Dysphagia Research Bites

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 settingHow to conduct a meaningful mealtime assessment, including the value of observing familiar caregivers feeding the person rather than jumping straight to a formal evaluationWhy 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 strokeChoking risk assessment in this population, including the limitations of existing tools and the power of instrumental assessment as a biofeedback toolHow 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 - RevisedWhy 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-surveyChoking 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 clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

If you're a speech pathologist working in the community, particularly in Australia or with adults with developmental disabilities, this episode is for you. But if you work with risk feeding plans in any setting, including the UK, there's plenty here that will resonate too.In this episode of Dysphagia Research Bites, Chantelle hosts a panel discussion with speech pathologists: 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 countriesHow community and hospital settings approach EDAR differently — and why community SLPs often bear the brunt of overly risk-averse policiesHow supported disability accommodation settings can inadvertently remove client autonomy and de-skill individualsWhy business decisions — not clinical ones — are often driving restrictive mealtime policies in community organisationsWhat coroner's reports actually tell us about SLP accountability in dysphagia-related incidentsThe concept of dignity of risk and how to balance it with duty of careWhy risk to pleasure, social engagement, and identity deserves as much attention as aspiration riskThe problem with waivers and how they oversimplify complex clinical decisionsWhat patient-centred decision-making actually looks like in practiceAdditional 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.pdfFor clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

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/s00455-022-10468-8https://www.tandfonline.com/doi/full/10.1080/17549507.2021.1953592#abstracthttps://onlinelibrary.wiley.com/doi/full/10.1111/coa.14202?msockid=077fa973c35469500a04bf97c2d968d3https://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 clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

In part 2, Chantelle continues her conversation with Jackie Rodriguez, SLP, picking up where they left off on the dual diagnosis of dysphagia and dementia.In this episode they cover:How dementia affects the visual field and what this can mean at mealtimesPractical approaches to assessing vision and how you can compensate for these impairments in your management approachUsing sensory strategies at mealtimes, including how something as simple as separating food into individual bowls can support attention and reduce overwhelmEnteral feeding and what the evidence actually says about whether it prevents aspiration pneumoniaJackie's approach to oral apraxia: the tips, tricks and techniques she uses in practiceProactive swallowing therapy and why early intervention matters in this populationThe hill Jackie dies on when it comes to dysphagia care at end of lifeBe 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.theslpThe 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.SIG15.1For clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

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 mindsetThe three key themes from Simone's research: holistic practice, client autonomy, and carer engagementThe unique challenges of working without a multidisciplinary teamHow grief, loss, and psychosocial factors show up in community dysphagia practiceWhy new graduates may feel underprepared for community roles — and what universities are doing about itThe importance of curiosity and conversation over rushing straight to assessmentCultural considerations in community dysphagia careWhere the research gaps are and why community practice deserves more attentionThe 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.auGoal-setting handout: https://dysphagia-bites.kit.com/interviewguideFor clinical resources and evidence-based dysphagia education beyond the podcast, head to www.dysphagiabites.com