{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:14:21Z","timestamp":1792782861089,"version":"4.5.0"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Canterbury","id":[{"id":"https:\/\/ror.org\/03y7q9t39","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dysphagia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The Test of Masticating and Swallowing Solids (ToMaSS) is a commonly-used adjunctive assessment to quantify solid bolus ingestion. However, published norms are characterised by relatively small sample sizes and wide age brackets, increasing the risk of skew, influence by outliers, and reduced statistical power. Regression-based approaches to norming may mitigate some of these limitations. To evaluate whether a regression-based approach offered a significant advantage over the traditional stratified approach for the refinement of ToMaSS norms. Prospective-retrospective design, with prospectively collected data combined with historical data from published and unpublished laboratory datasets. All data consisted of healthy adults (aged 20 to 80\u2009+\u2009years) recruited from the general public. McFadden\u2019s Pseudo R\u00b2 and Root Mean Squared Error (MSE) were calculated and compared for both statistical approaches. Regression-based norms (GAM Gamma and COM-Poisson models) showed a modest improvement in model fit over traditional stratified norms, with McFadden\u2019s Pseudo R\u00b2 increasing by 6% to 43% across outcomes. MSE values followed a similar trend, with regression-based norms reducing prediction error by up to 12%. Findings support that a regression-based approach offered a significant advantage over a traditional stratified approach to constructing ToMaSS norms. Advantages included smaller sample size requirements and individualised estimates across continuous age ranges. This flexibility allows for a more nuanced understanding of individual ToMaSS performance, which may be of particular relevance to clinical populations where changes in the oral phase of swallowing may vary greatly within a short time frame.<\/jats:p>","DOI":"10.1007\/s00455-026-10949-0","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T10:44:34Z","timestamp":1778237074000},"page":"987-1000","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating a Regression-Based Approach to Norming the Test of Masticating and Swallowing Solids (ToMaSS): A Comparison with Traditional Stratified Methods"],"prefix":"10.1007","volume":"41","author":[{"given":"Esther","family":"Guiu Hernandez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie-Lee","family":"Huckabee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"2","key":"10949_CR1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1044\/1058-0360.0802.149","volume":"8","author":"GH McCullough","year":"1999","unstructured":"McCullough GH, Wertz RT, Rosenbek JC, Dinneen C. Clinicians\u2019 preferences and practices in conducting clinical\/bedside and videofluoroscopic swallowing examinations in an adult, neurogenic population. Am J Speech Lang Pathol. 1999;8(2):149\u201363. https:\/\/doi.org\/10.1044\/1058-0360.0802.149.","journal-title":"Am J Speech Lang Pathol"},{"issue":"6","key":"10949_CR2","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1044\/1092-4388(2005\/089)","volume":"48","author":"GH McCullough","year":"2005","unstructured":"McCullough GH, Rosenbek JC, Wertz RT, McCoy S, Mann G, McCullough K. Utility of clinical swallowing examination measures for detecting aspiration post-stroke. J Speech Lang Hear Res. 2005;48(6):1280\u201393. https:\/\/doi.org\/10.1044\/1092-4388(2005\/089).","journal-title":"J Speech Lang Hear Res"},{"issue":"2","key":"10949_CR3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1007\/s00455-002-0094-z","volume":"18","author":"BA Mathers\u2013Schmidt","year":"2003","unstructured":"Mathers\u2013Schmidt BA, Kurlinski M. Dysphagia evaluation practices: inconsistencies in clinical assessment and instrumental examination decision-making. Dysphagia. 