Strategies & exercises

Multiple swallows (dry swallow / clearing swallow)

Also written as dry swallow, clearing swallow, double swallow, repeat swallow, second swallow, extra swallow.

Swallowing again after a bite or sip, with no new food, to help clear anything left behind in the throat.

A dry swallow is a swallow done with an empty mouth. When one is added right after a bite or sip, the idea is to move along anything still sitting in the throat. Research on swallowing uses the term "clearing swallow" for exactly this: published work in a peer-reviewed journal describes clearing swallows of pharyngeal residue that happen without the addition of new material from the mouth.

The thing being cleared is called residue — food or liquid that stays behind in the small pockets of the throat after the swallow finishes, rather than passing on to the esophagus. Adding a second (or third) swallow is one of the simplest approaches a clinician can try, which is part of why it is common.

One thing that confuses people: the same words can appear in a report as an observation rather than as a plan. "Multiple swallows" may describe something the clinician saw — that a person needed more than one swallow to get a single bite down — or it may describe a strategy being recommended. If it is not clear which one your report means, that is a good, specific question to ask the person who wrote it.

An SLP pays attention to what is left behind after the swallow, not just what happens during it, because residue is part of how efficient a swallow is. If extra swallows show up in your report, ask your SLP which meaning applies to you. Your SLP may teach this as a strategy — how many extra swallows, and with what — rather than it being something to start on your own.