SwallowStudy & Associates, LLC is an industry leader in the field of swallowing and swallowing disorders (dysphagia) and dysphagia expert witness work.

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A Dysphagia Resource for Professionals and People with Difficult Swallowing


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What is Dysphagia?

Dysphagia is the medical term for difficulty swallowing. It is when people have trouble moving food, liquid, pills or even saliva out of the mouth, through the throat and esophagus (food tube), and into the stomach.

SwallowStudy.com Blog

Dysphagia Digest: Why DRS?

Dysphagia Digest: Why DRS?

DRS Digest 2024: Why DRS ~ Part 1 by Karen Sheffler, MS, CCC-SLP, BCS-S of SwallowStudy.com Introduction to Why DRS Almost 400 people gathered in San Juan Puerto Rico this March from 22 different...

Resources and Services We Offer

Central place to guide people with dysphagia, their caregivers, and clinicians through the online world of information and services to enhance person-centered care.

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General and Clinical Resources

Medical speech-language pathologist provides litigation support for plaintiffs and defendants in cases related to adult swallowing and swallowing disorders (dysphagia), aspiration, and choking

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Medical Expert Witness

Expert-opinion on dysphagia products for industry & collaboration with organizations that promote dysphagia awareness and provide support for people with dysphagia and their caregivers.

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Industry & Organization Support

About Karen Sheffler, MS, CCC-SLP, BCS-S

I graduated from the University of Wisconsin-Madison in 1995 with a master’s degree in Speech-Language Pathology. There, I was influenced by great mentors in the field of swallowing and swallowing disorders (dysphagia) like Jay Rosenbek, JoAnne Robbins, and James Coyle. Once the “dysphagia-bug” bit, I have never looked back. Initially, I worked in skilled nursing facilities and rehabilitation centers, but since 1999 I have been in acute care. I obtained my Board Certification as a Specialist in Swallowing and Swallowing Disorders (BCS-S) in August of 2012. I am committed to life-long-learning. I was awarded my 10th ASHA Award for Continuing Education (ACE Award) in May 2024. I am committed to increasing public awareness in dysphagia. I was awarded the Hormel Health Hero Award in 2019. I am a member of the Dysphagia Research Society (DRS), the American Speech-Language Hearing Association’s Special Interest Group 13: Swallowing and Swallowing Disorders, and the National Foundation of Swallowing Disorders (NFOSD), and the International & US IDDSI Reference Groups. I am co-chair of the Public Relations & Communications Committee of the American Board of Swallowing & Swallowing Disorders, and I was elected to the board for the 2023-2025 term. 

I started SwallowStudy.com in May 2014 to create a valuable evidence-based dysphagia resource for professionals and people with difficulty swallowing (dysphagia). I formed SwallowStudy & Associates, LLC in December 2023.


Presenting at ASHA2023 on Litigation Mitigation!

Karen presented with her acute care colleague, Ana Garrido White, at ASHA in November, 2023 in Boston.

Ana shared from the heart about how she used to really worry about litigation in her dysphagia practice, even when she knew she was practicing within acceptable standards. After talking with Karen about all the ways to practice well and document thoroughly, she now has reduced fear and does not practice defensively or overly conservatively. She and the audience learned that when we practice with a person-centered and evidence-based approach, along with communicating well and documenting details, we don’t have to fear litigation. Karen and Ana turned this experience into a very well received 1 hour presentation for SLPs at ASHA.

Let us know if we can do the same for your organization!


The United States IDDSI Reference Group (USIRG) presented at ASHA in November, 2023 in Boston to provide solutions to overcome any barriers to IDDSI implementation.

Please always refer to our chart of resources: https://iddsi.org/United-States

We update that often. You may find your answers in our videos, handouts, FAQs, and more, but if not:

Go to the USIRG chart –> Email Best Practices group if you have implementation questions


Tips for Dysphagia During the Holidays

Do you need help managing your or your loved one’s dysphagia at home during the holidays or any time of year? SwallowStudy.com and Hormel Health Labs (HHL) teamed up to provide help and support for those who struggle with difficulty swallowing (dysphagia). We also collaborated with the National Foundation of Swallowing Disorders (NFOSD) and IDDSI!

