Episode details: Many SLPs think of cough as an airway protection mechanism, something patients either have too little of or manage fine. Dr. Miranda Wright, a postdoctoral fellow at the University of Florida's Breathe Center, works with the opposite problem: hypertussia, or heightened cough sensitivity. What happens when a cough won't go away, even after every test comes back normal?

In this episode, she breaks down the peripheral and central mechanisms driving chronic refractory cough, walks through irritable larynx syndrome as a diagnostic framework, and explains why these patients often bounce between specialists for years before getting help. She also covers the medical and behavioral treatment landscape, including SLN nerve blocks and the four-part behavioral cough suppression protocol, which has shown effectiveness rates up to 88 percent.

Disclaimer: This episode is intended for educational purposes and is not meant to equip you to diagnose a medical condition. Always verify what is said here with credible external sources, such as peer reviewed literature. Please be aware that the written transcript may contain errors.

Contact Dr. Wright: [email protected]

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Diagnose, stabilize, and move on to the next chart. That's a common model in acute care, but it's the one this team walked away from. One patient sat trached, decannulated, retrached, and off food, stuck until his care team decided the plan wasn't working and changed it. Three days later he was doing seventy-five to a hundred swallows a session. Four weeks after that, he was eating regular food, off the trach, and walking home. That case was one piece of a bigger shift. The SLP team at Johns Hopkin’s borrowed ideas from physical therapy, occupational therapy, and even an old animal study on stroke recovery, then built a case out of patient outcomes, hospital priorities, and a story that was hard to argue with.

Join us for a chat with Nicole Frost of Johns Hopkins Hospital.

Guest: Nicole Frost, M.A. CCC-SLP, BCS-S 

Contact: [email protected]

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What does it look like to bring value as a speech-language pathologist when productivity demands are real and time is limited?

In this episode, I talk with Jaimie Anderson, SLP and clinical researcher at one of the nation’s first multidisciplinary swallowing centers. We get into what this looks like in practice. Not in ideal settings, but in the day-to-day. Hallway conversations. Documentation that answers questions before they’re asked. Building relationships with the right people over time.

A big part of this conversation is the tension most clinicians feel. You know multidisciplinary care matters, but you don’t always have the structure or support to do it the way you’d like. Jaimie walks through how she has approached this, starting small and building from there rather than waiting for the system to change.

We also spend time on diagnostic reasoning, especially how to handle uncertainty without stepping outside your role. 

Advocacy comes up throughout the conversation as well. Not just identifying problems, but bringing a direction with them. Over time, that tends to land differently.

Personal Contact information:

• E-mail: [email protected] 
• Social Media: jaimieandersonslp
• LinkedIn Jaimie Anderson

Swallowing Symposium:

• https://health.usf.edu/medicine/internalmedicine/swallowing/annualswallowingsymposium-new/overview
• Social Media: usfswallowingsymposium

Neurological Disorders and the Speech-Language Pathologist​ Webinar:

• https://www.swallowthegap.com/neuroslp26

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Why do so many clinicians feel underprepared when they first begin treating dysphagia?

In a discussion that applies to SLPs in various settings, Dr. Jordan Hazelwood and I dive into challenges students face when transitioning from theory to clinical decision making, the importance of mentorship and critical thinking, and how simulation and structured training may help bridge the education-to-practice gap.

Gap Education:
https://swallowthegap.com

Instagram:
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This discussion explores what cognitive communication therapy can look like when it moves beyond worksheets and test scores. Guest Lauren Schwabish, an SLP with more than two decades of experience, explains how shifting into community-based practice allowed her to engage patients in more meaningful, real-life problem solving. She describes using self-anchored rating scales, functional observation, and collaborative strategies rather than relying solely on impairment-based models. The episode also touches on managing cognitive fatigue, reframing therapy goals, and addressing persistent myths about neuroplasticity. Listeners will hear practical examples of how SLPs can adapt interventions to match the demands of everyday life. Lauren’s enthusiasm for her work is matched by a thoughtful examination of how clinicians can avoid burnout and rediscover purpose. 

Find Lauren at neurospeechservices.com or Instagram @neurospeechservices 

 https://brainfatigue.se/wp-content/uploads/2020/06/MFS-English.pdf 

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Three head and neck cancer specialists from coast-to-coast share insights that may challenge some traditional dysphagia management approaches. Dr. Carly Barbon (MD Anderson), Dr. Mario Landera (University of Miami), and Dr. Heather Starmer (Stanford) discuss why functional goals are important with this population, the critical importance of shared decision-making, and how quality of life factors like depression and mental health should weigh in for clinical decisions. Through powerful patient stories and practical advice, these expert clinicians reveal what it really means to be a "battle buddy" for head and neck cancer patients. 

Thanks to financial sponsorship from BRACCO Diagnostics, Inc, access to the post-test and reporting for ASHA CEUs is offered at no cost to our learners for a limited time. More Info: https://www.swallowthegap.com/hncpod2025 (Oct 25, 2025 - Dec 31, 2025 only)

Live Webinar:

Interested in a deep dive into HNC? Join us for a six hour, advanced-level course, The Head and Neck Cancer Speech-Language Pathology Clinic​, on January 31, 2026. Details: https://www.swallowthegap.com/hncwebinar

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The BOLUS framework helps clinicians move beyond the idea that aspiration always translates to pneumonia by encouraging a critical, multi-factor approach to dysphagia care. Designed for use before, during, and after patient encounters, the framework supports more comprehensive assessment, treatment planning, and interdisciplinary communication.

In this episode, Dr. Phyllis Palmer and Aaron Padilla explore the clinical application of the BOLUS framework. Together, we discuss how clinicians can think critically about the many factors influencing dysphagia management, anticipate challenges before meeting the patient, and apply practical strategies to strengthen interdisciplinary communication and provide more individualized treatment.

This episode is eligible for 0.1 ASHA CEUs through Nov. 30, 2025. No partial CE credit is provided. Fee waived thanks for a donation from Bracco Diagnostics

Learn More: https://www.swallowthegap.com/boluspodcast

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We bring attention to a widespread challenge in clinical care: decisions and recommendation that don’t follow the patient. Whether it’s missing imaging, undocumented rationale, or unclear explanations, these breakdowns in continuity disrupt care, bias clinical judgment, and strip patients of informed choice.

Explore what happens when information isn’t transferred in a usable, human-centered way—and how clinicians can bridge the gaps with clearer communication, defensible rationale, and simple tools that empower both patients and providers.

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This episode explores the concepts of patient centric care and research—does intervention matter if your patient doesn’t care about it? With insights from decades of clinical practice and research, the guests share strategies for therapy that actually fits real lives.

Guests:

Dr. Giselle Carnaby, MPH, PhD, CCC-SLP, F-ASHA

Dr. Michael Crary, PhD, F-ASHA

Gap Education:
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Instagram:
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With our dedication to our patients, we've gained a deeper understanding of the complexity of swallowing and dysphagia. How can we use these insights to advance SLP education and our own professional growth?

Guest: Nicole Wiksten, MS, CCC-SLP, BCS-S

Gap Education:
https://swallowthegap.com

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