Respiratory function for speech, swallowing and cough for SLTs

This course is designed for Speech and Language Therapists, including students.

We will begin this presentation with a review of fundamental anatomical and physiological concepts to understand the role of the respiratory system in quiet breathing, speech, swallowing and cough. This will provide the background for the discussion of the coordination of breathing with swallowing (and chewing).

Dr David McFarland is currently Professeur Titulaire at the University of Montreal. He has several research appointments, and served for 4 years as Associate Editor for the Journal of Speech-Language and Hearing Research and for 8 years as the Editor-in Chief of the Canadian Journal of Speech-Language Pathology and Audiology. He holds a master's degree in Speech-Language Pathology from California State University, a doctorate in Speech Science and Neuroscience from Purdue University and he completed his postdoctoral fellowship in neurophysiology at the University of Montreal. Dr McFarland has published over 120 articles and abstracts in a number of leading international scientific journals, is a Fellow of the American Speech-Language-Hearing Association (ASHA) and received the OOAQ award for his lifelong contribution to the field of Speech-Language Pathology in the province of Quebec.

Dr David McFarland's over 30 years of collaborative research, and work of others, has demonstrated that swallowing is typically initiated at mid-to low quiet breathing lung volumes, between mid-expiratory and resting expiratory level. This optimal coordinative relationship imparts important biomechanical advantages that facilitate laryngeal elevation, cricopharyngeal sphincter opening, laryngeal vestibular closure, tongue base retraction, and pharyngeal clearance. Non-optimal coordination has been reported in various patient populations with swallowing impairment (dysphagia), such as in head and neck cancer survivors and patients with neurologic and/or pulmonary disorders. Based on our physiological identification of optimal respiratory-swallowing coordination and findings of non-optimal coordination in patients with swallowing disorders, Martin-Harris and colleagues have developed a respiratory-swallow training therapy (RST) that establishes a respiratory-swallow phase patterning shown to facilitate improved airway protection and swallowing efficiency in a series of past and ongoing clinical studies.

This workshop is designed to provide the participant with fundamental information about breathing and its coordination with swallowing. It is also designed to highlight the physiological/biomechanical advantages of initiating swallowing during the optimal respiratory-swallow phase patterning, and the impact that the neurorehabilitation through RST has on swallowing. We will conclude with a theoretical discussion cross-system interaction between feeding/swallowing and speech/language and the potential impact of LSVT LOUD on swallowing function.

At the end of this course, the attendee will be able to:

- Explain respiratory function for quiet breathing, speech and cough
- Identify optimal respiratory-swallowing phase relationships and the physiological advantages this coordination provides.
- Relate non-optimal coordination to swallowing disorders.
- Understand anatomical, physiological, and behavioural cross system interactions between feeding/swallowing and speech/language
- The potential impact of LSVT LOUD on swallowing function

The course will be held at the Institute of Translational Medicine within the University of Birmingham, based at the Queen Elizabeth Hospital in Birmingham. Lunch will be provided. Parking is limited therefore the event organisers would recommend train travel to 'University' station.

For any course queries, please contact molly.metcalf@uhb.nhs.uk