- Lower Glasgow Coma Score (3-5) (Morgan & Mackay, 1999)
- Presence of a tracheostomy.
- Poor cognitive or cognitive-communication functioning.
- Hypoactive gag reflex.
- Prolonged period of mechanical ventilation (Morgan & Mackay, 1999).
- Reduced pharyngeal sensation.
- Brainstem involvement.
- Difficulty swallowing oral secretions.
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- Coughing/throat clearing or wet/gurgly voice quality after swallowing water.
- Choking more than once while drinking 50 ml of water.
- Weak voice and cough.
- Wet-hoarse voice quality.
- Recurrent lower respiratory infections.
- Low-grade fever or leukocytosis.
- Auscultatory evidence of lower lobe congestion.
- Immunocompromised state.
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