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Tracheostomy care is a highly specialised clinical area, but when it comes to infants and children, the complexities multiply. Pediatric care requires a completely unique approach that accounts for anatomical differences, developmental milestones, and family dynamics. In this episode, Louise Edwards, Clinical Specialist Speech and Language Therapist and PhD candidate, joins us to explore the realities of pediatric tracheostomy care from an SLT perspective. Together, we examine the core clinical priorities, unpack the key differences between pediatric and adult management, and discuss the often-overlooked challenges of transitioning young people with complex needs from pediatric to adult services. Key takeaways: Pediatric vs. Adult Care: Understanding the critical physiological, anatomical, and developmental differences clinicians must recognize. SLT Clinical Priorities: Establishing communication, developmental feeding, and swallowing safety in infants and children with a tracheostomy. The “Trach” vs. The Underlying Condition: Teasing apart how much swallowing and feeding difficulties are caused by the tracheostomy tube itself versus the child’s broader medical and developmental profile. Transitions to Adulthood: Practical considerations for the multidisciplinary team to ensure young people and their families don’t feel lost when moving into adult services. The Future of Care: A forward-looking discussion on hoped-for advancements in family support and clinical care over the next five years. Networks: Global Tracheostomy Collaborative: not SLT specific, but they have a great website and provide research and webinars focused on supporting people living with a tracheostomy and their families across the age, as well as healthcare professionals. Royal College of Speech & Language Therapists Tracheostomy Clinical Excellence Network: UK based network of SLTs (and other HCPs) looking at tracheostomy across the age range. Often run virtual study days/webinars. Resources: National Tracheostomy Safety Project (NTSP): paediatric guidance and training References: Miles et al. (2025). Children with a tracheostomy: Global speech-language therapists’ practice. Streppel et al. (2019). Swallowing problems in children with a tracheostomy tube. Pullens & Streppel. (2021). Swallowing problems in children with a tracheostomy. Gupta et al. (2026). Impact of Tracheostomy on Dysphagia in Children. Lee et al. (2025). Incidence of Pediatric to Adult Transition Among Tracheotomy Patients. Ongkasuwan et al. (2014). The effect of a speaking valve on laryngeal aspiration and penetration in children with tracheotomies. Brooks et al. (2020). Passy muir valve tolerance in medically complex infants and children: Are there predictors for success?

When we think of Obstructive Sleep Apnea (OSA), we usually think of snoring, disrupted sleep, and daytime fatigue. But there is a critical link between OSA and dysphagia. In this episode, we sit down with Prof. Ankita Bhutada from Northwestern University to explore how upper airway collapse and chronic respiratory disruption can profoundly impact swallowing function. We cover: Understanding OSA: What is obstructive sleep apnea, its primary risk factors, and why it is a major public health concern. The link to dysphagia: Understanding the sensorimotor mechanisms and neuromuscular changes that connect sleep-disordered breathing to swallowing dysfunction. Clinical Presentation: How dysphagia typically manifests in individuals with OSA  Diagnostics: Why clinicians should consider routinely screening people with OSA for dysphagia and how to adapt existing assessment tools for this population. High-Risk Groups: Identifying which specific patient profiles within the OSA population face the highest risk for airway compromise. Management & Treatment: A look at current and emerging treatment approaches for dysphagia in people with OSA. Literature that we discuss: Bhutada et al. (2022). Predictors of Patient-Reported Dysphagia and Reflux Symptoms in Obstructive Sleep Apnea. Bhutada et al. (2020). Obstructive sleep apnea syndrome (OSAS) and swallowing function—A systematic review. Bhutada et al. (2025). Effects of Expiratory Muscle Strength Training on Oropharyngeal Swallow Physiology in Persons with Obstructive Sleep Apnea (OSA): A Preliminary Study.

What do you do when patients report severe swallowing difficulties, but all structural and neurological exams come back normal? In this episode, we talk to Prof. Anna Miles about her paper “Functional dysphagia: Developing a framework for assessment and treatment”. We explore why terms like “psychogenic dysphagia” or “phagophobia” are outdated, look into the neurobiological underpinnings of the condition, and discuss practical, biopsychosocial strategies for speech and language therapists. Key Takeaways: Language Matters: Why shifting from psychogenic to functional dysphagia reduces stigma and improves patient care. The Biopsychosocial Framework: Moving away from a diagnosis of exclusion toward a positive, holistic assessment. Neurobiology & Agency: How functional dysphagia relates to a real disruption in the voluntary control of swallowing (loss of agency). Hypervigilance: How past negative events (e.g., a choking incident) lock patients into a restrictive cycle. Clinical Crossovers: Applying techniques from voice therapy (e.g., laryngeal massage) and laryngeal hypersensitivity management (cough/gag reflex) to functional cases. Psychoeducation: Why explaining the underlying mechanisms to the patient is a highly effective therapeutic tool in itself.

