On this episode of The Swallow Your Pride Podcast, Theresa sits down with Paige DiStefano, MS, CCC-SLP, a speech-language pathologist and PhD candidate at McMaster University’s Aging Swallow Research Lab. Paige walks through her research on FEES implementation in an acute care hospital that already had regular access to video fluoroscopy, and what the data showed when FEES came back online after the equipment was down for over a year. VFSS volume held steady. Total instrumental exam volume increased by 25%. ICU instrumental exam completion more than doubled, from 7.1% to 15.1%. And for ICU patients, FEES was completed in a mean of 1.2 days compared to 2.3 days for VFSS. Theresa and Paige dig into the “weekend effect” and what it reveals about modifiable barriers in dysphagia care delivery, how SLPs can use this kind of data to make the institutional case for FEES access, why early and imperfect FEES programs can still produce meaningful results, and why the fear around FEES training may be getting in the way of patients receiving timely care.
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Paige DiStefano, MS, CCC-SLP, is a speech-language pathologist and PhD candidate in the Aging Swallow Research Lab at McMaster University. Her research examines dysphagia in people living with dementia, with a focus on caregiver experiences and accessibility. Through her work, she aims to identify where swallowing care systems fall short and develop equitable knowledge translation resources.
https://www.linkedin.com/in/paigedistefano/
Instagram: @paigeslp
References:
Allen, H. E., Reynolds, J. E., & Morrell, A. L. (2025). Launching a FEES program (PD103036) [Professional development course]. ASHA Learning Pass. https://stream.asha.org/launching-a-fees-program
American Speech-Language-Hearing Association. (n.d.). Flexible endoscopic evaluation of swallowing (FEES) [Practice Portal]. Retrieved May 5, 2025, from https://www.asha.org/practice-portal/resources/flexible-endoscopic-evaluation-of-swallowing/
Langmore, S. E., Scarborough, D. R., Kelchner, L. N., Swigert, N. B., Murray, J., Reece, S., Cavanagh, T., Harrigan, L. C., Scheel, R., Gosa, M. M., & Rule, D. K. (2022). Tutorial on clini-cal practice for use of the fiberoptic endoscopic evaluation of swallowing procedure with adult populations: Part 1. American Journal of Speech-Language Pathology, 31(1), 163–187. https://doi.org/10.1044/2021_AJSLP-20-00348
Miller, C. K., Reynolds, J., Kelchner, L. N., Scarborough, D., Langmore, S., & Gosa, M. (2023). Tutorial on clinical practice for use of the fiberoptic endoscopic evaluation of swallowing procedure with pediatric populations: Part 2. American Journal of Speech-Language Pathology, 32(1), 55–82. https://doi.org/10.1044/2022_AJSLP-22-00057
Pisegna, J. M. (2022). What’s the evidence? A commentary on FEES research. Perspectives of the ASHA Special Interest Groups, 7(6), 1941–1959. https://doi.org/10.1044/2022_PERSP-22-00128
