Swallowing is a process that is easily ignored by healthy people because it is done automatically without much thought. However, when an accident or disease interferes with this automatic process, the results can be devastating. People with degenerative diseases, head and neck cancer, and stroke survivors are prone to swallowing disorders (also known as dysphagia). Dysphagia involves two primary concerns: the ability to swallow safely (without food, liquid or saliva entering the airway), and the ability to swallow efficiently (without leaving material behind in the throat). The primary focus of the research in my lab is to develop resources that will help clinicians to identify the specific mechanisms of impairment behind problems with airway protection and bolus clearance in swallowing, thereby informing clinical decision making and treatment planning. The primary tool that we use for this work is videofluoroscopy, a dynamic x-ray of swallowing. We are working to establish and validate reference values for a comprehensive set of measures from videofluoroscopy in healthy swallowing across the healthy adult lifespan. This work has involved establishing a standard videofluoroscopy protocol, standard assessment stimuli (liquids of different consistencies), a standard operating procedure for rating, and training materials for researchers and clinicians who wish to use the method (which we call the ASPEKT Method—Analysis of Swallowing Physiology - Events, Kinematics and Timing). We are now extending this work to characterize the pathophysiology of swallowing in specific etiological groups (Parkinson Disease, Chronic Obstructive Pulmonary Disease, Stroke, Head and Neck Cancer, Amyotrophic Lateral Sclerosis, Oculopharyngeal Muscular Dystrophy) and to measure treatment outcomes.
Physiology of solid and liquid bolus movement in healthy swallowing
Study Status: completed
Institute: KITE Research Institute
Study Purpose: We wanted to learn how food and drinks move through the throat when people swallow. We looked at things like how thick the food and drinks were and how the muscles in the throat worked. First, we studied healthy adults to see how they swallowed different types of drinks. We used a system called IDDSI to describe how thick those drinks were.
Background: Dysphagia (trouble swallowing) can be a serious health issue. It affects many people, especially older adults and those with health problems like stroke or cancer. Dysphagia usually involves two problems:
* Swallowing safety – food or drink goes into the lungs
* Swallowing efficiency – food or drink gets stuck in the throat
Dysphagia can lead to issues like pneumonia and poor nutrition. Treating it costs hospitals about $547 million every year.
Healthcare workers often use video x-rays to check how someone swallows. Based on what they see, they might suggest changing the texture of a person’s food and drink. However, before our work there wasn’t enough information about how different textures move through the throat in healthy people or those with trouble swallowing.
Study Methods: We looked at 100 healthy adults. Each person had a video x-ray while they ate and drank different foods and drinks. We first looked at 38 videos of people drinking to help us understand what healthy swallowing of drinks looks like.
Key Findings: We found that in healthy people, the throat moves in a similar way for all drinks, no matter how thick or thin. It is very rare for drink to go into the lungs or stay behind in the throat. We used this information to start building reference values (charts with numbers that show what healthy swallowing looks like). These charts will help healthcare workers better understand swallowing problems and give care that better fits each person’s needs.
Health Conditions:
External Links:
Developing Standards for Measures of Swallowing
Study Status: active
Institute: KITE Research Institute
Study Purpose: The purpose of this study is to improve our understanding of swallowing by developing reference values. Reference values show what swallowing looks like for most people. These values help health care providers know if someone’s swallow is typical. This project is based on work we did before. To move forward with this work, we need to study more people. We are studying healthy adults aged 18 and up and those who have trouble swallowing.
Background: Having trouble swallowing is a big health problem. It can happen because of many diseases, illnesses, and injuries. One of the main tests to check for problems swallowing uses a special x-ray that takes moving pictures. Most people who get this video x-ray already have swallowing problems. This means we do not have much information about how normal swallowing looks. This makes it harder for health care providers to figure out and treat swallowing problems. To help improve health care practice, we want to measure healthy swallowing in people of all ages. We also plan to study people with diseases that make swallowing hard. By doing this, clinicians can see if their patient results are different from what is expected. In the end, we hope that this study will lead to better time management, treatment planning, and outcomes for patients.
Study Methods: We are studying people who have trouble swallowing and people who do not. Participants will have up to 3 appointments. The first is a 30-minute review of the study consent form. After, they will fill out short questionnaires. These can be done online or in-person. The study ends with an in-person visit for the video x-ray. During this visit, participants take around 30 sips or bites of food and drink. Afterwards, our research lab will study the videos to measure for reference values.
Health Conditions:
Digestive system conditions
External Links:
Amplifying the Patient Voice: Involving a Person with Lived Experience of COPD in Disseminating Swallowing Research at the Canadian Respiratory Conference 2026
Study Status: completed
Institute: KITE Research Institute
Study Purpose: This project aimed to study swallowing problems, called dysphagia, in people living with Chronic Obstructive Pulmonary Disease (COPD). The project also aimed to involve a Person with Lived Experience of COPD (PLEX partner) in sharing the research at the Canadian Respiratory Conference (CRC) 2026.
Background: Swallowing difficulties are common for people with COPD but are often missed when caring for people with breathing issues.
Study Methods: The research uses the Sydney Swallow Questionnaire (SSQ). The SSQ is a 17?question survey that helps people report their swallowing symptoms and daily experiences. The Steele Swallowing Lab is the first and only lab in Canada to study dysphagia in people with COPD in this clear and structured way.
Key Findings: This work looks at how common swallowing problems are, how severe they can be, how they affect daily life, and how they relate to breathing health. The findings can help improve screening, treatment, and teamwork among health care providers caring for people with lung disease. A key part of this project was including a PLEX partner. The PLEX partner will be a co?presenter at CRC 2026. She will share how swallowing problems affect her daily life and reflect on the study results from a patient’s point of view. Her involvement makes the research more meaningful, easier to understand, and more useful for health professionals and decision makers.
Health Conditions:
Lungs & Breathing conditions
- Professor (status), Department of Speech-Language Pathology, University of Toronto
- Faculty Member, Rehabilitation Sciences Institute, University of Toronto