What if a microphone and a few sensors placed on the neck could detect dysphagia; without access to FEES  or videofluoroscopy, maybe even without a dysphagia specialist in the room? In this episode, we sit down with Prof. Ervin Sejdic, a biomedical engineer at the university of Toronto, whose research is changing the way we think about dysphagia assessment. Ervin leads work on High-Resolution Cervical Auscultation (HRCA) – a method that captures the sounds and vibrations of swallowing using sensors on the throat, then analyses that data with signal processing algorithms and artificial intelligence to identify aspiration risk and characterise swallowing function. We talk about how to develop biomarkers for dysphagia, and how they could one day fill the gap of reliable swallowing assessment where FEES or videofluoroscopy may not be accessible; in hospitals, nursing homes, and community settings alike. We discuss: What a computational biomarker is and why it matters clinically What HRCA looks like in practice: setup, sensors, and data What the algorithms can detect today, and what’s still on the horizon The path from research lab to clinical routine

Dysphagia is an under-recognised but clinically important complication following cardiac surgery. In this episode, Prof. Cara Donohue discusses why dysphagia can occur despite surgery being anatomically distant from the swallowing mechanism. We explore the complexities of dysphagia in patients post cardiac surgery, highlighting risk factors, prevalence, assessment methods, and potential interventions. Cara shares her research findings and clinical perspectives, emphasising the importance of early detection and proactive management to reduce complications and improve patient outcomes. Topics covered Why dysphagia occurs after cardiac surgery Mechanisms contributing to postoperative swallowing impairment Prevalence and potential under-recognition of dysphagia in this population Typical clinical and instrumental findings Surgical and perioperative risk factors Consequences for recovery and patient outcomes The role of prehabilitation and respiratory strength training Identifying patients who may benefit from preoperative interventions Key clinical messages for SLTs in cardiothoracic settings

Preparing safe, enjoyable meals for people with dysphagia can be challenging but it does not have to mean sacrificing enjoyment of food, variety, and social connection. How can clinicians and caregivers help ensure meals remain safe and enjoyable? In this episode, we speak with Dr. Simone Howells from Griffith University, Australia, about the second edition of Beyond the Blender: Dysphagia Made Easier; a freely available cookbook featuring 30 recipes organised according to IDDSI Levels 2–6. We discuss: the inspiration behind creating the cookbook how recipes were developed, selected and adapted across IDDSI levels the challenges of modifying everyday meals while maintaining taste, texture, and visual appeal the broader responsibilities of SLTs beyond recommending modified diets practical strategies and resources to better support patients and families

Meta-analyses are powerful tools, but they can be challenging to interpret. In this episode, we explore how dysphagia clinicians can better understand and critically evaluate meta-analyses to support evidence-informed practice. We are joined by Prof. Kendrea Garand to talk about the article “How to Interpret and Evaluate a Meta-Analysis in the Field of Speech and Language Therapy: A Tutorial for Clinicians.” We discuss: What meta-analyses are and why they matter for dysphagia clinicians How to conduct a meta-analysis How to critically interpret and evaluate a meta-analysis Red flags in pooling studies in meta-analyses Rapid appraisal tips for clinical decision-making Integrating evidence with clinical expertise and patient values

In this episode, we talk to Dr. Raele Loy, a Speech and Language Therapist and research scientist at the Center for Health Disparities Research at the University of Wisconsin-Madison. We discuss a critical but often overlooked aspect of dysphagia care: health equity, or the lack thereof. Raele discusses what sparked her interest in health equity, and explains what ‘health disparities’ mean in clinical practice and research today. She discusses what is currently known about disparities in dysphagia assessment and management, and presents her conceptual framework which illustrates how disparities emerge and persist throughout the entire eating and swallowing care pathway in people with dementia.

Behind the tremor in Parkinson’s disease lies a complex neurodegenerative process that affects far more than movement. In this conversation, we are joined by Prof. emer. Werner Poewe, neurologist and one of the world’s leading experts in Parkinson’s disease. He unpacks the evolving understanding of Parkinson’s disease, from James Parkinson’s first observations to today’s insights into pathology, prodromal symptoms, diagnosis, and treatment. With a special focus on swallowing and dysphagia, we explore what clinicians need to know to support individuals with Parkinson’s disease across all stages of the disease.

