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The Source® for Dysphagia Third Edition
Ages: Adults   Grades: Adults         

This best-selling book is a practical resource that gives you an evidence-based, working knowledge of the evaluation and treatment of dysphagia plus tools to organize your dysphagia services.


  • Know the requirements of dysphagia evaluations and treatments
  • Understand the ethical issues of dysphagia treatment
  • Educate the healthcare team, patients, and families about dysphagia
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** This is a Cloud E-Book that is accessible from any device with Internet access. .

The book is filled with "need-to-know" information and patient/staff education materials that busy clincians can use every day! 

The chapters in the book cover:

  • Preparing for a Patient Assessment
  • Medicare Expectations and Other Billing Issues
  • Screenings and Bedside/Clinical Evaluations
  • Education and Advocacy: Patient/Family, Staff, Physicians, Administrators, and Payers
  • Ethics: Decision Making in Rehabilitative and End-of-Life Situations
  • Instrumental Assessment of Swallowing (Videofluoroscopic Swallow Studies and Fiberoptic Endoscopic Evaluation of Swallowing [FEES®])
  • Planning Dysphagia Treatment
  • Documenting Treatment
  • Special Considerations in Intensive Care
  • Using Data to Manage Dysphagia

The book comes with a FREE CD of an additional 139 printable pages of therapy materials in PDF format, including:

  • Bedside Dysphagia Evaluation form
  • FEES® Report form
  • Modified Barium Swallow Report form
  • Patient Interview form
  • Case examples
  • Patient/family education materials (e.g., What You'll See During a Modified Barium Swallow Study, How to Perform Safe Swallowing Exercises, LIfestyle Modifications for Patients with Gastroesophageal Reflux Disease)
  • Handouts of Swallowing Guidelines  (e.g., No Thin LiquidsTaking PO Meds, Silent Aspiration)
  • Staff inservice on dysphagia
  • Suctioning Competency Validation Tool
  • Efficacy references
  • Sample letters to physicians
  • Referral forms

Copyrights © 1996, 2000, 2007

191-page book plus a CD of an additional 139 printable pages in PDF format (printable educational handouts and therapy tools and forms)

The Source for Dysphagia Third Edition by Nancy Swigert is excellent because it has a little of everything.  It has pre-written inservices with brief tests, FAQ regarding dysphagia, printable signs for reflux and aspiration precautions, and excellent patient materials for swallow exercises.  I use this book like a Bible.  I educate staff and find it very helpful for my speech interns who are just beginning their experience with dysphagia patients.  It works well for me.  I am in an acute/care/rehab, 300-bed facility.

Kimberly Almstrom, SLP
Smithtown, NY


I recently purchased the Source for Dysphagia Third Edition and have found it to be extremely helpful especially for documentation purposes.  I am an SLP with experience in the schools, early intervention, and now a hospitial setting.  I especially liked the documentation "don't say" vs. "say" examples as these offered true "real life" scenarios that SLPs are faced to document every day.

Molly Rutledge, SLP
Window Rock, AZ


This book by Nancy Swigert is easy to follow, practical, and full of great therapy ideas.  The checklists make assessments effortless and the treatment ideas are both fun and functional.  This is my "go to" Source for clients and their families.  Nancy Swigert's work motivates me to be the best clinician I can be.  I am never disappointed with the Source products. 

Cheryl Moyer-Rafferty, SLP
New Milford, CT

Evidence-based practice (EBP) has been defined as  "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients . . . [by] integrating individual clinical expertise with the best available external clinical evidence from systematic research" (Sackett et al.,1996).  Guyatt et al. (2000) and Sackett et al. (2000) have emphasized the need to integrate patient values and preferences along with best current research evidence and clinical expertise in making clinical decisions.  To the extent possible, this book provides the evidence available on techniques and methods for dysphagia evaluation and treatment.

ASHA practice documents on dysphagia support the following guidelines, which are incorporated in this book:

  • SLPs should have a basic understanding of the following areas: 
    • normal and abnormal anatomy and physiology related to swallowing function
    • signs and symptoms of dysphagia
    • indications for instrumental evaluations
    • analyzing clinical and instrumental information to establish a diagnosis and prepare appropriate documentation
    • determining candidacy for intervention 
    • implementing compensations and therapy techniques
    • educating and counseling individuals with swallowing problems and their care providers
    • quality of life issues related to the individual and the individual's family
    • identifying and using appropriate functional outcome measures
    • related medical issues
  • SLPs are primary providers of evaluation and treatment for feeding and swallowing disorders.  SLPs should not train individuals or groups of individuals from other professions in the delivery of evaluation and treatment for infants, children, and adults with swallowing and feeding disorders.

