The mission of the SSR Lab is generate research that will translate into low-cost, efficient assessment tools, and interventions to improve respiratory support for speech and swallowing in adults with neurologic disorders.



The Effect of Intervention for Vocal Fold Immobility on Cough Effectiveness

Vocal fold immobility (VFI) is a common condition characterized by reduced movement of one or both vocal folds. This condition can lead to a weak voice, fatigue with speaking, difficulty swallowing, and a weak cough. The impact of intervention for VFI on voice quality has been well studied, but little is known about the impact on the ability to effectively cough. In this study, we compare objective measures of cough effectiveness and vocal fold kinematics in patients before and after intervention for VFI.  

The Impact of Noninvasive Positive Pressure Ventilation (NPPV) on Speech and Swallowing

Use of noninvasive positive pressure ventilation (NPPV) to provide ventilatory support without the need for a tracheostomy has been on the rise for more than a decade. This project involves analysis of qualitative interviews with individuals who require use of NPPV in order to gain insights into the benefits and challenges of speaking and swallowing with NPPV. 

Utility of Airflow Measures in Predicting Risk of Aspiration in Neurologic Populations

Breathing-swallowing coordination (BSC) and the ability to cough are essential lung defenses. Difficulty with the ability to swallow (dysphagia) and/or cough (dystussia) is associated with respiratory compromise. Dysphagia is common in individuals diagnosed with amyotrophic lateral sclerosis (ALS). In ALS, both cough and BSC may become impaired due to progressive involvement of the respiratory and/or bulbar (speech & swallowing) musculature. This project examines associations between BSC and cough-related airflow meaures and risk of aspiration in individuals with ALS.

Academy of Neurologic Communication Disorders & Sciences (ANCDS) project: Behavioral Management of Respiratory/Phonatory Dysfunction in Dysarthria. Volume I. A Systematic Review of Evidence in Neurodegenerative Disease

The mission of ANCDS is to enhance the communicative lives of people affected by neurologic disorders, and to ensure that every person affected by neurologic communication disorders receives the highest quality clinical services. As part of this mission, ANCDS assembles professional teams to develop professional practice publications to guide evidence-based intervention decisions. Dr. Britton currently chairs the ANCDS Dysarthria Writing Committee and is working with collaborative team to complete the above referenced systematic review.

Impact of Testosterone on Respiratory System for Voice in Transgender Individuals

This pilot study examines the impact of testosterone therapy, as part of medical treatment to align gender identity, on measures of respiration and voice. The primary outcomes of interest that we will be collecting pilot data on are respiratory volume and strength, reflected by measures of forced vital capacity (FVC), maximum inspiratory pressure (MIP), and maximum respiratory pressure (MEP).



Yorkston, K.M., Miller, R.M., Strand, E.A. & Britton, D. (2012).  Management of Speech and Swallowing Disorders in Degenerative Diseases (3rd ed.).  Pro-Ed., Inc., Austin, TX.


Miller, R. & Britton, D. (2011).  Dysphagia in Neuromuscular Disease.  Plural Publishing, Inc., San Diego, CA.


Book Chapters

Miller, R. & Britton, D. (2010).  Progressive Bulbar Palsy (PBP).  In Jones, H.N. & Rosenbek, J.C. (Editors).  Dysphagia in Rare Conditions, Plural Publishing, Inc., San Diego, CA.

Britton D., & Baarslag-Benson, R. (2007).  Spinal Cord Injury. In Beukelman DR, Garrett KL, Yorkston KM. (Editors), Communication Strategies for Adults with Acute or Chronic Medical Conditions, Paul H. Brookes Publishing Co., Baltimore, Maryland.

Refereed Publications 

Britton, D., Hoit, J.D., Pullen, E., Benditt, J.O., Baylor, C.R., & Yorkston, K.M. (2019). Experiences of speaking with noninvasive positive pressure ventilation (NPPV): A qualitative investigation.  American Journal of Speech-Language Pathology (AJSLP), 28(2S): 784-792.


Britton, D., Hoit, J.D., Poon, J., Hansen, M., Benditt, J.O., Baylor, C.R., & Yorkston, K.M. (2019). Swallowing with noninvasive positive pressure ventilation (NPPV). Dysphagia. Advance online publication. doi: 10.1007/s00455-019-09997-6


Palmer, A.D., Bolognone, R.K., Thomsen, S., Britton, D., Schindler, J., & Graville, D.J. (2018). The safety and efficacy of expiratory muscle strength training (EMST) for rehabilitation after supracricoid partial laryngectomy: A pilot investigation. Annals of Otology, Rhinology & Laryngology, 128(3), 169-176. doi:10.1177/0003489418812901


Britton, D., Karam, C. & Schindler, J. (2018).  Swallowing and secretion management in neuromuscular disease.  Clinics in Chest Medicine, 39, 449-457.


Britton, D., Roeske, A., Ennis, S. K., Benditt, J. O., Quinn, C., & Graville, D. (2018). Utility of Pulse Oximetry to Detect Aspiration: An Evidence-Based Systematic Review. Dysphagia, 33(3), 282-292. DOI 10.1007/s00455-017-9868-1  


Yorkston, K.M., Baylor, C.R. & Britton, D. (2017).  Speech versus speaking: The experiences of people with Parkinson’s disease and implications for intervention. American Journal of Speech-Language Pathology, Vo. 26 (2S): 561-568.  DOI 10. 1044/2017_AJSLP-16-0087.


