Super-Supraglottic Swallowing: Perform 10 sets at 3 times per day before eating with only saliva or with pureed foods to strengthen muscles in mouth and tongue and facilitate airway closure while swallowing to make swallowing more effective during the oral stage. This maneuver works by increasing tongue pressure on the hard palate of the mouth (Fujiwara, Ono, Minagi, Fujiu-Kurachi, Hori, Maeda, & Bohlender, 2014).
Grade up: perform super-supraglottic swallowing while eating food during mealtimes. Foods may be pureed and eventually presented as solid food. More repetitions may be added as endurance is improving.
Grade down: perform super-supraglottic swallowing with saliva in mouth to avoid aspiration and work up to this type of swallowing with pureed foods.