Dysphagia Episodes

How many repetitions does it take to improve swallowing? How hard should dysphagia exercises be? And are we prescribing enough therapy to make a meaningful difference? In this episode of Speech Talk, Emily and Eva tackle a question many clinicians have asked but few were formally taught to answer: how do we dose dysphagia therapy? Using the article Exercise Prescription for Dysphagia: Intensity and Duration Manipulation by Sapienza and colleagues, they explore how principles of exercise science can help guide swallowing rehabilitation. The discussion breaks down the concepts of treatment intensity and duration, why different energy systems matter for swallowing function, and how direct and indirect dysphagia exercises may target different physiologic goals. The conversation also moves beyond the research and into real-world practice. Emily and Eva discuss the challenges of delivering adequate treatment intensity in skilled nursing facilities, strategies for increasing patient parti…

When we talk about dysphagia, “choking” is often used as a worst-case scenario—but how often does it actually happen, who’s really at risk, and what can we actually do about it? This week on Speech Talk, Emily and Eva dive into the research article “Dying for a Meal” to unpack the realities of choking across populations. From defining what “choking” really means (hint: it’s not always what we think), to exploring who’s most at risk, they break down the evidence behind one of the most feared complications in swallowing. They also get into the messy, real-world side of things: the emotional impact of choking, the unintended consequences of diet modifications, and why person-centered care is often missing from the conversation. Plus, practical strategies SLPs can actually use—like pacing, environmental supports, interdisciplinary collaboration, and staff education—to reduce risk without over-restricting patients. And, as always, they keep it real with clinical stories, ethical d…

Does a “wet” voice really mean your patient is aspirating? In this episode, Eva and Emily unpack research that challenges one of the most common clinical signs used in dysphagia assessment, wet vocal quality. Turns out, what we’ve been trained to hear might not be as reliable as we think. The need for instrumentals hasn't gone away, but the biggest national providers of mobile FEEs has...So what happens when we know we can't solely rely on bedside exams and access to gold standard tools is limited? Let's talk about it. Citations: Centers for Medicare & Medicaid Services. (n.d.). Skilled nursing facility consolidated billing. U.S. Department of Health and Human Services. ⁠https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing⁠ American Speech-Language-Hearing Association. (2023). The case for FEES in skilled nursing facilities. ⁠https://leader.pubs.asha.org/do/10.1044/leader.OTP.28072023.fees-snf-slp.36/full/⁠ Weldon, K., Kelchner, L., Si…

Thickened liquids are one of the most common recommendations in dysphagia management—but are they always the safest option? In this episode of Speech Talk, we examine the complexities of thickened liquids in dysphagia management, sharing personal experiences and case studies. We discuss misconceptions about the safety and efficacy of thickening liquids, emphasizing the need for a patient-centered approach. We explore potential adverse effects and advocate for evidence-based guidelines like the Free Water protocol to enhance hydration.

This episode delves into the intricacies of Huntington's disease, derived from a recent patient encounter that underscored the challenges faced by speech-language pathologists. We provide a historical overview, tracing the condition back to George Huntington's 1872 paper, and discuss its neurodegenerative impact on motor and cognitive functions. Emphasizing informed consent in dysphagia treatment, and discuss advocating for a patient-centered approach that empowers individuals to make their own dietary choices. We also cover the progression of Huntington's, care challenges, and the importance of daily structure in enhancing patient quality of life.

In this episode of Speech Talk, Emily and Eva dive into cervical osteophytes (aka bone spurs in the neck) and how they can mechanically impact swallowing. We break down what osteophytes are, why they form, and how they can present just like “typical” dysphagia — globus, coughing, choking, wet vocal quality — but may gradually worsen over time. We talk about imaging (Because how else would we even know it’s there!?), conservative management strategies like texture modification and suprasubglottic swallow, and when a surgical consult might be appropriate.

In this episode, co-hosts Emily and Eva discuss the vital role of prehabilitation for head and neck cancer patients, emphasizing its importance for improving patient outcomes. They highlight the need for standardized protocols and share alarming statistics on swallowing dysfunction post-treatment. The conversation covers effective interventions like exercise programs, nutritional support, and psychosocial care, advocating for a collaborative approach among healthcare professionals. The hosts stress the necessity of early intervention and call for greater awareness and research on prehabilitation to enhance the quality of care for cancer patients.

This week on Speech Talk, we’re breaking down two of our favorite fast and evidence-backed dysphagia screeners: the TOMASS and the Yale Swallow Protocol. If you’ve ever been buried in a busy SNF day and wished for a quick but reliable way to check someone’s swallow, this episode is your new best friend. We walk you through how each tool works, what the research says, and why a simple cracker and a cup of water can give you so much clinically relevant information. You’ll hear practical tips for ...