2003;18(2):114\u201325. https:\/\/doi.org\/10.1007\/s00455-002-0094-z.","journal-title":"Dysphagia"},{"issue":"3","key":"10949_CR4","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00455-004-0004-7","volume":"19","author":"R Martino","year":"2004","unstructured":"Martino R, Pron G, Diamant NE. Oropharyngeal dysphagia: surveying practice patterns of the speech-language pathologist. Dysphagia. 2004;19(3):165\u201376. https:\/\/doi.org\/10.1007\/s00455-004-0004-7.","journal-title":"Dysphagia"},{"issue":"4","key":"10949_CR5","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3109\/17549507.2014.979877","volume":"17","author":"B Vogels","year":"2015","unstructured":"Vogels B, Cartwright J, Cocks N. The bedside assessment practices of speech-language pathologists in adult dysphagia. Int J Speech Lang Pathol. 2015;17(4):390\u2013400. https:\/\/doi.org\/10.3109\/17549507.2014.979877.","journal-title":"Int J Speech Lang Pathol"},{"issue":"2","key":"10949_CR6","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s004550010002","volume":"15","author":"GH McCullough","year":"2000","unstructured":"McCullough GH, Wertz RT, Rosenbek JC, Mills RH, Ross KB, Ashford JR. Inter- and intrajudge reliability of a clinical examination of swallowing in adults. Dysphagia. 2000;15(2):58\u201367. https:\/\/doi.org\/10.1007\/s004550010002.","journal-title":"Dysphagia"},{"issue":"9","key":"10949_CR7","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1136\/jnnp.55.9.822","volume":"55","author":"KM Nathadwarawala","year":"1992","unstructured":"Nathadwarawala KM, Nicklin J, Wiles CM. A timed test of swallowing capacity for neurological patients. J Neurol Neurosurg Psychiatry. 1992;55(9):822\u20135. https:\/\/doi.org\/10.1136\/jnnp.55.9.822.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10949_CR8","doi-asserted-by":"crossref","unstructured":"Hughes TAT, Wiles CM. Clinical measurement of swallowing in health and in neurogenic dysphagia. QJM: An International Journal of Medicine. 1996;89(2):109\u2013116.","DOI":"10.1093\/qjmed\/89.2.109"},{"issue":"2","key":"10949_CR9","first-page":"14","volume":"15","author":"A Sarve","year":"2021","unstructured":"Sarve A, Krishnamurthy R, Balasubramanium R. The timed water test of swallowing: reliability, validity, and normative data from Indian population. Int J Health Sci (Qassim). 2021;15(2):14\u201320.","journal-title":"Int J Health Sci (Qassim)"},{"issue":"4","key":"10949_CR10","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1080\/17549507.2022.2096925","volume":"25","author":"P H\u00e4gglund","year":"2023","unstructured":"H\u00e4gglund P, Karlsson P, Karlsson F. The timed water swallow test (TWST): normative data on swallowing capacity for healthy people aged 60 years and older. Int J Speech Lang Pathol. 2023;25(4):479\u201385. https:\/\/doi.org\/10.1080\/17549507.2022.2096925.","journal-title":"Int J Speech Lang Pathol"},{"issue":"1","key":"10949_CR11","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1111\/1460-6984.12768","volume":"58","author":"O Sella-Weiss","year":"2023","unstructured":"Sella-Weiss O. The test of mastication and swallowing solids and the timed water swallow test: reliability, associations, age and gender effects, and normative data. Int J Lang Commun Disord. 2023;58(1):67\u201381. https:\/\/doi.org\/10.1111\/1460-6984.12768.","journal-title":"Int J Lang Commun Disord"},{"key":"10949_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-024-10685-3","author":"P Martell","year":"2024","unstructured":"Martell P, Skogar \u00d6, Bergstr\u00f6m L. Swallowing characteristics and water swallow capacity in patients with Parkinsonism. Dysphagia. 