Swallowing Rehabilitation Research Lab

Focus on Accessibility Award

Award description: The Government of Ontario partnered with Toronto Rehabilitation Institute to create the Focus on Accessibility Awards. The winners contributed to the creation of a culture of accessibility in Ontario by developing cost-effective, practical and innovative concepts, programs, initiatives or designs tat dress every day accessibility issues and improve the quality of life.

Award winner: Toronto Rehabilitation Institute doctoral candidate Carly Barbon has been heavily involved in testing liquid consistencies using the International Dysphagia Diet Standardisation Initiative (IDDSI) Flow Test. Her work has included the development of blogs and webinars demonstrating how to perform the test, intended for clinicians, caregivers and kitchen staff. Her research has confirmed that the IDDSI Flow Test can detect important features of liquid consistency, including changes over time or due to changes in temperature. A particularly exciting aspect of Carly’s research has been the testing of barium liquids that are used in the radiological assessment of swallowing function. This assessment is widely considered the gold standard for determining the liquid and food consistencies that are appropriate for a person with dysphagia. Carly’s research has developed recipes for the preparation of barium for use in swallowing assessment, with matched flow characteristics to liquids prescribed for patients with dysphagia, using the IDDSI Flow Test. This use of the IDDSI Flow Test, ensuring a match between diagnostic liquids and those prescribed at mealtime is revolutionary in facilitating patient safety. When a swallowing assessment has confirmed that a patient is able to consume liquids of a particular flow-level safely, the people who prepare beverages for that individual can be taught to test and confirm the suitability of a liquid prior to serving.

Geoff Fernie Impact Award

Award description: The Geoff Fernie Impact Awards have been created to honour TRI stars whose work and presence have impact internally at TRI, and whose research has impact externally in the world. 

Award winner: Carly Barbon is a doctoral trainee in the Swallowing Rehabilitation Research Lab and expects to defend her dissertation early in 2019. Her work has focused on the use of thickened liquids to address swallowing impairment in individuals who have undergone radiation treatment for head and neck cancer. A major part of her research has involved the development of recipes for liquids used in swallowing assessment and characterization of liquid flow using the new International Dysphagia Diet Standardisation Initiative (IDDSI) flow test. This work has had widespread impact on the clinical community. At Toronto Rehab, Carly has become the go-to resource person in the Swallowing Lab regarding liquid flow testing. In particular, Carly’s work exploring the similarities in flow between the stimuli used in videofluoroscopic swallowing assessments and the thickened liquids that are provided to patients at meals is groundbreaking. We were previously aware that the addition of barium to pre-thickened liquids led to further thickening, but Carly’s work with flow testing has found a way to solve this challenge and prepare assessment stimuli that are a valid match for the thickened liquids provided to patients from the hospital kitchen. Her work on this topic, which was featured in two peer-reviewed publications in 2018, has led to the implementation of standard assessment stimuli not only in our research but also for the videofluoroscopic swallowing assessments performed by the clinical speech-language pathologists at TRI. Her recipes are featured in the barium recipes area of our lab website as a resource for clinicians around the world: https://bit.ly/2CbyOsq. Carly’s work in this area has also included a peer-reviewed publication in collaboration with clinicians from the Colorado Children’s Hospital, specifically investigating the dilemma of different flow characteristics between infant formula and barium used in pediatric swallowing assessments.

TRI Best Publication Award

Award winner: Ashley is a doctoral candidate supervised by Prof. Catriona Steele at the Toronto Rehabilitation Institute and the University of Toronto’s Department of Speech-Language Pathology. Ashley’s research focus is on the important topic of swallowing impairment (dysphagia) in Amyotrophic Lateral Sclerosis (ALS). Ashley’s goal is to conduct research that will help us to better understand the nature of progressive swallowing impairments, which are debilitating in the ALS population. Ashley’s research has the potential to dramatically influence outcomes for people with this disease. Early in her doctoral studies, Ashley conducted an extensive scoping review to identify what is known and what gaps in knowledge remain regarding swallowing difficulties in ALS. She then completed some pilot work exploring the pathophysiology of impaired swallowing in ALS through a collaboration with Dr. Emily Plowman at the University of Florida, presented in the award-winning publication. Ashley has also presented her doctoral research at national and international conferences including the 2016 European Society for Swallowing Disorders Congress (Milan, Italy), 2018 Dysphagia Research Society Meeting (Baltimore, Maryland, USA), and the 2018 International Symposium on ALS/MND (Glasgow, Scotland, UK). In addition to her involvement in research, Ashley works as a clinical Speech-Language Pathologist in the Inpatient Stroke and Acquired Brain Injury programs at the Toronto Rehabilitation Institute. She also completed a short-term research exchange with the University of Florida to facilitate a new collaborative research project between the Plowman and Steele laboratories, and obtain valuable mentorship related to her PhD studies from Dr. Plowman and her research team. 

Award winning publication: Waito, A. A., Tabor-Gray, L., Steele, C. M. & Plowman, E, K. (2018). Reduced pharyngeal constriction is associated with impaired swallowing efficiency in Amyotrophic Lateral Sclerosis (ALS). Neurogastroenterology and Motility.https://onlinelibrary.wiley.com/doi/full/10.1111/nmo.13450