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How to assess automation of secondary swallowing?
Assessing automation is tricky since the patient shouldn't realize they're being evaluated. Dr. Fellus, the appliance's inventor, suggests three techniques:
Hidden Observation:
Observe the patient when they're unaware, such as in the waiting room or during casual conversation. Spot 'a swallowing moment' and determine if they use primary or secondary swallowing.
Distraction
Use a screen or another attention-capturing method to ensure the device is properly worn and to catch spontaneous swallows. Parents can also use this technique for daily monitoring.
Speech:
Tongue posture during speech is hard to control consciously. A well-retrained tongue should stay within the dental arches and avoid contact with labial mucosa, unlike in primary swallowing.
