Silent aspiration is difficult to assess when screening a patient for dysphagia as well as during the clinical (bedside) swallow evaluation. Asking a patient to elicit a cough does not provide information about airway response. An absent cough while eating and drinking also does not reliably indicate absence of aspiration, as aspiration may be silent. However, coughing while eating and drinking remains the number one reason for referral to speech-language pathologist and the

Cough is already an integral part of the clinical practice of the Speech-Language Pathologist. When Speech-Language Pathologists complete a clinical (bedside) swallow evaluation, we often assess whether or not the patient coughs in response to the presentation of food or liquid, and if they do, we make certain hypotheses about the patient’s airway protective functioning. If the patient does not cough, but has a delayed swallow or a wet vocal quality, we consider the possibili

Speech-Language Pathologists often make comments concerning mastication in clinical and instrumental swallowing assessments such as “prolonged mastication,” “inefficient chewing,” “no rotary jaw movements.”. The issue is there is very little information in our dysphagia textbooks or the literature related to this process. We are left to figure out details on our own. Chewing represents the beginning of the digestion process. It is the time when food is reduced in size, while

The term “presbyphagia” refers to natural changes within the swallowing mechanism for aging adults. As the prevalence of swallow disorders increases with age, the characteristics of presbyphagia may put the patient at risk for aspiration. A contributing factor to these common changes as we age is sarcopenia (the loss of muscle mass associated with the natural aging process). Studies have determined that the natural deterioration of buccal (cheek), labial (lip), and lingual