About TOR-BSST©
A primary focus of the lab over the last two decades 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.
TOR-BSST(c) FormThe TOR-BSST© was developed and validated among over 300 stroke patients across the continuum of care. It is a stable and accurate dysphagia screening tool, which is quick and easy to use, taking less than 10 minutes to administer, score and document in the chart.
The tool is a one-page, double-sided form. Page one consists of the screening protocol, 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 a Speech Language Pathologist dysphagia expert.
The full psychometric properties of the TOR-BSST© are found in the March 2009 issue of Stroke.
Ongoing work by our lab focuses on supporting the clinical implementation of the TOR-BSST© tool and ensuring that it has the broadest reach possible. To this end, we have developed resources to support implementation, including screener training modules, an online assessment for trained TOR-BSST© screeners and refresher training modules. Most recently, we developed eLearning versions of the training programs for Speech-Language Pathologist dysphagia experts and TOR-BSST© screeners.
We have also translated the TOR-BSST© into several languages – including Canadian French, Italian, Brazilian Portuguese, German and Japanese – and have collaborated with international clinician researchers to continue translation work for even more languages, including Chinese, Norwegian, Thai, Turkish and Urdu.
TOR-BSST© Stats-at-a-Glance
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In order to ensure proper identification of increased dysphagia risk in stroke patients, any health professionals who plan to screen for dysphagia using the TOR-BSST© are required to complete training by either a Speech-Language Pathology (SLP) dysphagia expert or via eLearning.
SLP Dysphagia Expert Training
If you are a Speech-Language Pathology dysphagia expert and would like to implement the TOR-BSST© at your facility and/or train screeners, we offer TOR-BSST© Training for the SLP dysphagia expert. Currently, we are moving this training to an eLearning format. SLPs will be able to register for this new training (and earn ASHA CEUs) starting in late 2024. In the meantime, if you or an SLP colleague require training on a more urgent basis, please let us know via our contact form.
Following training, all certified SLPs will gain access to a secure website where we provide resources to support TOR-BSST© implementation, in-person screener training, and ongoing assessment.
Screener Training
Screeners may be healthcare professionals from a variety of disciplines (ex. nursing, dietitian, occupational therapy, etc.).
Since 2007, screeners have completed training via in-person, SLP-led sessions. Beginning in 2025, we will offer an alternate option for delivering screener training: independent eLearning. Facilities will be able to choose between these two training delivery models. Note: Both training models include a live one-on-one competency observation component that must be completed prior to screeners administering the TOR-BSST© clinically.
If you are a health professional who would like to receive training to become a TOR-BSST© screener, please check with your hospital/unit. Your training and observation will be coordinated by your manager.
If you are a health professional, or a dysphagia expert but not a Speech-Language Pathologist, and would like to find out how the TOR-BSST© might can be implemented in your facility, please contact us.
Be sure to include the name of a Speech-Language Pathologist with whom you work, if applicable.