DOSS It Matter? (Spoiler: Yes.) In this episode, Emily and Eva explore the Dysphagia Outcome and Severity Scale (DOSS), an assessment tool for quantifying swallowing disorders. They discuss the history and importance of the DOSS in bringing objectivity and consistency to dysphagia evaluations, highlighting its relevance for effective documentation and insurance communication. The conversation details the seven-point scale, emphasizing how it aids clinicians in monitoring patient progress and fostering interdisciplinary collaboration. Advocating for enhanced communication among healthcare providers and families to improve patient care and outcomes, ultimately reinforcing the significance of evidence-based practices in dysphagia management.

In this episode, I, Eva, alongside co-host Emily, discuss the often-overlooked topic of puree diets in speech therapy. Wondering- Should food be pretty? Does food presentation help with patients' perceptions of unappetizing puree food and share insights from a study revealing that molded puree enhances meal satisfaction. We offer practical tips for caregivers to improve food presentation, emphasizing the importance of creating enjoyable dining experiences in settings like palliative care. This conversation blends humor with advocacy for innovation in food presentation, calling on clinicians to rethink puree diets for better nutritional intake and overall patient well-being.

In this episode, Eva and Emily discuss the Eating Assessment Tool (EAT-10), a vital dysphagia screener for adults that assesses swallowing difficulties through patient self-reports. They highlight the importance of interpreting scores accurately, particularly in identifying clinically significant impairments. Through findings from a study involving 200 participants, the researchers distinguished between neurogenic and structural/esophageal dysphagia, noting how each affects patient experiences differently. We also address the practical use of the EAT-10 in clinical settings and the challenges of patient self-reporting.

In this episode of Speech Talk, Eva and Emily explore how GERD and dysphagia impact on swallowing, nutrition, and patient care in skilled nursing facilities. Learn how to recognize GERD-related symptoms, advocate for proper referrals, educate CNAs, and navigate precautions like posture and diet modifications. With clinical research and personal stories, they break down practical steps SLPs can take to make a difference in GERD management—without overstepping scope. You’ll learn: How GERD ...

What does your oral mech exam really tell you? In this episode of Speech Talk, Eva and Emily get down and dirty (with tongue depressors, not drama) and explore why the phrase 'say ahh' is so iconic. They cover what is a normal oral cavity for our geri crowd, how to link findings to clinical hypotheses, and how to improve your diagnostic skills even when patients can’t cooperate as much as you might like. If you’ve ever opened someone's mouth and wondered, “...Is that normal?” This one’s for you You’ll learn: What the oral mech exam actually reveals (and what it doesn’t) Common pitfalls: symmetry obsession, passive exams, and more How to link oral mech findings to real clinical hypotheses Normal vs …Definitely not normal oral structures Why “ahh” is more than just a sound

To PEG or not to PEG? In this episode of Speech Talk, Emily and Eva confront the clinical gray zones around percutaneous endoscopic gastrostomy (PEG) tube placements in older adults. They unpack what PEG tubes actually do (and don’t do), their potential impact on malnutrition and aspiration pneumonia, and how to talk to families and care teams when emotions and ethics collide. You’ll also learn how to interpret key research on PEG tube outcomes and what guidelines say about feeding tubes in dementia. No guilt, no judgment—just smart, compassionate guidance from two SLPs who’ve had those hard conversations many times before. Articles Cited: ⁠⁠Rahnemai-Azar et. al. “Percutaneous endoscopic gastrostomy: Indications, technique, complications and management⁠⁠ Freebies: ⁠PEG Tube Badge Buddy⁠ https://www.podpage.com/dashboard/speech-talk/pages/627463/ Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠  Instagram: @speechtalkpod Part of the⁠ Huma…

Today, we talk about how dentures impact dysphagia- if we can answer Where Are My Teeth? In this episode of Speech Talk, we explore the critical role dentures play in the swallowing abilities of edentulous patients. We begin by discussing the prevalence of dentures among older adults and the connection between aging, tooth loss, and swallowing disorders. Analyzing key research, we highlight how removable dentures can impact swallowing mechanics, presenting both benefits and challenges. We also address the importance of proper denture fit and maintenance, advocating for patient education and interdisciplinary collaboration to ensure safety and efficacy in swallowing. By sharing practical insights and experiences, we emphasize the need for effective communication with patients about their denture use and its impact on their dietary choices. We conclude with a checklist resource designed to aid clinicians in assessing denture care, reaffirming our commitment to patient-centered practice …