Button batteries may be small, but their impact can be devastating. In this episode, we speak with Prof. Kris Jatana about the serious and often hidden dangers of button battery ingestion in children. Found in everyday household items, these small batteries can cause severe injuries to the esophagus and surrounding structures within hours of ingestion. Kris explains what button batteries are, how they cause injury when swallowed, and why quick recognition and management are critical. We discuss the challenges in diagnosing unwitnessed ingestions, the steps parents and caregivers should take in an emergency, and current strategies for acute and long-term management. Helpful resources: Global injury research collaborative (GIRC): www.globalirc.org Sethia et al. (2021). Current management of button battery injuries. https://doi.org/10.1002/lio2.535

​​What is it like to live with dysphagia due to ineffective esophageal motility (IEM)? In this episode, Adrienne shares her personal journey: from first noticing symptoms, through the path to diagnosis, and how the condition has evolved over time. We explore the deep impact of IEM on eating, drinking, social life, and quality of life. Adrienne talks about what it is like to have an invisible disease, the struggles of explaining the condition to family and friends, the treatments and strategies she has tried, what has helped, and what remains challenging. To close, she offers thoughtful advice for others newly diagnosed with IEM, as well as important insights for healthcare professionals supporting people with this condition. Literature that we talk about: Kamboj et al. (2024). A practical approach to ineffective esophageal motility. https://doi.org/10.1111/nmo.14839 Schroeder et al. (2024). Ineffective Esophageal Motility: Current Criteria and Management. https://doi.org/10.1007/s11938-024-00466-0 Tuchman, J. (2022). Dysphagia Naturally: Tips, Tools, and Resources for Patients with Swallowing Disorders.

Prof. Taher Omari, Physiologist, Principal Research Fellow and lead of the Swallowing Research Group at Flinders University in Adelaide (Australia) joins us to share insights on the new Leuven Consensus. This research project sets out recommendations for pharyngeal and upper esophageal sphincter (UES) disorders using high-resolution manometry with impedance (P-HRM-I). Taher explains: the principles of P-HRM-I how the consensus was developed the diagnostic procedure when using P-HRM-I what it means for advancing clinical practice and research in dysphagia Literature that we talk about: Omari et al. (2011). A Method to Objectively Assess Swallow Function in Adults With Suspected Aspiration. https://doi.org/10.1053/j.gastro.2011.02.051 Omari et al. (2025). Defining Pharyngeal and Upper Esophageal Sphincter Disorders on High‐Resolution Manometry‐Impedance: The Leuven Consensus. https://doi.org/10.1111/nmo.70042

In this episode, we’re joined by Prof. Kathryn Steadman, who gave an excellent presentation at last year’s European Society for Swallowing Disorders conference in Münster, Germany. Her talk explored the question: Does swallowing tablets with an IDDSI Level 4 gel impact drug absorption? Because this topic isn’t discussed much – and Kathryn brings a lot of expertise as a pharmacist – we’re happy to have her with us to talk about safe and effective medication intake for people with dysphagia. Topics we discuss: the role of swallowing gels in medication administration dysphagia as a potential side effect of medication the pros and cons of crushing tablets or pills what the future might hold for medication strategies in dysphagia care Links & Literature: Malouh et al. (2025). Does using oral medication lubricants to swallow whole or crushed tablets alter drug absorption in vivo? A randomised, single-dose crossover bioequivalence study in healthy adults. https://doi.org/10.1016/j.jddst.2024.106552 Don’t Rush to Crush – Advanced Pharmacy Australia

There are many rare diseases, where dysphagia can manifest. In this episode, we are joined by Dr. Bendix Labeit, neurology physician and clinical scientist at University Hospital Düsseldorf in Germany to talk about dysphagia in one of these rare diseases: myositis. Together, we discuss: What is myositis, and what are its different forms? How does dysphagia manifest in people with myositis? What does the diagnostic process look like, including an algorithm where dysphagia plays a key role? What are the current treatment approaches for dysphagia in myositis? Literature that we discuss: Labeit et al. (2022). Detecting myositis as a cause of unexplained dysphagia: Proposal for a diagnostic algorithm. https://doi.org/10.1111/ene.15202 Labeit et al. (2020). The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis. https://doi.org/10.3390/jcm9072150

In this episode, we speak with Prof. Shaun Treweek about why so much health research still falls short. Shaun argues that big parts of health research is “bad” and does not bring the value to the evidence-base we need. As a leading expert in trials methodology he explains how we can change that and how we can conduct “good” research for our patients. Other topics we cover What leads to “bad” studies and eventually research waste The gender health gap and what a Pink Floyd lyric has to do with it   Literature we discuss Daly et al. (2025). Tolerating bad health research (part 2): still as many bad trials, but more good ones too. https://doi.org/10.1186/s13063-025-08747-4 De Paoli et al. (2022). Another Brick in the Wall … no More! Breaking the Sex Bias. https://doi.org/10.1016/j.clon.2022.09.052 Pirosca et al. (2022). Tolerating bad health research: The continuing scandal. https://doi.org/10.1186/s13063-022-06415-5 Rogus-Pulia et al. (2024). A Proposed Framework for Rigor and Transparency in Dysphagia Research: Prologue. https://doi.org/10.1044/2024_AJSLP-23-00368 Treweek et al. (2022). Getting it wrong most of the time? Comparing trialists’ choice of primary outcome with what patients and health professionals want. https://doi.org/10.1186/s13063-022-06348-z Werden Abrams et al. (2024). Participant Characteristics for Dysphagia Research: A Proposed Checklist. https://doi.org/10.1044/2024_AJSLP-22-00183 FRONTIERS website www.frontiersframework.com