Strategies & exercises

Effortful swallow

Also written as hard swallow, effortful swallow maneuver, squeeze swallow.

A swallowing technique in which a person swallows hard, pressing the tongue firmly against the roof of the mouth.

An effortful swallow is a normal swallow done with extra muscle effort on purpose. ASHA describes it this way: to perform an effortful swallow, the patient is instructed to swallow hard while pushing hard with the tongue against the hard palate — the firm front part of the roof of the mouth.

The goal is more force behind the food or liquid. ASHA notes that the effortful swallow is known to increase pressure from the tongue, increase pressure in the upper part of the throat, and improve tongue base retraction — meaning the back of the tongue pulling backward during the swallow. In practice, clinicians use it hoping less food or liquid is left behind in the throat afterward.

It shows up in two different roles, and a report may mean either one. It can be a strategy used during meals, bite by bite, or an exercise done as repetitions to build strength over time. Which one applies to a given person is a clinical decision, and ASHA points out that some maneuvers require following multistep directions and may not be appropriate for patients with cognitive impairments.

An SLP considers an effortful swallow when the concern is food or liquid staying behind in the throat rather than moving through. Seeing it in your report means it was part of the clinical thinking about your swallow — your SLP may teach it to you, with instruction on how hard, how often, and with what. It is not something to add on your own from a written description.