  1. Recent blog with many recipes: It’s Party Time!
  2. Check out this HHL article: Tips for Managing Dysphagia at Home During the Holidays
  3. IDDSI.orgNational Foundation of Swallowing Disorders webinar December 2, 2021: Celebrating the Holidays with Dysphagia. See the full webinar on IDDSI’s YouTube Chanel here.
  4. That talk by the dietitian Laura Michaels provided these two terrific handouts:
    1. The Purees of Fall: The Holiday Meal, by Diane Wolff (Author of Essential Puree – The A to Z Guidebook and EssentialPuree.com
    2. Making Holiday Meal Safer for those with Swallowing Difficulties (dysphagia), by Laura Michael of Dysphagia Solutions.

Dysphagia Outreach Project

Karen met Hillary Cooper, MA, CCC-SLP (co-founder of Dysphagia Outreach Project) at ASHA2021. That started SwallowStudy.com’s sponsorship of The Dysphagia Outreach Project – with donations in 2021 and 2022. They are an incredible 100% volunteer-run organization that is dedicated to providing assistance to individuals and families with swallowing disorders across the lifespan. You can apply for assistance from their food bank today.

To reach out to become a sponsor, please contact the Dysphagia Outreach Project at this link. Companies can learn more about donating food, drinks, and equipment supplies here. 

To provide a financial donation of any amount to support people who struggle daily with food insecurity in addition to dysphagia, click here. 

United States IDDSI Reference Group (USIRG)

The United States IDDSI Reference Group (USIRG) has been hard at work since 2020. IDDSI is the International Dysphagia Diet Standardization Initiative — a global wave to standardize dysphagia diets for the safety of people with dysphagia. I have been blogging about IDDSI since 2014, and now I am actively co-creating resources in our USIRG chart at IDDSI.org to foster the implementation of the IDDSI framework around the world. I am a member of the Resources & Best Practice and the Implementation & Advocacy work groups.

Join the excitement! The world has reached a consensus on how to label, describe/define, and test foods and liquids within dysphagia diets. It has been truly inspiring meeting people from around the world (over 40 different countries) who are forming reference groups to launch IDDSI in their countries. We are all now speaking the same language and can avoid the errors of the past with vague diet labels and descriptions! Don’t take my word for it: Check out this video where people recorded “Why I IDDSI!” (presented at the Food & Nutrition Conference & Expo, 2021).

Caring For Caregivers Discussion with Researchers & Clinicians

Karen Sheffler, MS, CCC-SLP, BCS-S & Yvette McCoy, MS, CCC-SLP, BCS-S (on behalf of the American Board of Swallowing and Swallowing Disorders) hosted a live discussion for June’s Dysphagia Awareness Month. AB-SSD’s focused on caring for caregivers. Go to @BCSSwallowing on Facebook for the recording (June 18th, 2020). Listen to Dr. Ashwini Namasivayam-MacDonald, PhD, CCC-SLP, SLP(C), Reg. CASLPO & Dr. Samantha Shune, PhD, CCC-SLP who researched caregiver burden when a loved one has difficulty swallowing (dysphagia). Listen for tips for what clinicians can do to reduce caregiver burden.

Make sure you scroll down on @BCSSwallowing to April 24, 2020 to see the Facebook Live Event with Dr Georgia Malandraki, PhD, CCC-SLP, BCS-S on Telehealth recommendations for dysphagia evaluation and management. See also May 2022 for Dr. Bonnie Martin-Harris’ discussion of the importance of SLPs having their advanced certification as board certified specialists in swallowing. (Find a BCS-S swallowing specialist here).

Giving Back to Graduate School Students

  1. Educators and students have endured extreme challenges during this COVID-19 pandemic. Thank you to Dr. Jamie Fisher, PhD, CCC-SLP, from Western Kentucky University, for inviting me to share tips and resources during her medical speech-language pathology course. Read more and hear from these resilient graduate school students in this blog. 

