Medical Speech Pathology

08/06/2026

This pilot study explored respiratory-swallow training combined with variable practice in people with Parkinson’s disease.

One of the most interesting aspects of the paper wasn’t just the respiratory-swallow focus,it was the use of variable practice.

In dysphagia rehab, we often rely heavily on repetition and fixed tasks.
But real swallowing is inherently variable:
• different textures
• different volumes
• changing posture
• changing environments
• dual-task demands
• fatigue

This study applies motor learning principles that aim to improve adaptability and transfer of skill, not just performance within the therapy task itself.

It’s an important shift in thinking. Rehabilitation isn’t only about strengthening a movement, it’s about helping the system respond flexibly to real world demands.

Particularly in neurodegenerative conditions like Parkinson’s disease, that distinction matters.

Reference
Curtis, J. A., Borders, J. C., Kiefer, B., Alcalay, R. N., Magill, R., Quinn, L., Edmonds, L., Molfenter, S., & Troche, M. S. (2026). Respiratory-swallow training and variable practice in Parkinson’s disease: A clinical trial pilot study. Folia Phoniatrica et Logopaedica. https://doi.org/10.1159/000552197

05/06/2026

✨ Exciting News! ✨

We are excited to announce that we now have a clinic space available for appointments!

Through our partnership with The Coomera Specialist & Diagnostics Centre, we now offer in-clinic Speech Pathology appointments in addition to our home visiting and telehealth services.

This gives our patients even more flexibility to access support in the way that works best for them.

Our new clinic space also provides a dedicated location for Flexible Endoscopic Evaluation of Swallowing (FEES) assessments and other specialised services.

We look forward to welcoming you to our new clinic space!

In-clinic & mobile services for adults with swallowing and communication difficulties
Queensland's first mobile Flexible Endoscopic Evaluation of Swallowing (FEES) service

Referrals can be made at: https://medicalspeechpathology.com.au/make-a-referral/

26/05/2026

Aerodynamic voice assessment has traditionally required highly specialised equipment, which can make it difficult to access outside major voice centres.

This paper explores a lower-cost alternative: the Phonation Quotient for Connected Speech (PQ-CS).

Instead of relying only on sustained vowels, the researchers examined connected speech tasks and found promising relationships with directly measured airflow.

Early research only at this stage, but a really interesting direction for making aerodynamic voice assessment more accessible in everyday clinical settings.

Reference:

Curtis, J. A., Jimenez, E. A., Aberin-Angulo, I. M., & Seidman, A. (2025). Development and initial validation of phonation quotient for connected speech (PQ-CS): A low-cost, indirect aerodynamic measure of phonatory airflow. Folia Phoniatrica et Logopaedica. Advance online publication.

30/04/2026

AI in FEES is moving beyond detection, and into something much more clinically meaningful!
This paper (Araújo et al, 2926) presents a framework that combines anatomical tracking, image enhancement, and pixel-based analysis to objectively identify airway invasion and classify pharyngeal residue.

What’s most interesting isn’t just the accuracy, it’s the shift toward standardising visuoperceptual analysis.

Because we all know:
Two clinicians can look at the same FEES and interpret it differently.

This kind of technology doesn’t replace clinical reasoning, but it has the potential to support it by making our observations more consistent, reproducible, and transparent.

Particularly relevant for:
• clinician training
• consistency across services
• supporting complex decision-making

Still early, but definitely a space worth watching!

REFERENCE (APA)
Araújo, L., Rangel, E., Cotrina-Atencio, A., Santos, V. G., Reis, A. M. C. S., Magalhães, H., Ferreira, L., Dantas, A. F. O. A., & Espírito-Santo, C. C. (2026). Artificial intelligence and image processing framework for automated airway invasion detection and residue classification from swallowing endoscopy. Scientific Reports. https://doi.org/10.1038/s41598-026-44495-4

16/04/2026

This paper isn’t just reminding us to look beyond aspiration,
it’s questioning whether we’re drawing the right conclusions at all from dysphagia research.

In this large trial of HPV-related oropharyngeal cancer, long-term swallowing outcomes were often interpreted as showing “no meaningful difference” between treatment approaches.

But when you look closer, two critical issues emerge:

👉 The dominant impairment wasn’t airway safety,it was inefficient swallowing (residue, incomplete clearance, repeated swallows)
👉 And a substantial number of participants were lost to follow-up over time, likely biasing results toward those with better function

So the real question becomes:
Are we underestimating dysphagia severity and overestimating how “good” outcomes actually are?

