Dysphagia Research Bites

Dysphagia Bites
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Dysphagia Research Bites is the podcast for speech pathologists who want to stay evidence-based without spending hours in the library. Host Chantelle interviews practising SLPs, researchers, and clinician-researchers about their work, unpacking one research paper at a time and exploring how the findings translate into real clinical practice. It has been designed with the community and home-based SLP in mind, but is relevant wherever you work with adults with dysphagia.

  1. 14 hr ago

    Not All Aspiration is Equal: The Evidence Behind The BOLUS Framework with Melissa Kane

    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 outcomesThe 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 HealthHow oral health, feeding dependence, mobility, tube presence, and medical co-morbidities each factor into aspiration riskThe importance of person-centred language when discussing risk with clients and familiesHow 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.pdfDrooling Frequency and Severity Scale (DFSS): https://www.movementdisorders.org/MDS-Files1/PDFs/Task-Force-Papers/sm004.docFunctional Oral Intake Scale (FOIS): https://www.archives-pmr.org/article/S0003-9993(05)00196-6/abstractOral 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.PDFLangmore, 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-pneumoniaO'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 clinical resources and evidence-based dysphagia education beyond the podcast, head to:  www.dysphagiabites.com

  2. 13 Aug

    Food, Identity & Chronic Dysphagia: A Patient Perspective That Will Change Your Practice with Yvonne McClaren

    In this episode of Dysphagia Research Bites, Chantelle sits down with writer, speaker, and educator Yvonne McClaren — a qualified chef, winemaker, and head and neck cancer survivor living with chronic dysphagia — to talk about the parts of dysphagia care that rarely make it into our clinical training. Yvonne 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 chemoradiotherapyThe concept of commensality and why the deeply human need to eat socially is one of the most overlooked dimensions of chronic dysphagiaWhat Yvonne was actually told at discharge, and the gap between that and what she needed to knowHow caregiver involvement in meal preparation, however well-intentioned, can gradually sever a person's connection to foodWhy "just eat soft food" is not a plan, and what asking "what is your favourite food?" could change about the way we approach managementWhat the mealtime environment at home actually looks like and why it matters more than we thinkThe 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.comThe No Feeding Tubes Podcast The Commensality Comeback Movement and the Back at the Table Framework — details via Yvonne's website  For clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

  3. 30 Jul

    Functional Chewing Therapy (FuCT): A Protocol Every Community SLP Needs to Know About with Dr Carol Tran

    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 gradingWhy assessing posture and trunk control is the non-negotiable first step before any chewing interventionThe role of the chew tube and tools like the Gnosh Sidebiter in stimulating the chewing muscles and encouraging lateralisationHow tongue thrusting relates to chewing dysfunction, and why addressing the thrust may need to come before oral hygiene can even happenThe 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 hippocampusWhy 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 clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

  4. 16 Jul

    The Role of Cough Reflex Testing in Detecting Silent Aspiration Risk with Dr Phoebe Macrae

    In this episode of Dysphagia Research Bites, Chantelle sits down with Dr Phoebe Macrae from the University of Canterbury to 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 riskThe 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 passedWhat that pattern reveals about our default assumptions around airway sensationHow aspiration pneumonia risk factors influenced clinician decision-making in the studyThe sensitivity and specificity of CRT and why it's not a perfect predictor of aspirationThe complexity of interpreting CRT results across different textures — including patients who silently aspirate on thickened fluids after overtly aspirating on thinWhy Phoebe frames CRT as one piece of a bigger clinical picture, not a standalone decision-making toolWhat 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 clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

  5. 2 Jul

    The 8 Principles of Community-Based Dysphagia Care with Chantelle Hutchinson

    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 insteadThe specific populations and practice contexts where this gap is most pronouncedWhat the research says about how experienced community SLPs actually approach dysphagia managementWhy 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. For more clinical resources and evidence-based dysphagia education head to: www.dysphagiabites.com

  6. 18 Jun

    Dysphagia In Developmental Disabilities "They Don't Read the Textbook" with Jen Biener

    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

  7. 4 Jun

    sEMG & The Evolution of Swallowing Rehabilitation with Professor Maggie-Lee Huckabee

    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 rehabilitationThe shift from compensation-based approaches to muscle strengthening, and then to skill-based trainingThe importance of the cranial nerve examination in directing our rehabilitation approachHow skill-based swallowing impairments might look on VFSSPractical application of sEMG biofeedbackBiSSkApp: 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 clinical resources and evidence-based dysphagia education beyond the podcast, head to: www.dysphagiabites.com

  8. 21 May

    Eating & Drinking with Acknowledged Risk: A Panel of SLPs Get Honest

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

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About

Dysphagia Research Bites is the podcast for speech pathologists who want to stay evidence-based without spending hours in the library. Host Chantelle interviews practising SLPs, researchers, and clinician-researchers about their work, unpacking one research paper at a time and exploring how the findings translate into real clinical practice. It has been designed with the community and home-based SLP in mind, but is relevant wherever you work with adults with dysphagia.

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  • Creator
    Dysphagia Bites
  • Years Active
    2026
  • Episodes
    14
  • Rating
    Clean
  • Copyright
    © Dysphagia Bites
  • Show Website
    Dysphagia Research Bites

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