2024. https:\/\/doi.org\/10.1007\/s00455-024-10685-3.","journal-title":"Dysphagia"},{"issue":"12","key":"10949_CR13","doi-asserted-by":"publisher","first-page":"2769","DOI":"10.1002\/hed.27194","volume":"44","author":"L Watson","year":"2022","unstructured":"Watson L, Woodman SH, Ganderton D, Hutcheson KA, Pringle S, Patterson JM. Development of the remote 100 ml water swallow test versus clinical assessment in patients with head and neck cancer: do they agree? Head Neck. 2022;44(12):2769\u201378. https:\/\/doi.org\/10.1002\/hed.27194.","journal-title":"Head Neck"},{"key":"10949_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-024-03117-3","author":"P Vasconcellos","year":"2024","unstructured":"Vasconcellos P, Mafort TT, Ribeiro-Alves M, da Costa CH. Association between swallowing dynamics, tongue pressure and pulmonary function in patients with idiopathic pulmonary fibrosis. BMC Pulm Med. 2024. https:\/\/doi.org\/10.1186\/s12890-024-03117-3.","journal-title":"BMC Pulm Med"},{"issue":"4","key":"10949_CR15","doi-asserted-by":"publisher","first-page":"501","DOI":"10.3233\/NRE-203089","volume":"46","author":"C Sayaca","year":"2020","unstructured":"Sayaca C, Sapci\u00f3glu TY, Kaya D. Does the right or left hemisphere involvement affect swallowing in patients with hemiplegia? NeuroRehabil. 2020;46(4):501\u20139. https:\/\/doi.org\/10.3233\/NRE-203089.","journal-title":"NeuroRehabil"},{"issue":"10","key":"10949_CR16","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1177\/0269215514564087","volume":"29","author":"A Reyes","year":"2015","unstructured":"Reyes A, Cruickshank T, Nosaka K, Ziman M. Respiratory muscle training on pulmonary and swallowing function in patients with Huntingtons disease: a pilot randomised controlled trial. Clin Rehabil. 2015;29(10):961\u201373. https:\/\/doi.org\/10.1177\/0269215514564087.","journal-title":"Clin Rehabil"},{"issue":"6","key":"10949_CR17","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.clnu.2008.06.011","volume":"27","author":"P Clav\u00e9","year":"2008","unstructured":"Clav\u00e9 P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27(6):806\u201315. https:\/\/doi.org\/10.1016\/j.clnu.2008.06.011.","journal-title":"Clin Nutr"},{"key":"10949_CR18","volume-title":"MASA: The Mann Assessment of Swallowing Ability","author":"G Mann","year":"2002","unstructured":"Mann G. MASA: The Mann Assessment of Swallowing Ability. Clifton Park, NY: Thomson Delmar Learning; 2002."},{"issue":"2","key":"10949_CR19","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1161\/STROKEAHA.107.510370","volume":"40","author":"R Martino","year":"2009","unstructured":"Martino R, et al. The Toronto Bedside Swallowing Screening Test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke. 2009;40(2):555\u201361. https:\/\/doi.org\/10.1161\/STROKEAHA.107.510370.","journal-title":"Stroke"},{"issue":"5","key":"10949_CR20","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1093\/gerona\/50A.5.M257","volume":"50","author":"J Robbins","year":"1995","unstructured":"Robbins J, Levine R, Wood J, Roecker EB, Luschei E. Age effects on lingual pressure generation as a risk factor for dysphagia. J Gerontol. 1995;50(5):257\u201362.","journal-title":"J Gerontol"},{"issue":"2","key":"10949_CR21","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s00455-011-9328-2","volume":"27","author":"HM Clark","year":"2012","unstructured":"Clark HM, Solomon NP. Age and sex differences in orofacial strength. Dysphagia. 2012;27(2):2\u20139. https:\/\/doi.org\/10.1007\/s00455-011-9328-2.","journal-title":"Dysphagia"},{"key":"10949_CR22","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s00455-008-9171-2","volume":"24","author":"S Youmans","year":"2009","unstructured":"Youmans S, Youmans G, Stierwalt J. Differences in tongue strength across age and gender: is there a diminished strength reserve? Dysphagia. 