Britton, D., Hoit, J.D. & Benditt, J.O. (2017).  Dysarthria of spinal cord injury (SCI) and its management.  Seminars in Speech and Language, Vol 38 (3): 161-172. DOI 10.1055/s-0037-1602835.


Yorkston, K.M., Baylor, C.R. & Britton, D. (2017).  Incorporating the principles of self-management into treatment of dysarthria associated with Parkinson’s Disease.  Seminars in Speech and Language, Vol. 38 (3): 210-219. DOI 10.1055/s-0037-1602840.


Britton, D., Benditt, J.O. & Hoit, J.D. (2016).  Beyond tracheostomy - Noninvasive ventilation and potential positive implications for speaking and swallowing.  Seminars in Speech and Language, Vol 37(3): 173-84. DOI 10. 1055/s-0036-1583545.


Britton, D. (2016).  The impact of aging and progressive neurological disease on swallowing:  A concise overview. Journal of Texture Studies, Online 25 APR 2016, DOI 10.1111/jtxs.12189.


Britton, D., Benditt, J.O., Merati, A.L., Miller, R.M., Stepp, C.E., Boitano, L., Hu, A., Ciol, M.A., & Yorkston, K.M. (2014).  Associations between laryngeal and cough dysfunction in motor neuron disease with bulbar involvement. Dysphagia, Vol. 29: 637-646.  DOI 10.1007//s00455-014-9554-5.

Britton, D., Yorkston, K.M., Eadie, T., Stepp, C.E., Ciol, M., Baylor, C., & Merati, A.L. (2012).  Endoscopic assessment of vocal fold movements during cough. Annals of Otology, Rhinology and Laryngology, Vol. 121:  21-27.

Hanson, E., Yorkston, K.M. & Britton, D. (2011).  Dysarthria in amyotrophic Lateral Sclerosis:  A systematic review of characteristics, speech treatment and AAC options.  Technical Report Number 7, Academy of Neurologic Communication Disorders and Sciences.  Journal of Medical Speech Pathology, Vol. 19, No 3: 12-30.

Baylor, C., Burns, M., Eadie, T., Britton, D., & Yorkston, K. (2011).  A qualitative study of interference with communication participation across communication disorders in adults.  American Journal of Speech-Language Pathology, Vol. 20: 269-287. **Winner of the ASHA 2011 Editors’ Award for the article of highest merit in AJSLP.

Baylor, C., Yorkston, K., Bamer, A., Britton, D. & Amtmann, D. (May 2010).  Variables associated with communication participation in people with multiple sclerosis:  A regression analysis. American Journal of Speech-Language Pathology, Vol. 19: 143-153.

Britton, D., Goldstein, B., Jones-Redmond, J., & Esselman, P. (2005).  Case Report: Baclofen pump intervention for spasticity affecting pulmonary function.  Journal of Spinal Cord Medicine, Vol 28; No 4:343-347

Britton, D., Jones-Redmond, J., & Kasper, C. (2001).  The use of speaking valves with tracheostomized and ventilator-dependent patients.  Current Opinion in Otolaryngology & Head and Neck Surgery, Vol. 9:147-152.

Non-Refereed Publications 

Britton, D., Cleary, S. & Miller, R. (March 2013).  What is ALS and what is the philosophy of care?  Perspectives on Swallowing and Swallowing Disorders, American Speech-Language-Hearing Association, Division 13, Vol 22; No 1:4-11.  DOI: 10.1044/sasd22.1.4.


Miller, R. & Britton, D. (2007)  Experience With Amyotrophic Lateral Sclerosis:  Incidence, Pathology, and Treatment Considerations.  Perspectives on Gerontology, American Speech-Language-Hearing Association, Division 15, Vol 12:17-22. DOI:10.1044/gero12.1.17.



Selected Conference Proceedings 

Britton, D., Benditt, J.O., Poon, J., Baylor, C.R., Yorkston, K.M. & Hoit, J.D. (March 2-4, 2017).  Swallowing with noninvasive positive pressure ventilation (NPPV) in individuals with muscular dystrophy.  Proceedings from the Dysphagia Research Society 25th Annual Meeting, Portland, Oregon.


Britton, D., Lederle, A., Ennis, S.K., Benditt, J.O., Quinn, C. & Graville, D. (March 2-4, 2017).  Utility of pulse oximetry in detecting aspiration – Evidence based systematic review. Proceedings from the Dysphagia Research Society 25th Annual Meeting, Portland, Oregon.


Britton, D., Merati, A., Benditt, J., Stepp, C., Hu, A., Miller, R., & Yorkston, K. (March 13-16, 2013).  Associations between laryngeal and cough dysfunction in motor neuron disease (MND). Proceedings of the Dysphagia Research Society 21st Annual Meeting, Seattle, Washington.


Britton, D., Merati, A., Benditt, J., Stepp, C., Max, L., & Yorkston, K. (March 7-12, 2012).  Associations between vocal fold movements and peak expiratory cough flow in healthy middle-aged adults:  Preliminary analyses. Proceedings of the Dysphagia Research Society 20th Annual Meeting, Toronto, Ontario, Canada.


Stepp, C.E., Britton, D., Chang, C., Merati, A., & Matsuoka, Y. (April 27 – May 1, 2011).  Feasibility of game-based electromyographic biofeedback for dysphagia rehabilitation.  Proceedings of the 5th International IEEE EMBS Conference on Neural Engineering of the IEEE Engineering in Medicine and Biology Society, Cancun, Mexico.  **Winner of the NSF Neural Engineering Travel Award

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