Medical Speech Pathology

Curiosity, Dialogue, and Knowledge

3 Ounces of Water

Dr. Debra Suiter and Dr. Steven Leder have done a great job with the research behind the decision tree that I’m posting below.  I made this diagram up based on information from their research.  If you need more information on the research, or have questions about the use of this protocol, then see the references below.  Email me with questions too.  I’ll do my best to answer or refer to others with better insight.

3 ounce protocol decision tree

based on the research of Dr. Debra Suiter and Dr. Steven Leder


Suiter DM, Leder SB, Karas DE. The 3 ounce (90 cc) water swallow challenge: A screening test for children with suspected oropharyngeal dysphagia. Otolarygology Head & Neck Surgery 2009;140:187-190.

Leder SB, Suiter DM, Lisitano HL. Answering orientation questions and following single step verbal commands: effect on aspiration status. Dysphagia 2009;24:290-295.

Suiter DB, Leder SB. Clinical utility of the 3 ounce water swallow test. Dysphagia 2008;23:244-250


One comment on “3 Ounces of Water

  1. Cheri
    December 6, 2016

    Thanks for this~

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