Objectives: Sensation is an integral component of laryngeal control for breathing, swallowing, and vocalization. Laryngeal sensation is assessed by elicitation of the laryngeal adductor reflex (LAR), a brainstem-mediated adduction of the true vocal folds. During Flexible Endoscopic Evaluations of Swallowing (FEES), the touch method can be used to elicit the LAR to judge laryngeal sensation. Despite the prevalence of this method in clinical practice and research, prior studies have yet to examine inter- and intra-rater reliability. Methods: Four speech-language pathologists rated 125 randomized video clips for the presence, absence, or inability to rate the LAR. Fifty percent of video clips were re-randomized and re-rated 1 week later. Raters then created guidelines and participated in formal consensus training sessions on a separate set of videos. Ratings were repeated post-training. Results: Overall inter-rater reliability was fair (κ = 0.22) prior to training. Pre-training intra-rater reliability ranged from fair (κ = 0.35) to almost perfect (κ = 0.89). Inter-rater reliability significantly improved after training (κ = 0.42, P < .001), though agreement did not reach prespecified acceptable levels (κ ≥ 0.80). Post-training intra-rater reliability ranged from moderate (κ = 0.49) to almost perfect (κ = 0.85). Conclusion: Adequate inter-rater reliability was not achieved when rating isolated attempts to elicit the LAR. Acceptable within-rater reliability was observed in some raters 1 week after initial ratings, suggesting that ratings may remain consistent within raters over a short period of time. Limitations and considerations for future research using the touch method are discussed.

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Purpose The purpose of this study was to investigate the perceptions of speech-language pathologists (SLPs) regarding their academic preparation and current confidence levels for providing dysphagia services, and the relationship between their perceptions of graduate school preparation and their current levels of confidence. Method This study utilized an online survey to gather information from 374 American Speech-Language-Hearing Association–certified SLPs who currently provide dysphagia services in the United States. Surveys were primarily distributed through American Speech-Language-Hearing Association Special Interest Group forums and Facebook groups. The anonymous survey gathered information regarding SLPs' perceptions of academic preparation and current confidence levels for providing dysphagia services in 11 knowledge and skill areas. Results Findings indicated that more than half of respondents did not feel prepared following their graduate academic training in five of the 11 knowledge and skill areas related to dysphagia service delivery. However, about half of respondents indicated they were currently confident about their ability to provide services in eight of the 11 knowledge and skill areas. Findings also indicated that their current confidence levels to provide dysphagia services were significantly higher than their perceptions of preparation immediately following graduate school. However, no significant relationships were found between respondents' self-reported current confidence levels and their perceptions of the adequacy of their academic preparation. Conclusions Despite SLPs' low perceptions of the adequacy of their graduate preparation for providing dysphagia services in specific knowledge and skill areas immediately following graduation, they reported high confidence levels with respect to their actual service delivery. Implications of these findings are discussed.