The Source for Dysphagia Third Edition incorporates these principles and is also based on expert professional practice.


American Speech-Language-Hearing Association. (2002). Knowledge and skills needed by speech-language pathologists providing services to individuals with swallowing and/or feeding disorders [Knowledge and Skills]. Available from

American Speech-Language-Hearing Association. (2004). Evidence-based practice in communication disorders: An introduction [Technical Report]. Available from

American Speech-Language-Hearing Association. (2004). Speech-language pathologists training and supervising other professionals in the delivery of services to individuals with swallowing and feeding disorders [Technical Report]. Available from

Guyatt, G.H., Haynes, R.B., Jaeschke, R.Z., Cook, D.J., Green, L., Naylor, C.D., Wilson, M.C., & Richardson, W.S. for the Evidence-Based Medicine Working Group. (2000, September). Users' guides to the medical literature: XXV. Evidenced-based medicine: Principles for applying the users' guides to patient care. JAMA, 284, 1290-1296.

Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes, R.B., & Richardson, W.S. (1996). Evidence-based medicine: What it is and what it isn't: It's about integrating individual clinical expertise and the best external evidence. British Medical Journal, 312, 71-72.

Sackett, D.L., Straus, S.E., Richardson, W.S., Rosenberg, W., & Haynes, R.B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). New York: Churchill Livingstone.


Nancy B. Swigert


Nancy B. Swigert, M.A., CCC-SLP, is the director of Speech-Language Pathology and Respiratory Care at Central Baptist Hospital, an acute care facility in Lexington, KY.  Prior to this, for 26 years, Nancy was the president of Swigert & Associates, Inc., a private practice providing speech-language pathology services in the Central Kentucky area.  She is a Board Recognized Specialist in Swallowing and Swallowing Disorders.

Nancy received her master's degree from the University of Tennessee – Knoxville.  She is a former President of the Kentucky Speech-Language-Hearing Association (KSHA), the Council of State Association Presidents, the American Speech-Language-Hearing Association, and the American Speech-Language-Hearing Foundation Board of Trustees.  She was on the Steering Committee for ASHA Special Interest Division 13, Swallowing and Swallowing Disorders, for six years and Coordinator for three of the six years.  She chairs the Health Care Economics Committee for ASHA.  Nancy was twice awarded the Honors of KSHA and is a Fellow of ASHA.

Nancy's main interests are in the areas of pediatric and adult dysphagia and other neurogenic disorders.  She has authored these publications with LinguiSystems: The Source for Dysphagia Third Edition, The Source for Dysarthria Second Edition, The Source for Pediatric Dysphagia, The Source for Reading Fluency, Reading Fluency and Comprehension Activities and Exercises, The Early Intervention Kit, and The Source for Children's Voice Disorders.  She lectures extensively in the areas of pediatric and adult dysphagia and motor speech disorders.


Working with adults with dysphagia is a challenging and rewarding part of the practice of speech-language pathology.  I am fortunate to have the opportunity to evaluate and treat patients in a variety of settings and find that I continually learn from them how to be a better dysphagia clinician.  This book is a compilation of what I have learned and how I have applied that information to different practice settings.  It is meant to be a practical resource for you to use on a day-to-day basis, but it also has reference information that will help you when you encounter a challenging patient.  It should be just one of many resources you use to build your knowledge and skills in dysphagia management.

The Source for Dysphagia was first published in 1996 and then updated in 2000.  Because it is crucial to practice from an evidence-base in dysphagia, and research in the area provides new information on an almost monthly basis, it was time again for a comprehensive review and update.  This Third Edition provides information that is current in evaluation and treatment, with particular attention to updating evidence for treatment techniques.

Most chapters contain significant revisions, such as the following:

  • descriptions of the swallowing physiology match the new diagnostic descriptors of the overlapping phases of swallowing
  • information on billing based on the changes to the Medicare Beneficiary Manual
  • description of the bedside/clinical swallowing evaluation as an evaluation, not a screening, with information on establishing a screening program
  • updated educational materials with new handouts on the SLP's role in palliative care and end-of-life decision making and the ethical challenges encountered with the end of life
  • information about the National Dysphagia Diet and some revisions to the diet levels previously published in this book
  • updated reference list

Due to the expanded information in this edition, many of the pages previously included within the book (primarily reproducible pages) have been transferred to a CD (located inside the back cover). 

Speech-language pathologists are the preferred providers of services to patients with dysphagia.  To remain in this position, we must continually update our knowledge and skills.  I hope The Source for Dysphagia Third Edition is one of the ways you will keep your skills on the cutting edge of dysphagia services.  I also hope you'll take advantage of ASHA's Special Interest Division 13, Swallowing and Swallowing Disorders, which is a great value and an easy way to stay current in our area of practice.