Sep 17, 2026 · 37 min · 10 segments
**Episode details:** Many SLPs think of cough as an airway protection mechanism, something patients either have too little of or manage fine. Dr. Miranda Wright, a postdoctoral fellow at the…
Miranda WrightGuest
Tim StockdaleHost
So you work with cough and I'm going to leave it broad at first because it sounds like you work with cough in a way that's different than what we typically think about.
So cough is such a big general term, and you could go so many ways with your thinking of what cough is.
As probably a lot, I would say most speech pathologists, when they think of cough, as they think of it as a way to protect the airway, which is absolutely accurate.
And that's what a lot of speech pathologists focus on is having making sure their patients who have dysphagia have the ability to protect their airway with a cough.
And then when they aren't sensitive, which is probably what you're used to working with, is those people who have hypotasia, so a reduced cough sensitivity to stimuli.
Then there's the opposite end, which is hypertasia, which they have a heightened cough sensitivity to stimuli.
I work with patients with hypersensitive cough reflex, whereas I think a lot of speech pathologists think of patients either they need to cough to protect their airway or they don't feel that or they're not as sensitive as they need to be.
So, yeah, I sort of come at it at that the opposite realm that other people, other speech pathologists tend to think of cough as.
Most of us know what hyper means and what hypo means and perhaps even what tussia means.
Coming from, well, not coming from distussia, but the same sort of thing as tussia, disordered cough.
When does this become problematic? Because, I mean, you were mentioning earlier on the hypotasia side, that's what we really think of as SLPs.
Oh, someone's a silent aspirator, they're not coughing and we want them to cough or maybe their cough is disordered.
There's not a good compression and so it's not allowing great expulsion of whatever materials are there.
So you work with cough and I'm going to leave it broad at first because it sounds like you work with cough in a way that's different than what we typically think about.
So cough is such a big general term, and you could go so many ways with your thinking of what cough is.
As probably a lot, I would say most speech pathologists, when they think of cough, as they think of it as a way to protect the airway, which is absolutely accurate.
And that's what a lot of speech pathologists focus on is having making sure their patients who have dysphagia have the ability to protect their airway with a cough.
And then when they aren't sensitive, which is probably what you're used to working with, is those people who have hypotasia, so a reduced cough sensitivity to stimuli.
Then there's the opposite end, which is hypertasia, which they have a heightened cough sensitivity to stimuli.
I work with patients with hypersensitive cough reflex, whereas I think a lot of speech pathologists think of patients either they need to cough to protect their airway or they don't feel that or they're not as sensitive as they need to be.
So, yeah, I sort of come at it at that the opposite realm that other people, other speech pathologists tend to think of cough as.
Most of us know what hyper means and what hypo means and perhaps even what tussia means.
Coming from, well, not coming from distussia, but the same sort of thing as tussia, disordered cough.
When does this become problematic? Because, I mean, you were mentioning earlier on the hypotasia side, that's what we really think of as SLPs.
Oh, someone's a silent aspirator, they're not coughing and we want them to cough or maybe their cough is disordered.
There's not a good compression and so it's not allowing great expulsion of whatever materials are there.
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