Medical Speech Pathology

14/08/2026

How often we swallow may matter more than we think.

Two recent studies examined daily swallowing frequency and geniohyoid muscle mass in two different clinical populations.

Uota and colleagues studied 62 adults with severe motor and intellectual disability, while Kawamichi and colleagues studied 84 older adults in long-term care.

In both studies, people who swallowed more frequently had greater geniohyoid muscle mass.

Swallowing frequency remained independently associated with geniohyoid muscle mass after adjustment for other factors.

Why is this interesting?

We often think about swallowing muscle activity in terms of rehabilitation exercises: repetitions, resistance, frequency and intensity. But swallowing also occurs spontaneously throughout the day, including between meals to manage saliva.

For some people, everyday swallowing can be substantially reduced with low oral intake, enteral feeding, illness, frailty or reduced alertness.

These studies do not show that reduced swallowing causes muscle atrophy, or that increasing swallowing frequency will preserve muscle or improve swallowing. Both were cross-sectional.

But together, the findings make total daily swallowing activity an interesting variable to consider alongside the more deliberate exercise dose we prescribe in dysphagia rehabilitation.

We’ve explored this further in our newest blog post, including the research behind swallowing frequency, its role in dysphagia rehabilitation, and how it can be measured using clinical observation, RSST, laryngeal microphones, sEMG and wearable technologies.

References
Uota C, Nohara K, Tanaka N, Fujii N, et al. Effect of daily swallowing frequency on swallowing-related muscle mass in individuals with severe motor and intellectual disability. Brain and Development. 2026;48(4):104553. DOI: 10.1016/j.braindev.2026.104553.

Kawamichi H, Obana A, Nohara K, Tanaka N, Sakai T. Relationship Between Swallowing Frequency and Swallowing-Related Muscle Mass in Older Adults. Journal of Oral Rehabilitation. 2026;53:42–49. DOI: 10.1111/joor.70056.

28/07/2026

There’s a side of tube feeding we probably don’t talk about enough: living with it.

In Speech Pathology, conversations about tube feeding often happen through a clinical lens: swallowing safety, nutrition and hydration, rehabilitation, feeding regimens, and decisions around oral intake. These things matter, but they’re only one part of what it means to live with a feeding tube.

What do you wear when clothing catches on your tube? How do you travel with feeds, equipment and supplies? What is it like to eat socially when you don’t eat in the same way as everyone else? What about body image, dating, work or university?

These aren’t necessarily questions a clinical appointment can answer.

That’s why we were so pleased to be introduced to The Blend, a lifestyle magazine created specifically for the tube-feeding community. It brings together lived experience, practical information and professional perspectives, without making the medical side of tube feeding the whole story.

And it really is a lifestyle magazine. Alongside information about enteral and parenteral nutrition, you’ll find stories and conversations about travel, fashion, food, relationships, family life, advocacy, navigating healthcare and the everyday realities of living with tube feeding.

For us as Speech Pathologists, that broader perspective matters. When tube feeding is discussed as part of dysphagia management, it’s easy for the conversation to centre on swallowing physiology, safety and nutritional adequacy. But someone considering a feeding tube is making a decision that may affect their life, not just their nutrition.

Clinical information matters. So does hearing from people who actually live it.

Whether you live with a feeding tube, support someone who does, or work with people considering one, The Blend is a resource well worth knowing about.

Head over to to explore the magazine, their online stories and the Tubie Talks podcast.

We’ve also explored the practical, social and emotional aspects of living with tube feeding in our latest blog post, Beyond the tube: Living well with tube feeding, over on the Medical Speech Pathology website.

01/07/2026

6 years ago, I had the opportunity to join the Centre for Neuroscience of Speech team at the University of Melbourne as a Research Assistant exploring the question: Can changes in the way we speak help identify Alzheimer's disease earlier?

I’m proud to say that this work has finally been published!

This paper has been years in the making. Like many research projects, it involved countless hours reviewing the literature, writing, rewriting, incorporating new evidence, responding to feedback, and patiently waiting as the project evolved over time. Seeing it finally published is a really special milestone.

I'm incredibly grateful to have had the opportunity to contribute alongside such an outstanding multidisciplinary team. Working with researchers whose expertise spans Speech Pathology, Neuroscience, Neuropsychology and Dementia research was an invaluable experience that continues to influence my clinical practice today.

Speech isn't simply a way of expressing our thoughts, it reflects the incredibly complex interaction between language, memory, attention, executive function and motor control. As these systems begin to change, our speech often changes too.

Emerging research suggests that subtle alterations in speech and language may one day help us identify Alzheimer's disease earlier, monitor progression more objectively, and provide accessible, non-invasive digital biomarkers alongside existing diagnostic methods.

There's still plenty of work to do before that becomes routine clinical practice, but it's an exciting direction for both dementia research and speech pathology.

I'm proud to have contributed to this publication and am grateful to everyone involved in bringing it to fruition.

Reference
Dhareshwar, S., Kane, M., Lewis, C., Mineur, R., Yao, K., Snyder, P. J., Alber, J., Robb, C., Lim, Y. Y., & Vogel, A. P. (2026). Update on the current state of speech and language testing in Alzheimer's disease. Journal of Alzheimer's Disease, 112(1), 5–19. https://doi.org/10.1177/13872877261446637

26/06/2026

Do you ever consider the heart as a possible cause of dysphagia?

This 2026 case series describes three patients whose swallowing difficulties were ultimately linked to severe cardiac disease and enlargement of the left atrium, resulting in mechanical compression of the oesophagus.

For Speech Pathologists, it's a powerful reminder that dysphagia isn't always neurological, muscular, or oesophageal in origin. When symptoms don't fit the picture, when investigations seem contradictory, or when a patient has significant cardiac disease, it may be worth considering whether the problem is occurring outside the swallow tract altogether.

Sometimes the most important clue isn't in the pharynx.
It's in the anatomy surrounding it.

Reference
Margol, C., Ali, S., Randhawa, N., Sridhar, S., & Sifuentes, H. (2026). Cardiac dysphagia: When the heart disrupts swallowing. Cureus, 18(5), e109146. https://doi.org/10.7759/cureus.109146

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?