A primary focus of the lab over the last decade has been the development, validation and implementation of the Toronto Bedside Swallowing Screening Test (TOR-BSST©). Dr. Martino developed the TOR-BSST© to be a tool by which patients can be screened for the presence of swallowing difficulties early in the course of their disease.

The premise of the TOR-BSST© is that earlier identification will initiate earlier intervention, and thereby reduce the incidence of preventable medical complications such as pneumonia, malnutrition and even death while at the same time promote earlier overall recovery. The TOR-BSST© was first validated among stroke patients across the continuum of care and has been distributed to speech language pathologists worldwide. It is currently being translated into several languages and is also undergoing validation among critically ill cardiac patients who have undergone prolonged intubation, thereby ensuring that many more people will benefit from early detection of swallowing problems.

About the TOR-BSST©

The Toronto Bedside Swallowing Screening Test© (TOR-BSST©) is a stable and accurate dysphagia screening tool, which has been tested on over 300 stroke patients in both the acute and rehabilitation setting.  It is quick and easy to use, taking less than 10 minutes to administer, score and place in the chart.  Screeners may be healthcare professionals from a variety of disciplines (ex. nursing, dietitian, occupational therapy, etc.) who have received proper training using the standardized 4-hour training program.

The TOR-BSST© is a one-page, double-sided form. Page one consists of the screening tool, which is composed of three sections – two brief oral exams and one section on water swallowing.  Page two contains standardized instructions for the administration of the tool.  Failure on any item discontinues the screen and prompts referral to the Speech Language Pathologist dysphagia expert.

TOR-BSST(c) Form
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TOR-BSST© Screener Training

TOR-BSST© screener training consists of a standardized and tested 4-hour training program, provided in Powerpoint format on DVD. The program consists of two modules.

Module One covers:

  1. An overview of what a screening tool should be
  2. The conceptual background and development of the TOR-BSST©
  3. A brief review of normal swallowing physiology
  4. The impact and consequences of dysphagia in stroke survivors
  5. A detailed description of the components of the TOR-BSST©

Module Two covers:

  1. A detailed review of the TOR-BSST© form and its administration
  2. Five case studies depicting the administration of the TOR-BSST© (for scoring practice)

In order to be qualified to teach the TOR-BSST© modules, speech language pathologists must first attend a training course provided by Dr. Rosemary Martino via webcast. To register for this training course, please register with us via our registration form.

TOR-BSST© Assessment for Trained Screeners

The TOR-BSST© Assessment for Trained Screeners is designed for TOR-BSST© screeners who have already successfully completed the screener training program within their facility (training provided by a TOR-BSST©-certified speech language pathologist). The TOR-BSST© Assessment for Trained Screeners is a tool that speech language pathologists can use to determine whether their screeners continue to be proficient in dysphagia screening or may require refresher training. This assessment is exclusively available to speech language pathologists who have completed the TOR-BSST© training program offered through the Swallowing Lab.