Because if:
• we prioritise aspiration as the primary endpoint
• AND the patients with the worst dysphagia are less likely to be captured in
long-term data

👉 then “no difference” may not mean “no impact”
👉 it may mean we’re not measuring or retaining the right things

For clinicians, this isn’t just making sure efficiency is part of your assessment.
It’s about:
• critically appraising outcome data
• recognising survivorship and follow-up bias
• reconsidering what we define as a “good” swallow

Because in this population,
the problem may not be what’s going down the airway, but what’s left behind.

References
Hutcheson, K. A., Flamand, Y., Manduchi, B., et al. (2025).
Functional impact of transoral surgery and risk-based adjuvant therapy in human papillomavirus–associated oropharyngeal cancer: Swallowing outcomes from ECOG-ACRIN E3311. JCO Oncology Advances. https://doi.org/10.1200/OA-25-00092
Rocco, J. W., & Plowman, E. K. (2025).
Reply to: Building on ECOG-ACRIN E3311 to strengthen interpretation of swallowing outcomes. JCO Oncology Advances.

10/04/2026

This paper looks at something we don’t talk about enough, whether dysphagia therapy is actually effective in dementia. The findings are… mixed.

There is some evidence that intervention can improve swallowing safety, intake, and aspiration risk. But overall, the quality of evidence is low, and results are inconsistent. That doesn’t mean therapy isn’t worthwhile.

It means we need to be clear about what we’re trying to achieve.

In dementia, dysphagia management often sits at the intersection of:
• rehabilitation
• compensation
• and quality of life

Rather than aiming for “normal swallowing,” the focus may shift toward:
• maintaining function
• supporting safe intake
• reducing distress
• and working closely with caregivers

A good reminder that this is not a population where a one-size-fits-all approach works. How are you approaching dysphagia management in dementia?

08/04/2026

A new paper by Messina (2026) explores the role of the sphenoid bone in linking the temporomandibular–tongue–hyoid system with the cervical spine.

The key idea is that this is not a set of isolated structures, but a continuous biomechanical chain. The sphenoid sits centrally at the cranial base, meaning forces and positioning at the jaw, tongue and hyoid can influence the cervical spine and overall posture, and importantly, the reverse is also true.

Changes in cervical alignment can influence tongue position, suprahyoid function, and both voice and swallowing mechanics.

Clinically, this helps explain presentations where:
• symptoms don’t match local findings
• voice or swallowing change with posture
• tension patterns extend across the jaw and neck

These patterns don’t always make sense when viewed in isolation - because they’re being driven by the system, not just the structure.

Reference:
Messina, G. (2026). The role of the sphenoid bone in the connection between the temporal-mandible-tongue-hyoid system and the cervical spine. European Journal of Translational Myology. https://doi.org/10.4081/ejtm.2026.14947

24/03/2026

Not all “dry mouth” is the same… and not all of it is being measured

The Challacombe Scale is a simple, evidence-based tool used to objectively assess clinical oral dryness - something that’s often observed, but not consistently quantified in practice.

In Speech Pathology, this matters more than we think.

Oral dryness can impact:
• bolus formation + oral clearance
• saliva management
• voice comfort + effort
• overall oral health over time

And importantly…
👉 what we see doesn’t always match what patients feel

That’s why combining objective measures + patient-reported symptoms is key.

The Challacombe Scale gives us:
✔ a structured way to assess oral dryness
✔ a severity rating we can track over time
✔ stronger clinical reasoning + documentation

✨ We’ve put together a comprehensive clinical handout on how to use the Challacombe Scale in practice (including scoring, interpretation, and integration with other measures). Comment "DRY" and we'll send it through.

23/03/2026

Pulse oximetry doesn’t detect aspiration - but it still has a role.

This is something that’s been well established in the research for a long time, yet its role as a supportive (not diagnostic) tool isn’t always recognised.

SpO₂ changes during swallowing are:
• inconsistent
• not specific to aspiration
• often absent in silent aspiration

So it can’t be used to rule aspiration in or out.
But that doesn’t make it useless.

When used well, pulse oximetry can provide insight into:
• respiratory load during eating or talking
• fatigue across a meal or task
• breath–swallow coordination
• overall physiological response

The key shift is this:
👉 from diagnostic tool → clinical context tool

Looking at patterns over time, rather than single readings, is where it becomes meaningful.
Like most things in dysphagia and voice, it’s not about one data point - it’s about how everything fits together.

Keep your eye out for the new resources section of our website where you can find clinical guides and resources, including our clinical protocol for the use of pulse oximetry in Speech Pathology

www.medicalspeechpathology.com.au