Episodes

Do oral and pharyngeal exercises help treat post-stroke dysarthria? Emily and Eva examine a recent review (Yunusova et al.), unpack why swallowing outcomes often show benefit while speech outcomes do not, discuss goal-writing pitfalls, and offer practical treatment options and compensatory strategies clinicians can use now. Citations: Marzouqah R, Huynh A, Chen JL, Boulos MI, Yunusova Y. The role of oral and pharyngeal motor exercises in post-stroke recovery: A scoping review. Clin Rehabil. 2023 May;37(5):620-635. doi: 10.1177/02692155221141395. Epub 2022 Nov 25. PMID: 36426582; PMCID: PMC10041576. Get in Touch: hello@speechtalkpod.com Or Visit Us At: www.SpeechTalkPod.com Instagram: @speechtalkpod Support: buymeacoffee.com/speechtalkpod Part of the Human Content Podcast Network

Supervision is so much more than signing off on competencies. It shapes clinician confidence, patient care, and the future of our profession. In this episode of Speech Talk, Emily and Eva welcome their very first guest, Olivia, to reflect on her completed externship and unpack what effective supervision really looks like. Together, they explore the research on clinical supervision, discuss different supervisory styles, and share honest stories about balancing mentorship with productivity demands in skilled nursing facilities. Whether you're supervising students, preparing for an externship, or reflecting on your own clinical training, this episode offers practical strategies grounded in research and real-world experience. Research discussed: Terry, D., Nguyen, H., Perkins, A. J., & Peck, B. "Supervision in Healthcare: A Critical Review of the Role, Function and Capacity for Training." Get in Touch: hello@speechtalkpod.com Or Visit Us At: ⁠www.SpeechTalkPod.com⁠ Instagram: @s…

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…

A patient survives a stroke, starts rehab, and begins making progress. But what if their greatest risk isn't behind them? In this episode of Speech Talk, Emily and Eva dive into the often-overlooked topic of recurrent stroke. While many clinicians focus on recovery, research suggests the first 90 days after a stroke may carry a surprisingly high risk for another cerebrovascular event—and the way researchers define "stroke recurrence" dramatically changes the numbers. Join us as we unpack the article Underestimation of the Early Risk of Recurrent Stroke: Evidence of the Need for a Standard Definition and discuss what these findings mean for speech-language pathologists, rehabilitation professionals, and the patients we serve. Whether you work in a SNF, hospital, home health, or outpatient setting, this episode will leave you thinking differently about patient education and the critical role clinicians play during those first three months after stroke. Because sometimes the most…

What happens when we can’t stop aspiration? In this episode, Eva and Emily talk about chronic aspiration and what happens when small, repeated events start to add up. From inflammation and airway damage to serious complications like pneumonitis and lung abscess, we break down what’s really happening in the lungs. We also connect the research to real clinical practice—what this means for your patients, how to approach treatment, and why oral care will forever be in the mix when talking about aspiration.

Ever feel like you’re fighting your patient just to get through a session? Explore Acceptance and Commitment Therapy (ACT) as a framework for speech therapy—not psychotherapy, but a way to rethink how we approach resistance, engagement, and progress. Using the metaphor of “the river and the rock,” Eva and Emily unpack how ACT shifts us away from power struggles and toward flexibility, values-based care, and meeting patients where they are. They break down the research on ACT in post-stroke depression and emerging work in aphasia, showing how emotional adjustment and communication recovery are deeply connected. Plus, we translate ACT concepts into real clinical scenarios—from dysphagia refusals to cognitive pushback to aphasia shutdowns—and walk through how to respond without arguing, forcing, or “fixing.” Because sometimes the most effective therapy isn’t pushing harder—it’s learning how to flow.

