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.

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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…

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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.

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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.

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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:

• It focuses on whole-swallow training using real food.

• It uses a hierarchical progression of bolus types.

• It includes pass/fail criteria and objective outcomes.

• 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.

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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.

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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:

• A structured therapy protocol

• Functional swallowing targets

• Real-world outcome measures

• No need for expensive tools or materials

It’s evidence-based, efficient, and ready to implement right after training.

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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.

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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 (insert your affiliate or course registration link if available!).

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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.

Are you ready for a deeper dive with even more resources available? Join the Dysphagia Skills Accelerator today. You will get so many great tools with new tools being added all the time! Click here to join now!

Have you ever wanted a way to create a more standardized protocol for your Clinical Swallow Evaluation?   Do you often forget or leave out parts of the CSE, you know, the parts that are important for your Plan of Care?  You probably need the Clinical Dysphagia Assessment Toolkit if you answered yes.   You can get your copy here.  

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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.

Carnaby, G. D., LaGorio, L., Silliman, S., & Crary, M. (2020). Exercise‐based swallowing intervention (McNeill Dysphagia Therapy) with adjunctive NMES to treat dysphagia post‐stroke: A double‐blind placebo‐controlled trial. Journal of Oral rehabilitation, 47(4), 501-510.

Carnaby-Mann, G. D., & Crary, M. A. (2010). McNeill dysphagia therapy program: a case-control study. Archives of physical medicine and rehabilitation, 91(5), 743-749.

Crary, M. A. McNeill Dysphagia Therapy Program–10 years of research experience with an exercise based dysphagia rehabilitation approach.

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.

Sia, I., Carvajal, P., Lacy, A. A., Carnaby, G. D., & Crary, M. A. (2015). Hyoid and laryngeal excursion kinematics–magnitude, duration and velocity–changes following successful exercise‐based dysphagia rehabilitation: MDTP. Journal of Oral Rehabilitation, 42(5), 331-339.

Lan, Y., Ohkubo, M., Berretin-Felix, G., Carnaby-Mann, G. D., & Crary, M. A. (2012). Normalization of temporal aspects of swallowing physiology after the McNeill dysphagia therapy program. Annals of Otology, Rhinology & Laryngology, 121(8), 525-532.

Charters, E., & Clark, J. (2022). Intensive dysphagia rehabilitation program for patients with head and neck cancer. ANZ Journal of Surgery, 92(3), 505-510.

Dewi, A. F., & Rahayu, U. B. (2025). Exercise for Dysphagia Pasca Stroke: A Literature Review. ACTIVE: Journal of Physical Education, Sport, Health and Recreation, 14(1), 239-244.