“…Clinicians utilise a variety of symptoms and signs as indicators of OPA and swallowing dysfunction, including cough, wheeze, recurrent pneumonia, gagging, choking, congestion, tachypnoea, bradycardia, apnoea, cyanosis with feeds, oxygen desaturations, noisy or wet breathing, delayed swallows and voice changes [5][6][7][8][9]. In addition, signs such as gurgly respiration or wet voice can also be associated with hypopharyngeal or laryngeal pooling of secretions, or pharyngeal residue of food materials [5,10].…”