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…

Research is supposed to guide our practice—but what happens when we can’t actually access it? In this episode of Speech Talk, Eva and Emily get into the reality of paywalled research and what it means for evidence-based practice in speech-language pathology. Breaking down the article “The Effect of Open Access on Scholarly and Societal Metrics of Impact in the ASHA Journals,” they explore how access (or lack of it) shapes who reads, shares, and applies research. From citation counts to social media reach, the data is clear: the more accessible the research, the greater its impact. But with thousands of articles still behind paywalls, clinicians are often left out of the conversation. This episode gets real about the barriers SLPs face—and why making research more accessible isn’t just convenient, it’s essential for better patient care. Citations Long, H. L., Drown, L., & El Amin, M. (2023). The effect of open access on scholarly and societal metrics of impact in the ASHA journa…

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.

Setting the stage for dementia care: aka staging! Emily and Eva to examine dementia staging and its impact on care. We share our personal experiences in acute care/SNF/LTC and emphasize the importance of adaptation and effective communication for patients and families. Discussing the mild, moderate, and severe stages, we highlight care strategies tailored to each level, including compensatory techniques for early-stage patients and Montessori-inspired approaches for those in severe stages. We refer to the article "Staging and Treatment Frameworks for Dementia Management" to underscore the need for ongoing education in dementia care. I also reflect on my efforts to develop a dementia staging program, encouraging listeners to engage further in these vital discussions

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.

A very Geri Problem: TBI (traumatic brain injury) in Aging. In this episode of we share insights on the trends of traumatic brain injuries (TBIs) among older adults and their implications for our practice as speech-language pathologists. Our discussion includes an exploration of various TBI types, with a focus on cases like a motor vehicle accidents and falls. We examine statistics, highlight the importance of interdisciplinary collaboration in assessing and managing TBI symptoms, as well as practical strategies for rehabilitation focused on cognitive, linguistic, and emotional challenges.

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 ...

In this episode, we spill the tea on the impact of productivity standards on moral distress in allied healthcare within skilled nursing facilities (SNFs). We share personal stories and reflect on Akyko West's research, highlighting the ethical dilemmas that arise from unrealistic expectations. Our discussion emphasizes the correlation between high productivity demands and clinician burnout, as well as potential solutions, such as setting boundaries and advocating for realistic expectations. We aim to empower listeners to navigate the challenges of productivity-driven environments while prioritizing patient care. Now let's hope we don't get fired.

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.

You've tested your patient and they are sitting at a 25/30 on the MoCA. They have an MCI.. now what? In this episode, we explore mild cognitive impairment (MCI), a condition that sits between normal aging and dementia. We discuss the nuances of MCI, its subtypes, and the critical need for early identification to prevent progression to dementia. Personal anecdotes highlight the emotional challenges patients face, as we share strategies for sensitive discussions around diagnosis and care. Our conversation also includes insights from recent research on identifying high-risk MCI cases, advocating for tailored approaches to support cognitive health.

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, we examine the transformative role of AI [large language models (LLMs)] like ChatGPT in speech therapy and clinical practice. While we didn't have Chat write our episode, we do discuss how ChatGPT and other AI help our practice. We delve into how these AI tools enhance clinical efficiency and support evidence-based practices, particularly in assessing dysarthria severity. Our discussion includes a review of a systematic study showcasing AI's capability to classify speech disorders objectively, addressing the challenges of traditional assessment methods. We explore innovative technologies like VoiceIt that improve communication for patients with motor speech impairments and discuss a case study on generating customizable therapy materials through AI. Throughout, we highlight the efficiency gains from AI integration, urging clinicians to embrace these advancements to enhance patient engagement and therapy outcomes.

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, we delve into the intricate relationship between hearing loss and dementia, addressing a topic that is ever-present in skilled nursing environments. As speech therapists, we share our anecdotal experiences where the challenges of communicating with elderly patients often lead to unintended loudness, as we raise our voices in an attempt to connect. We discuss how prevalent hearing loss is among our patients and highlight the frustration of encountering those who, despite having hearing aids, may still not engage properly. We looked into three studies to examine our clinical question: Does hearing loss contribute to dementia? As we navigate these findings, we emphasize our clinical responsibilities, advocating for regular hearing screenings as an integral part of patient care in nursing homes. Recognizing the interplay between hearing capabilities and cognitive status equips us to better support our patients, particularly the elderly, whose comprehension may be mi…

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 ...