Bridging Voice and Swallowing: A Qualitative Study on Speech-Language Pathologist Perspectives of Integrated Therapy

Despite overlapping anatomical foundations, voice and swallowing disorders are often treated separately in clinical practice. This study aimed to explore how speech-language pathologists (SLPs) conceptualize the physiological and therapeutic overlap between these domains, apply integrated strategies in clinical care, and navigate systemic and institutional barriers. Through qualitative analysis of clinician perspectives, we identified factors shaping the use of cross-system approaches.

This qualitative analysis involved semistructured interviews with 25 experienced clinicians working with voice and swallowing disorders in clinics, hospitals, and private practices. The interviews were audio-recorded, transcribed, and analyzed using NVivo software. A hybrid thematic approach combined deductive codes from the interview guide with inductive codes from the data, aiming to identify key themes related to therapeutic integration and system-level influences.

Clinicians recognized a significant anatomical and functional overlap between voice and swallowing. Fifteen themes emerged, grouped into four domains: (a) Perspectives on Integrating Voice and Swallowing Therapy; (b) Implementing Integrated Therapy; (c) Barriers to Integration; and (d) Expanding Education, Research, and Institutional Support. Although various dual-purpose strategies were described, their use was inconsistent. Key challenges included reimbursement policies favoring one modality, segmented training that reinforces clinical silos, and limited interdisciplinary collaboration.

Although SLPs recognize the overlap between voice and swallowing, systemic, educational, and policy-level barriers limited consistent integration. Addressing these challenges through training reform, institutional support, and stronger research-practice collaboration may enhance access to comprehensive care for patients with co-occurring disorders.