Free IDDSI Webinars

Karen’s IDDSI Presentations:

1. BeckyDorner.com, providing the following 2 FREE webinars, brought to you by Hormel Health Labs. Learn more about IDDSI by listening to both of the webinars at: https://www.beckydorner.com/hormelhealthlabs/

Webinar 1: The International Dysphagia Diet Standardisation Initiative: The Who, Why, What & How

Webinar 2: Teamwork From Regulatory Requirements to Successful Implementation Webinar

2. NEW 15-20 minute IDDSI Training Modules at Hormel Health Labs:

Sign up for free inservice training series for your staff and get test kits to test foods and liquids IDDSI-style! https://www.hormelhealthlabs.com/resources/for-healthcare-professionals/in-service-training-series-iddsi-testing/

A True IDDSI Champion

Karen is an IDDSI Champion and has been writing blogs and lecturing about IDDSI to raise awareness since 2014. Karen is pictured here again with Peter Lam, RD, CFE, Co-Chair of IDDSI (Note: Peter’s co-chair is Dr Julie Cichero, BA, BSpThy(Hons), PhD, who is a Speech-Language Pathologist in Australia).

Karen is displaying a colorful IDDSI informational poster. Go to www.IDDSI.org/Resources/ to download your own IDDSI posters, Powerpoints and more.

Iddsi launched in the US May 1, 2019. See this launch date advertised at the Dysphagia Research Society meeting in 2019 by Karen Sheffler (of SwallowStudy.com) and Peter Lam (an IDDSI co-chair).

Dysphagia Research Society (DRS) annual conference May 2019

Karen attended the Dysphagia Research Society’s (DRS) annual conference March 6-9, 2019. In spring 2020, she completed her 2 year term on the DRS Website, Communications, and Public Relations Committee, which assisted with fundraising and social media promotion for the event. This global conference drew people to San Diego, CA from 24 different countries. Karen had thousands of people following her 85+ live tweets, helping to connect the global dysphagia community of clinicians and researchers. Karen has also been promoting the International Dysphagia Diet Standardization Initiative (www.IDDSI.org) for years, and she is seen here at the IDDSI booth at the 2019 DRS conference with the IDDSI co-chair, Peter Lam. RD, CFE.


IDDSI / USIRG booth at ASHA2021!

There just had to be an IDDSI booth at our first in-person ASHA convention since the start of the pandemic. I organized this booth along with my fellow USIRG members.

ASHA is the American Speech-Language & Hearing Association, and typically a convention will draw over 15,000 speech-language pathologists. There were over 5,000 in-person and over 5,000 virtual attendees.

ASHA has been a long-time supporter of IDDSI, and we are so grateful that ASHA provided us this booth for free in the exhibit hall! We had a blast sharing IDDSI with students, clinicians, professors, and industry. All left with IDDSI posters, IDDSI Flow Test Cards, IDDSI Food Test Cards, and IDDSI approved 10ml syringes for the IDDSI Flow Test (donated by BD!).

Follow @IDDSI on Instagram to see more photos! Thank you!

JUNE is National Dysphagia Awareness Month

June is National Dysphagia Awareness Month in the United States! Check out Karen’s posts on her Twitter and Facebook pages (@SwallowStudySLP). Read more about Dysphagia Awareness Month here.

In 2019, she posted over 70 times to raise awareness during the month of June.

In 2020, follow Karen’s posts @BCSSwallowing on Facebook & Twitter. (Karen is co-chair of the public relations committee for the American Board of Swallowing and Swallowing Disorders/ABSSD). The ABSSD did a “Caring for Caregivers” Series (see infographic gallery here) with infographics honoring caregivers across the lifespan! Additionally, follow hashtags: #DysphagiaAwareness and #Dysphagia across social media every June.

