Speech Talk

How do we actually diagnose apraxia of speech when there’s no gold-standard diagnostic test? In this episode, we break down recent research on apraxia differential diagnosis and discuss how to distinguish apraxia from aphasia and dysarthria. We cover common characteristics of apraxia, clinical impressions, the Apraxia of Speech Rating Scale (ASRS), and why relying on obvious signs like groping may...

In this episode of Speech Talk, Emily and Eva explore how chewing, food texture, and swallowing are connected—and why diet texture matters for swallowing safety and patient care. Why do we care about diet texture? Because the texture of the food changes as we chew or don’t chew and food factors like gumminess, hardness, and moisture impact the strength we recruit for the swallow.  They break...

What happens when the brain can’t hear its own speech errors? In this episode of Speech Talk, Emily and Eva explore the speech-auditory feedback loop and how it can be disrupted after brain injury. They unpack new research on error detection, automatic versus voluntary correction, and what these findings mean for aphasia therapy. Plus, practical strategies for helping patients build awareness, sel...

This week on Speech Talk, we're diving into one of the most medically complex—and often intimidating—areas of speech-language pathology: tracheostomy rehabilitation. We break down the research on how speech-language pathologists are involved (or unfortunately, often not involved) in tracheostomy care and why early SLP intervention can make a significant difference in communication, swallowing, and...

Do oral and pharyngeal exercises help post-stroke dysarthria? Emily and Eva examine a recent review (Yunusova et al.), unpack why swallowing outcomes often show benefit while speech outcomes do not, discuss goal-writing pitfalls, and get into practical treatment. Talking about their own practice and how they address dysarthria treatment- because if we don't talk we can't learn from each other. Cit...

Supervision is so much more than signing off on competencies. It shapes clinician confidence, patient care, and the future of our profession. In this episode of Speech Talk, Emily and Eva welcome their very first guest, Olivia, to reflect on her completed externship and unpack what effective supervision really looks like. Together, they explore the research on clinical supervision, discuss differe...

How many repetitions does it take to improve swallowing? How hard should dysphagia exercises be? And are we prescribing enough therapy to make a meaningful difference? In this episode of Speech Talk, Emily and Eva tackle a question many clinicians have asked but few were formally taught to answer: how do we dose dysphagia therapy? Using the article Exercise Prescription for Dysphagia: Intensity an...

A patient survives a stroke, starts rehab, and begins making progress. But what if their greatest risk isn't behind them? In this episode of Speech Talk, Emily and Eva dive into the often-overlooked topic of recurrent stroke. While many clinicians focus on recovery, research suggests the first 90 days after a stroke may carry a surprisingly high risk for another cerebrovascular event—and the way r...

What happens when we can’t stop aspiration? In this episode, Eva and Emily talk about chronic aspiration and what happens when small, repeated events start to add up. From inflammation and airway damage to serious complications like pneumonitis and lung abscess, we break down what’s really happening in the lungs. We also connect the research to real clinical practice—what this means for your patie...

Ever feel like you’re fighting your patient just to get through a session? Explore Acceptance and Commitment Therapy (ACT) as a framework for speech therapy—not psychotherapy, but a way to rethink how we approach resistance, engagement, and progress. Using the metaphor of “the river and the rock,” Eva and Emily unpack how ACT shifts us away from power struggles and toward flexibility, values-based...

Choking is one of those moments where everything goes from normal to crisis in seconds—but how well are we actually measuring that risk? In this episode of Speech Talk, Emily and Eva break down the integrative review “Dying for a Meal” to explore what really contributes to choking across populations. From who is most at risk to the foods most commonly involved, the research reveals that choking is...

Research is supposed to guide our practice—but what happens when we can’t actually access it? In this episode of Speech Talk, Eva and Emily get into the reality of paywalled research and what it means for evidence-based practice in speech-language pathology. Breaking down the article “The Effect of Open Access on Scholarly and Societal Metrics of Impact in the ASHA Journals,” they explore how acce...

Does a “wet” voice really mean your patient is aspirating? In this episode, Eva and Emily unpack research that challenges one of the most common clinical signs used in dysphagia assessment, wet vocal quality. Turns out, what we’ve been trained to hear might not be as reliable as we think. The need for instrumentals hasn't gone away, but the biggest national providers of mobile FEEs has...So what h...

