True or False? The tongue is a bundle of muscles important for speech and swallowing.

True or False?  Tongue strength can be impacted by age, injury, and neurological diseases and disorders.

True or False? The Tongueometer (tongue-om-eter, pronounced like ‘thermometer’) is a non-prescription medical device designed to measure and increase tongue strength and endurance.

If you answered “True” to the statements above, you are correct! The Tongueometer is a new, affordable, and portable device designed to measure and increase tongue strength and endurance for individuals who may have reduced tongue strength secondary to disease, injury, or even aging.

The developers of the device, Ed Steger, a head and neck cancer survivor, and President of the National Foundation of Swallowing Disorders, and Elizabeth Lipton Daly, a speech-language pathologist, have used their combined knowledge, personal experiences, and feedback from numerous patients, clinicians, and researchers, to create a rehabilitation device that patients can purchase, and under the guidance of a speech-language pathologist, use independently at home to strengthen the tongue as part of their dysphagia rehabilitation program.

As an entrepreneur, myself, I am always interested in how and why others develop and pursue their inventions, so, I thought it might be interesting to interview Ed and Elizabeth and learn more:

Mary: I know that in your leadership role at the National Foundation of Swallowing Disorders (NFOSD), you hear from people all over the world who are suffering from dysphagia. Do they tell you that they are they looking for therapies or devices that they can use at home?

Ed: In my role with the NFOSD, we receive 15 to 20 inquiries from patients and caregivers per month worldwide who are often seeking a solution to their swallowing disorder. Periodically, we have provided information these devices with patients and caregivers, however, as a patient advocacy organization, we do not advise or recommend patient-specific treatment options. We recognize that swallowing disorders in individuals are unique and understand the importance of a proper evaluation with a qualified provider. For patients and caregivers who are interested, the NFOSD website (www.nfosd.org) includes an article on medical devices titled: Tongue Strengthening Devices for Dysphagia Rehabilitation.

Mary: Whose idea was it to develop the Tongueometer? Why did you choose the tongue as the focus for endurance training and strengthening?

Elizabeth: In 2016, Ed and I attended a conference together where research was presented on tongue strengthening and functional swallow outcomes. Ed asked whether I used tongue strengthening devices in my clinical practice. I explained that one of the primary limiting factors to using tongue strengthening devices that offer biofeedback was the cost of the devices and the inability to provide these devices to patients as part of a home-exercise program. I shared with Ed my idea to create an app-based biofeedback device that can measure and exercise tongue strength, given that most patients already own smartphones and/or tablets. Weeks later, we began brainstorming this idea to make it a reality. With input from clinicians, researchers, and patients, we designed an app that pairs with a light-weight hand-held device, working on a tight budget so that we could keep this device affordable to those who might benefit.

Mary: The device interfaces with an Android phone or tablet which displays the graphics for the training. What happens if a patient/customer does not own an Android device?

Elizabeth: Great question. Currently, our device works with most Android phones and tablets. Our intention was to launch with a version compatible with both Android and iOS (Apple) devices. The Tongueometer currently uses the phone/tablet as the power source, and Apple requires companies to complete a rigorous application process and pay heavy fees in order for external devices to use Apple products as the power source. We currently have a working Tongueometer prototype that pairs to both Android and iOS phones/tablets via Bluetooth, eliminating the need for the phone/tablet to serve as a power source. We hope to have this available in mid-2020.

If users do not own an Android device, they can purchase a new tablet from our website for $129. Users can also find new and used Android phones/tablets online for less than that. The price for both a new tablet and the Tongueometer is still a fraction of the cost of other similar biofeedback devices.

One point to mention is that the Android device must have a 4.4 operating system version or higher. We recognize that if users are unfamiliar with Android, they might not be sure which device to order if they choose to go through another vendor. We are happy to answer any questions users may have about the Android phone/tablet before they purchase, even if they choose to go through another vendor.

Mary: Recent research indicates that in the healthy adult swallow, the tongue exerts a force on the bolus, setting into motion a series of physiologic events that are all needed for the swallow to unfold in a coordinated, highly-timed fashion, and improvements in tongue strength can result in favorable therapeutic outcomes for some individuals diagnosed with dysphagia. Is there an ideal patient/customer who could benefit from use of the Tongueometer?

Elizabeth: Although tongue strength training is a promising intervention for oropharyngeal dysphagia, and while tongue strength training generally demonstrates improvements in tongue strength across a variety of patient populations, the current available literature at this time is too variable to confidently report specific therapeutic benefits. It’s important for patients, including those with head and neck cancer, stroke, and degenerative neuromuscular disease, to consult with the speech-language pathologist to determine if this device is recommended as part of their rehabilitation program.

Mary: Many patients with Parkinson’s complain of drooling due to poor swallowing of saliva. Would use of the Tongueometer help to improve saliva swallows?

Elizabeth: While there is little research examining the effects of tongue strengthening in patients with Parkinson’s, the device may be beneficial as a part of the treatment program if the person with Parkinson’s is experiencing difficulty controlling saliva within his/her mouth due to reduced tongue or lip strength. While the primary purpose of the Tongueometer is to measure and exercise tongue strength and endurance, it could also be used to measure and exercise lip strength by placing the bulb between the corners of the lips and the teeth.

Mary: Is the device able to be used by pediatric patients?

Elizabeth: There is limited, but emerging, data available on normal tongue strength in children and whether there are benefits of tongue strengthening in children with dysphagia, however literature has shown that children as young as three have been able to understand the directions for using similar biofeedback devices measuring tongue strength.

Mary: Congratulations on bringing your device to market. Most people don’t realize how many steps there are to moving from an idea to an invention, and it’s tempting to give up when you meet obstacles along the way. I’m sure that your device is going to benefit many therapists and patients looking for motivating and meaningful ways to increase tongue strength and hopefully improve swallowing function. Any final comments either of you would like to make?

Elizabeth: Thank you, Mary, for the kind opportunity to share our new device with you and your community. We appreciate the hard work that you and other clinicians and researchers are doing to help those that are impacted by swallowing disorders and are hopeful to see continued improvements to treatment options.

To learn more about the Tongueometer, including ordering information, please visit: https://e2scientific.com/.

Tongueometer interfaces with an Android device to provide the user feedback and training goals.

My MissionTo enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower.Mary Spremulli, MA, CCC-SLP

                                                   Voice Aerobics: The heART and Science of Speech and Voice Therapy     

                                        Visit our website and learn more: https://voiceaerobicsdvd.com/