Read more about #dysphagia with this article on RightAtHome.net, written after interviewing Karen Sheffler (in 2019): https://www.rightathome.net/blog/dysphagia-difficulty-swallowing-in-older-adults

ASHA COVID-19 Updates / Telepractice

Speech-Language Pathologists and related healthcare providers can stay on top of COVID-19 recommendations by the American Speech-Language & Hearing Association’s (ASHA) by visiting the www.ASHA.org website often. This is a quickly changing pandemic and crisis.

Important Resources: 

  1. ASHA, SIG13 (Special Interest Group for Swallowing and Swallowing Disorders) posted these SLP Resources on COVID19 & Telepractice (PDF)
  2. Stay up-to-date on ASHA.org: https://www.asha.org/About/Coronavirus-Updates/

Reframing Documentation with a Person-Centered Approach

WEBINAR:  Karen Sheffler and Yvette McCoy are two board certified specialists in swallowing and swallowing disorders who have created this in depth look at how to perform good documentation that is person-centered and targeted to the individual. (November, 2021)

Go to Karen’s homepage on Medbridge Education here learn more: https://www.medbridgeeducation.com/a/karen-sheffler-swallow-study

When you sign up for the course through this link, you will receive a discount on your purchase while supporting our work! Thank you!

Webinar Recording Now Available! More than Oral Care – Let’s Talk Oral Infection Control

Download FREE webinar: https://swallowingdisorderfoundation.com/webinar-oral-care/ on Oral Infection Control.

Learn why #oralinfectioncontrol is more than #oralcare & comfort. Of course, we are always deeply concerned with the comfort of people while in healthcare institutions, AND now we need to view cleaning their mouth (#oralhealth) as much more! It is an infection control issue, as well as medical and ethical issues. We need to make oral health a top priority. Poor oral health has been a long under-evaluated and under-treated medical condition. To underscore that point, only 4% of our webinar participants on March 25, 2021 felt that the people they serve were receiving adequate oral cleaning! In this webinar, I share 50 years of research to support this oral health revolution that we need in medicine today. We need good mechanical deriding and brushing with suction toothbrushes (not swabs), and we also need to bring #dentistry back into healthcare facilities (#dentalhygienists).
I show how to start improving the evaluation and treatment of poor oral health. Decontamination of oral pathogens from the oral cavity can help restore a healthy #oralmicrobiome, improve the saliva’s immune properties, restore saliva’s ability to aide in the ease of swallowing, and PREVENT aspiration pneumonia and other medical issues. The time for change is now!

Hormel Health Labs Health Hero Award

Karen was the first recipient of the Hormel Health Labs Health Hero Award in May 2019!

Read the full article: Health Hero Advances Dysphagia Research – Hormel Health Labs

3D Printed Pharmaceuticals Summit

Karen presented at the first ever 3D Printed Pharmaceuticals Summit on November 8, 2018 in Livingston, NJ. She was invited to be on a panel titled: 3D Printing of Pharmaceuticals and Biologics to Address Unmet Medical Needs. The conference was sponsored by the Center for Medicine in the Public Interest (CMPI.org) and Aprecia – The 3DP Pharmaceutical Company (Aprecia.com).

Dysphagia is a significant unmet need in traditional drug manufacturing, as people struggle every day to safely swallow their medications. Please see Karen’s blog for more exciting information on how 3D printing will revolutionize what we think of as a finished drug product.

American Speech-Language & Hearing Association (ASHA) in Boston, MA

Karen spoke at the 2018 national convention of the American Speech-Language & Hearing Association (ASHA) in Boston, MA with Theresa Richard, MA, CCC-SLP, BCS-S from SwallowYourPride podcast. They advocated to revolutionize the old concept that the videofluoroscopic swallow study/VFSS (aka, modified barium swallow study) is the only gold standard for dysphagia evaluations. It is NOT a dichotomy between the two exams of the VFSS versus the FEES/Fiberoptic Endoscopic Evaluation of Swallowing. You choose the exam that best fits your clinical questions and hypotheses. You choose the exam that is best for the person with dysphagia. Karen coined the new term of a Platinum Standard of Personalized Medicine for Dysphagia.” This means that you are using a personalized medicine approach for your comprehensive dysphagia evaluations, targeting treatment to the individual’s needs. Read more on personalized medicine and precision medicine in Karen’s blog.

