If you treat people with dysphagia and haven’t heard of the McNeill Dysphagia Therapy Program (MDTP) yet, buckle up, this could change your practice.
MDTP is a systematic, evidence-based swallowing therapy program that takes a functional, exercise-based approach to rehab. And yes, it’s the real deal.
Let’s walk through what MDTP is, why it matters, and how it’s different from the traditional “stick your tongue out 10 times” therapy model we all started with.
My Introduction to MDTP
Back in 2010, I attended a session at the ASHA convention in Philadelphia led by Dr. Michael Crary and Dr. Giselle Carnaby. Their research on MDTP showed better outcomes than traditional dysphagia therapy, and not just marginally better.
I was intrigued, and honestly, a little confused. Why hadn’t I heard more about this before?
Well, turns out there’s a reason for that…
Why All the Secrecy?
To become an MDTP provider, you must complete an official course and sign an agreement not to teach or distribute the program to others. Only trained, certified clinicians can officially use the MDTP protocol.
Why so strict?
Dr. Carnaby and Dr. Crary emphasize the need for consistency and clinical accuracy in administering MDTP. The integrity of the approach depends on proper execution not just winging it based on a slide deck or article summary.
They’re not gatekeeping, they’re protecting the science.
Why MDTP Just Makes Sense
We’ve learned a ton about neuroplasticity and motor learning over the past decade. We know that to change a skill, you have to practice the skill. If we want someone to get better at swallowing, they need to actually swallow, not just practice isolated oral motor exercises.
You don’t train for a marathon by doing jumping jacks. You train by running.
Likewise, if we want swallowing to improve, we need to treat swallowing directly, in a structured, progressive way. That’s exactly what MDTP offers.
What MDTP Is (and Isn’t)
MDTP is not a random collection of exercises. It is a systematic, structured, exercise-based dysphagia therapy program. While the full protocol can’t be shared publicly (you have to take the course), here’s what you can know:
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It focuses on whole-swallow training using real food.
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It uses a hierarchical progression of bolus types.
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It includes pass/fail criteria and objective outcomes.
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It targets muscle adaptation using food as functional resistance.
Sound familiar? It’s exactly how PTs and OTs treat motor deficits, through progressive resistance exercise and functional task training.
A Real-World Patient Success
Shortly after taking the course, I had my first MDTP patient: NPO with a feeding tube and little progress after traditional therapy.
In our very first MDTP session, the patient progressed through the first four levels of the program. We also incorporated NMES due to the patient needing 5–6 swallows per bolus initially.
By the end of the session, they were clearing with just 1–2 swallows. It wasn’t magic, it was targeted, functional swallowing rehab with measurable change.
What Makes MDTP Different?
MDTP is one of the few dysphagia programs that treats the entire swallowing system, not just the tongue or lips or larynx in isolation.
It provides:
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A structured therapy protocol
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Functional swallowing targets
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Real-world outcome measures
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No need for expensive tools or materials
It’s evidence-based, efficient, and ready to implement right after training.
Why I Recommend It
Honestly, MDTP gave me the clinical structure I didn’t know I was missing. The course is packed with research, muscle science, neuroplasticity principles, and practical application.
And it works. Not for everyone, no technique is 100% effective, but it gives our patients the best shot at true swallowing recovery.
In a world where functional outcomes drive reimbursement and therapy success, MDTP helps us deliver results.
Want to Learn More?
Interested in learning more or getting certified in the McNeill Dysphagia Therapy Program? You can find official course listings and info here.
Final Thoughts
At the end of the day, our patients deserve the most current, evidence-supported, and effective dysphagia therapy we can offer.
MDTP isn’t just another technique, it’s a shift in how we think about swallowing rehab.
Let’s get out of the “tongue wag” era and into therapy that moves the needle.
Ready to take a deeper dive?
References:
Crary, M. A., Carnaby, G. D., LaGorio, L. A., & Carvajal, P. J. (2012). Functional and physiological outcomes from an exercise-based dysphagia therapy: a pilot investigation of the McNeill Dysphagia Therapy Program. Archives of physical medicine and rehabilitation, 93(7), 1173-1178.
Huckabee, M. L., & Burnip, E. (2018). Still rethinking rehab: Motor learning treatment approaches for dysphagia. Perspectives of the ASHA Special Interest Groups, 3(13), 146-156.
Sorrell, L. (2016). Effectiveness of the McNeill Dysphagia Therapy Program in the treatment of dysphagia following tailored cricoplasty for subglottic tracheal stenosis: A case study. Lamar University-Beaumont.
Charters, E., & Clark, J. (2022). Intensive dysphagia rehabilitation program for patients with head and neck cancer. ANZ Journal of Surgery, 92(3), 505-510.
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