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Metadegluttion

Metadeglutition is a new term coined by speech-language pathologist Paul M. Evitts, Ph.D., to refer to the potential need for people to consciously attend to their swallowing ability. The term was published in an article titled “Metadeglutition? Rate of aspiration-related events in healthy females using a novel data collection app” in Perspectives of the ASHA Special Interest Groups. Per the article, metadeglutition “is loosely defined as the thinking about swallowing” or more specifically, defined as “the ability to accurately process and attend to the sensory and motor experiences associated with eating and swallowing” (p. 461, Evitts, Fields, & Lande, 2021).  

The concept of metadeglutition was based on the results of their study which showed that healthy females experienced a higher-than-expected rate of aspiration while eating and drinking.  Aspiration is more colloquially known as food or liquid going ‘down the wrong pipe’ or into the respiratory system. The study adds to a recent spotlight on understanding the typical (normal) swallow so as to better be able to define what constitutes disordered swallowing which is defined as dysphagia. Historically, the presence of aspiration in any person was typically considered as disordered but this view is being reconsidered and a better understanding of the typical swallow is being offered with new research.  

 

Evitts and colleagues (2021) created an app which participants downloaded onto their smartphones and were instructed to access when they experienced a problem with their swallow. A total of 69 healthy female participants (aged 18-39 years) used the app across 95 consecutive days. Participants were asked to use an app on their cellphones to record the frequency of aspiration-related events and the environmental circumstances in which they occurred. They were to answer three questions after any of these events in order to determine how often they occurred and a potential reason why they occurred.  

 

Overall results showed that 53 of the 69 (76.8%) participants reported coughing or choking, 43 (62.3%) reported clearing their throat, 19 (27.5%) reported a globus sensation, and 14 (20.2%) reported difficulty initiating a swallow. The common circumstances with these related events were talking, being distracted, and using an electronic device. These results show that aspiration events commonly occur in young, healthy adults and mostly occur during activities that require dual attention.

Results of the study suggest that healthy people may experience difficulties eating and drinking more often than what is considered as ‘normal’ and that researchers should address the issue of ecological validity in their data collection procedures. Ultimately, the issue of metadeglutition may be important as people age. That is, people may need to pay more attention to their swallow as they get older to reduce the potential of food or liquid ‘going down the wrong pipe’.  

Further Reading

Deglutition