Online Dysphagia Seminars at Summit Education

Dysphagia courses now available online at Summit Professional Education.

I would have liked to call this: “Are You Ready for Dysphagia?” Are you asking yourself as an SLP: Do I want to do more medical speech pathology with adults with dysphagia? This course is a broad sweep across the field with screening, comprehensive dysphagia evaluation, and targeted treatment, as well as palliative care/ethical considerations. We also cover standardization of dysphagia diets and terminology with IDDSI. It is also excellent for SLPs of all experience levels who need to make sure they have the latest evidence-based practices and resources.

Speech Pathologists & Registered Dietitians Collaborating!

Karen attended the Academy of Nutrition and Dietetics’ (AND) Food and Nutrition Conference Expo (#FNCE17) for the first time. This was a great opportunity for collaboration between speech pathologists & registered dietitians, especially in the promotion of IDDSI and increasing patient safety with standardized dysphagia diets. Karen presented at the Hormel booth to raise awareness about the International Dysphagia Diet Standardization Initiative (IDDSI). Karen (middle) is here with Peter Lam, RD, CFE, Co-Chair of IDDSI (on left) and Tim R. Garry, RD, LD, Director of Marketing for Hormel Health Labs / Hormel Food Sales, LLC

Online Training & Webinars

With her clinical expertise, connections with researchers around the world and witty humor, bring Karen on to enrich your next conference, lecture series or webinar.


I used Ms. Sheffler as an expert on a nursing home choking death case. Her report was one of the best expert reports I have seen in thirty years of practice. The report was very helpful in getting the case resolved at mediation. She was quick and thorough with her work and it was a pleasure working with her.

Defense Attorney

That may seem like an insignificant gestures of outreach on your part have contributed so greatly to my professional growth in the past year already – that no amount of praise would be sufficient! The level of advocacy you offer and the breadth and depth of knowledge you possess on this topic is unfathomable.

Anthony Lewis, M.A., CCC-SLP

Thank you very much for your involvement in this case as an expert. Your report was very helpful in assisting the parties in settling the case.

Defense Attorney

Highly recommend Karen Sheffler’s VFSS courses on SpeechPathology.com! Karen’s presentation style was engaging and the information was in depth yet easy to understand. I gained functional knowledge that will improve my clinical decision-making in dysphagia.

Nina Ziemba, M.S., CCC-SLP

Karen’s ability to reach and educate professionals and the public from her review of current literature and conference proceedings helps us all!


Kaen has a wonderful way of synthesizing science for clinical audiences. Her ability to communicate clearly and apply scientific results to real challenges in the clinical world is extremely important and goes a long way to filling the knowledge translation gap that scientists face.

Dr Catriona M. Steele, Ph.D., CCC-SLP, BCS-S, S-LP(C), Reg. CASLPO, ASHA Fellow

Karen Sheffler is an inspiring clinician and colleague. As an expert in the area of swallowing disorders (dysphagia), she has contributed greatly to our profession. She has written informative evidence-based articles, summarizing and translating the latest research in a simple and easily comprehensible format for clinicians and researchers alike.

Rinki Varindani Desai, MS, CCC-SLP

Thank you for your presentation. Your extensive knowledge and sense of humor helped to advance the knowledge base of our attendees. It was an asset to the program.

A hospital-based Geriatrics Program Committee

I would like to personally thank you for taking the time to review this matter for us and for our client. Your willingness to devote your time to the review of this matter helped us to achieve an excellent resolution.

Defense Attorney

Karen Sheffler was a great speaker, educating our audience of Dietary Managers and Registered Dietitians on IDDSI. She is so easy to work with, and she provided many great additional online resources for the audience to get more information.

Mary Sell, MPA, RDN, LD, Menu Services Manager, Martin Bros. Dist. Co., Inc.