Tilt the Head (Postures and Maneuvers)
Chin-to-chest posture that widens vallecula and slows bolus flow.
What is the chin tuck?
Changing bolus viscosity to slow flow rate and allow more time for airway closure.
What are thickened liquids?
Using strong flavor, sour, cold, or carbonation to heighten sensory input.
What is sensory enhancement?
A rehab approach with repeated, effortful swallows to improve tongue base and pharyngeal strength.
What is the effortful swallow (as exercise)?
The physiological component targeted when exercises aim to improve the upward and forward movement of the hyolaryngeal complex.
What is hyolaryngeal elevation?
Increases airway closure by bearing down or applying effort before and during the swallow.
(Bonus points if you can name both and difference between the two)
What is the supraglottic swallow?
A bolus consistency modification that increases cohesion and is easier for patients with poor bolus control.
What is puree?
Rubbing the faucial pillars with a cold instrument to trigger faster swallow initiation.
What is thermal-tactile stimulation (TTS)?
An exercise requiring sustained head lifting to strengthen suprahyoid muscles.
What is the Shaker exercise?
The physiologic goal addressed when exercises aim to increase tongue pressure for more efficient bolus propulsion.
What is tongue base retraction / lingual pressure generation?
A head posture used to redirect bolus down the stronger side of the pharynx.
What is the head turn?
This material may worsen pharyngeal residue if used with patients with reduced pharyngeal contraction.
What are thickened liquids?
Changing the feeding environment to reduce distractions and support attention.
What are environmental modifications?
A rehabilitation version of the chin tuck that uses resistance to strengthen anterior neck muscles.
What is the CTAR (chin tuck against resistance)?
Rehabilitative efforts that seek to improve timing and coordination between airway closure and bolus transit target this physiologic domain.
What is swallow–respiratory coordination?
Technique requiring the patient to maintain laryngeal elevation during the swallow to improve UES opening.
What is the Mendelsohn Maneuver?
Adjusting bolus amount to minimize aspiration risk by reducing volume per swallow.
What is small single sips/bites?
Allowing the patient time between bites to reduce fatigue and support swallow-breath coordination.
What is paced feeding?
A rehabilitation exercise performed by holding the tongue gently between the teeth while swallowing, designed to improve pharyngeal wall movement.
What is the Tongue Hold (Masako) exercise?
This physiologic target is addressed when exercises aim to widen the opening of the upper esophageal sphincter for improved bolus passage.
What is UES opening?
Used when oral propulsion is weak; promotes gravity-assisted bolus transit but is contraindicated when airway protection is impaired.
What is Chin up posture?
This approach changes the presentation of the bolus (e.g., cup vs. spoon vs. straw) to improve safety.
What is bolus delivery modification?
Using adaptive equipment such as nosey cups, weighted utensils, or specialized straws.
What are feeding tools/adaptive equipment?
A structured rehabilitation approach that targets increased tongue pressure and improved bolus propulsion through repeated resistance-based tasks.
What is tongue strength training (lingual resistance exercise)?
Rehabilitation that aims to increase the force and speed of pharyngeal contraction is designed to improve this physiologic aspect of swallowing.
What is pharyngeal constriction / pharyngeal pressure generation?