How To Do An Effortful Swallow

How To Do The Effortful Swallow

  1. Sit up straight
  2. Gather saliva in your mouth or take a sip of water
  3. Swallow while squeezing your throat as hard as you can (pretend that you’re swallowing a whole grape)
  4. Repeat to fatigue (or in sets of 5-10 swallows, as appropriate)

You can also prompt patients to press their tongue hard against their palate as they swallow.

If your patient is NPO, the effortful swallow can be done without a bolus.

For premade dysphagia handouts and treatment guides, check out The Adult Speech Therapy Starter Pack!

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About The Effortful Swallow

how to do an effortful swallow

The effortful swallow is a swallowing strategy. Its goal are to: keep food or liquid from getting stuck in the throat when eating or drinking, to clear any residue, and to protect the airway.

It aims to do this by:

  • Increasing orolingual and upper pharynx pressure
  • Improving tongue base retraction and
  • Increasing the duration of a swallow (total swallow time, laryngeal vestibule closure, hyoid maximum anterior excursion, upper esophageal sphincter opening)

The effortful swallow can also be used as an exercise to increase the strength, speed, and endurance of swallowing muscles.

When To Use The Effortful Swallow

effortful swallow

Use the effortful swallow with the following signs of dysphagia:

  • Reduced epiglottic movement
  • Post-swallow residue (base of tongue, valleculae, posterior pharyngeal wall)
  • Laryngeal penetration
  • As an exercise to improve swallowing strength, speed, and endurance


  • American Speech-Language-Hearing Association. (n.d.). Adult Dysphagia. (Practice Portal). Retrieved Feb, 10, 2023, from
  • Bahia, M. M., & Lowell, S. Y. (2020). A Systematic Review of the Physiological Effects of the Effortful Swallow Maneuver in Adults With Normal and Disordered Swallowing. American journal of speech-language pathology29(3), 1655–1673.
  • Fukuoka, T., Ono, T., Hori, K., & Kariyasu, M. (2022). Effects of Tongue-Strengthening Exercise on Tongue Strength and Effortful Swallowing Pressure in Young Healthy Adults: A Pilot Study. 65 (5), 1686-1696.…
  • Huckabee, M. L., & Steele, C. M. (2006). An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Archives of physical medicine and rehabilitation87(8), 1067–1072.

Patient Handouts

For evidence-based patient handouts, worksheets, templates, and much more, check out The Adult Speech Therapy Starter Pack!

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