[Dysphagia] spontaneous vs volitional cough

[atsslp at yahoo.com (Alyce Schoenagel)]

Sandi,
           Is this patient apraxic?  When I see folks who can not cough to command, but do spont, and have dysphonic vocal quality, I think motor planning/apraxia. I feel the volitional cough will reduce the choking risk. The spont cough  can be important in therapy, to be used as a compensation based upon mbs.. ie: Does the pt need to cough post swallow to alleviate penetrated material ?  Of course if the pt can learn to cough to command,  it gives you some info about return of VF fx, motor planning,  can be used as a tx tool, and may lessen choking risk as well.
 
Alyce Schoenagel
M.S. CCC-SLP
Harford Memorial Hospital, MD

		
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