Which of the following is NOT a compensatory swallowing strategy used to reduce aspiration risk?

• A. Chin-tuck (chin-down)
• B. Head-turn toward the weaker side
• C. Swallowing a large bolus before the meal
• D. Supraglottic swallow

Answer: (C)

Compensatory swallowing strategies protect the airway during swallow by altering posture, how the swallow is performed, or how the bolus is managed. The chin-tuck (chin-down) posture helps by narrowing the airway entrance and guiding the bolus in a way that improves airway protection during the swallow. Turning the head toward the weaker side biases the bolus away from the impaired side and can enhance laryngeal closure on the remaining strong side, reducing penetration or residue. The supraglottic swallow involves a breath-hold before and during the swallow to voluntarily protect the airway by closing the vocal folds, then swallowing and sometimes coughing to clear any material—this adds a safeguard against aspiration.

Swallowing a large bolus before the meal isn’t a compensatory strategy to reduce aspiration risk; it doesn’t modify the swallow to protect the airway and can actually increase residue or risk of coughing and aspiration.