal Neuromuscular Stimulation

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Part 2 of this conversation, talks about how changes in the visual field can affect eating and drinking and practical ways to assess this, as well as oral apraxia, enteral feeding and the hills Jackie will die on as an SLP when it comes to End of Life care.

In this episode they cover:

• How dementia affects the visual field and what this can mean at mealtimes
• Practical approaches to assessing vision and how you can compensate for these impairments in your management approach
• Using sensory strategies at mealtimes, including how something as simple as separating food into individual bowls can support attention and reduce overwhelm
• Enteral feeding and what the evidence actually says about whether it prevents aspiration pneumonia
• Jackie's approach to oral apraxia: the tips, tricks and techniques she uses in practice
• Proactive swallowing therapy and why early intervention matters in this population
• The hill Jackie dies on when it comes to dysphagia care at end of life

Be sure to check out Jackie's ebook: The SLPs Guide to Dementia which you can access through Teachers Pay Teachers or through her instagram page: @unlearnwithme.theslp

The publication this episode is based on: Dysphagia in Persons with Dementia: The Dual Diagnosis Challenge Author: Michelle Tristani Publication: Perspectives of the ASHA Special Interest GroupsVolume 1, Number 15, Pages 105-116https://doi.org/10.1044/persp1.SIG15.1

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

Dysphagia doesn't show up in isolation. It shows up alongside memory loss, behavioural & sensory changes, communication breakdowns and alongside an aging swallow.

In part 1 of this episode of Dysphagia Research Bites, Chantelle sits down with Jackie Rodriguez, Speech-Language Pathologist, to unpack the dual diagnosis challenge of dementia and dysphagia, and why assessing swallowing in this population requires a fundamentally different clinical lens.

In this episode we cover:

• Why dementia and dysphagia together present a unique and underrecognised clinical challenge
• Jackie's story of how this became an area of interest
• An introduction to the article: Dysphagia in Persons with Dementia: The Dual Diagnosis Challenge by Michelle Tristani
• A discussion on terminology and why the language we use with this population matters
• Functional approaches to assessing dysphagia in adults with dementia
• Some cognitive assessments that SLPs should know about 

Assessments mentioned in this episode:

• Dementia Mealtime Assessment Tool (DMAT)
• Environment & Communication Assessment Toolkit (ECAT) for Dementia Care
• The Saint Louis University Mental Status (SLUMS) 
• The Mini Mental State Examination (MMSE)
• Cognitive Linguistic Quick Test (CLQT)
• Global Deterioration Scale (GDS)

Be sure to check out Jackie’s ebook: The SLPs Guide to Dementia

You can find it here: https://www.teacherspayteachers.com/Product/The-SLPs-Guide-to-Dementia-11781923

The publication this episode is based on: Dysphagia in Persons with Dementia: Tristani, M (2016). The Dual Diagnosis Challenge. Perspectives of the ASHA Special Interest Groups

Volume 1, Number 15 Pages 105-116

https://doi.org/10.1044/persp1.SIG15.105

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course

If you're a speech pathologist working in the community, you already know it feels different to the hospital. But did you know the research actually backs that up? In this episode of Dysphagia Research Bites, Chantelle sits down with Dr Simone Howells from Griffith University to unpack her research on community-based dysphagia practice and why the skills that made you great in the hospital might need a rethink when you step into someone's home.

In this episode we cover:

• Why community-based dysphagia care requires an adapted skillset and mindset
• The three key themes from Simone's research: holistic practice, client autonomy, and carer engagement
• The unique challenges of working without a multidisciplinary team
• How grief, loss, and psychosocial factors show up in community dysphagia practice
• Why new graduates may feel underprepared for community roles — and what universities are doing about it
• The importance of curiosity and conversation over rushing straight to assessment
• Cultural considerations in community dysphagia care
• Where the research gaps are and why community practice deserves more attention

The publication this episode is based on: Howells SR, Cornwell PL, Ward EC, Kuipers P. Dysphagia care for adults in the community setting commands a different approach: perspectives of speech-language therapists. Int J Lang Commun Disord. 2019 Nov;54(6):971-981. doi: 10.1111/1460-6984.12499. Epub 2019 Sep 3. PMID: 31479197.

Where to find the resources mentioned:

• Beyond the Blender cookbook (second edition): www.beyondtheblender.com.au
• Goal-setting handout: https://dysphagia-bites.kit.com/interviewguide

For comprehensive evidence-based dysphagia education beyond the podcast, head to: https://www.dysphagiabites.com/clinical-swallow-evaluation-course