Which component is NOT part of the Clinical Swallow Evaluation (CSE)?

• A. Chart review
• B. Instrumental imaging of swallow
• C. Cognitive assessment
• D. Cranial nerve exam

Answer: (B)

The key idea is that a Clinical Swallow Evaluation is a bedside, non-imaging assessment of swallowing function, built from history, observation, and basic examination rather than visualization techniques. Chart review is included because understanding the patient’s medical history, medications, prior swallow problems, and nutritional status helps plan safe trials and tailor recommendations. Cognitive assessment may be done to judge the patient’s ability to participate in the evaluation and to assess safety considerations related to attention and memory during swallowing tasks. Cranial nerve examination is performed to check the neural control of the muscles involved in swallowing—evaluating functions of the nerves that influence lip, jaw, tongue, palate, and pharyngeal movement. Instrumental imaging of swallow, such as videofluoroscopic swallow study or FEES, is not part of the bedside CSE; it requires special equipment and directly visualizes the swallow to confirm issues like aspiration, residue, or regurgitation, and is ordered if the CSE findings warrant more detail.