Thickened liquids are one of the most common recommendations in dysphagia management—but are they always the safest option? In this episode of Speech Talk, Emily and Eva review The Adverse Effects and Events of Thickened Liquid Use in Adults: A Systematic Review and dig into the real evidence behind thickened liquids. We talk aspiration risk, dehydration, pneumonia, quality of life, and why dyspha...

What does evidence-based practice look like when the disease is progressive, fatal, and relentlessly complex? This week on Speech Talk, Emily and Eva discuss clinical management of Huntington’s disease in long-term and residential care settings. Using a comprehensive 2007 primer for speech-language pathologists, we explore dysphagia progression, dysarthria, AAC challenges, behavioral supports, sta...

In this episode of Speech Talk, Emily and Eva dive into cervical osteophytes (aka bone spurs in the neck) and how they can mechanically impact swallowing. We break down what osteophytes are, why they form, and how they can present just like “typical” dysphagia — globus, coughing, choking, wet vocal quality — but may gradually worsen over time. We talk about imaging (Because how else would we even...

How do we decide what to treat—and how—as dementia progresses? In this episode of Speech Talk, Emily and Eva break down the article Staging and Treatment Frameworks for Dementia Management by Mason-Baughman, Raupp, and Corman. We review how dementia is staged clinically, how those stages show up in communication and daily function, and what evidence-based treatment actually looks like across early...

Up to 80% of patients treated for oropharyngeal head and neck cancer experience swallowing dysfunction—but what if we intervened before impairment starts? In this episode of Speech Talk, Eva and Emily break down the evidence behind prehabilitation for head and neck cancer, drawing from the literature review by Loewen et al. We unpack what prehab actually is, how swallowing therapy before and durin...

Traumatic brain injury isn’t just a young‑guy‑playing‑sports problem. This week on Speech Talk, we’re diving into TBI in older adults—a population with the highest rates of hospitalization, morbidity, and mortality related to brain injury. Using the ASHA review Traumatic Brain Injury in Older Adults: Epidemiology, Etiology, Rehabilitation, and Outcomes, we break down why TBIs are so common (and so...

This week on Speech Talk, we’re breaking down two of our favorite fast and evidence-backed dysphagia screeners: the TOMASS and the Yale Swallow Protocol. If you’ve ever been buried in a busy SNF day and wished for a quick but reliable way to check someone’s swallow, this episode is your new best friend. We walk you through how each tool works, what the research says, and why a simple cracker and a...

Productivity: the push button topic in the SNF world. If you’ve ever felt torn between what’s ethical and what’s expected, this episode will hit home. Instead of a research article, we dive into Akyko S. West’s dissertation on productivity requirements and moral distress in SNF rehab therapists (SLPs, PTs, OTs, RTs, and their assistants). This paper READS like every conversation we’ve had in break...

We break down the Dysphagia Outcome and Severity Scale (DOSS)—a 7-point scale created to bring consistency, clarity, and objective severity ratings to dysphagia evals. We dig into the original 1999 article, why the scale was developed, and how SLPs can use it to support documentation, payor justification, and person-centered goal writing. Citation: Dysphagia Outcome and Severity Scale (DOSS)O’Neil...

How likely is someone with Mild Cognitive Impairment (MCI) to develop dementia down the line? In this episode, we’re digging into two key studies that explore how different types of MCI—amnesic, non-amnesic, and multi-domain—relate to the risk of Alzheimer’s disease. Breaking down what the data says, what tests matter most, and what we can actually say when patients ask, “So… am I going to have de...

How gross is puree? This week, we’re talking about dysphagia and food presentation. We looked at a study that compared how patients felt about molded versus un-molded purees (spoiler: looks matter, but taste still wins). We’ll talk about how this ties into patient intake, quality of life, and what we actually can do about it in real-world settings—especially when we're not running the kitchen. Gra...

In this episode, we’re diving into the world of AI and how it’s showing up in speech-language pathology. We looked at two articles—one on using AI to rate dysarthria severity, and another on using ChatGPT to help make therapy materials. We’ll break down the basics of machine learning and deep learning, talk about what works (and what’s still kind of clunky), and share how we’ve been using these to...