2009;24:57\u201365.","journal-title":"Dysphagia"},{"issue":"7","key":"10949_CR23","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1016\/j.apmr.2014.03.001","volume":"95","author":"RP Athukorala","year":"2014","unstructured":"Athukorala RP, Jones RD, Sella O, Huckabee M-L. Skill training for swallowing rehabilitation in patients with Parkinson\u2019s disease. Arch Phys Med Rehabil. 2014;95(7):1374\u201382. https:\/\/doi.org\/10.1016\/j.apmr.2014.03.001.","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"10949_CR24","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1111\/1460-6984.12332","volume":"53","author":"M-L Huckabee","year":"2018","unstructured":"Huckabee M-L, et al. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and international normative data. Int J Lang Commun Disord. 2018;53(1):144\u201356. https:\/\/doi.org\/10.1111\/1460-6984.12332.","journal-title":"Int J Lang Commun Disord"},{"issue":"3","key":"10949_CR25","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1111\/1460-6984.12450","volume":"54","author":"K Lamvik-Gozdzikowska","year":"2019","unstructured":"Lamvik-Gozdzikowska K, Guiu Hernandez E, Apperley O, McIntosh T, Huckabee M. Quantitative assessment of oral phase efficiency: validation of the Test of Masticating and Swallowing Solids (TOMASS). Int J Lang Commun Disord. 2019;54(3):444\u201350. https:\/\/doi.org\/10.1111\/1460-6984.12450.","journal-title":"Int J Lang Commun Disord"},{"issue":"3","key":"10949_CR26","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s12070-021-02429-8","volume":"73","author":"S Kothari","year":"2021","unstructured":"Kothari S, Krishnamurthy R, Balasubramanium RK, Huckabee M-L. The Test of Masticating and Swallowing Solids (TOMASS): reliability, validity and normative data for the adult Indian population. Indian J Otolaryngol Head Neck Surg. 2021;73(3):327\u201332. https:\/\/doi.org\/10.1007\/s12070-021-02429-8.","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"issue":"3","key":"10949_CR27","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1111\/1460-6984.12613","volume":"56","author":"F Todaro","year":"2021","unstructured":"Todaro F, Pizzorni N, Scarponi L, Ronzoni C, Huckabee ML, Schindler A. The Test of Masticating and Swallowing Solids (TOMASS): reliability and validity in patients with dysphagia. Int J Lang Commun Disord. 2021;56(3):558\u201366. https:\/\/doi.org\/10.1111\/1460-6984.12613.","journal-title":"Int J Lang Commun Disord"},{"issue":"2","key":"10949_CR28","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1044\/2020_AJSLP-20-00234","volume":"30","author":"JC Borders","year":"2021","unstructured":"Borders JC, Sevitz JS, Malandraki JB, Malandraki GA, Troche MS. Objective and subjective clinical swallowing outcomes via telehealth: reliability in outpatient clinical practice. Am J Speech Lang Pathol. 2021;30(2):598\u2013608. https:\/\/doi.org\/10.1044\/2020_AJSLP-20-00234.","journal-title":"Am J Speech Lang Pathol"},{"issue":"1","key":"10949_CR29","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s00455-022-10490-w","volume":"38","author":"F Karlsson","year":"2023","unstructured":"Karlsson F, Lovric L, Mattheli\u00e9 J, Brage L, H\u00e4gglund P. A within-subject comparison of face-to-face and telemedicine screening using the Timed Water Swallow Test (TWST) and the Test of Mastication and Swallowing of Solids (TOMASS). Dysphagia. 2023;38(1):483\u201390. https:\/\/doi.org\/10.1007\/s00455-022-10490-w.","journal-title":"Dysphagia"},{"issue":"3","key":"10949_CR30","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1080\/17549507.2020.1800090","volume":"23","author":"P H\u00e4gglund","year":"2021","unstructured":"H\u00e4gglund P, Blom S, Thoden P, Karlsson F. The Test of Masticating and Swallowing Solids (TOMASS): normative data for two crackers available in the Scandinavian and international markets. Int J Speech Lang Pathol. 2021;23(3):329\u201337. https:\/\/doi.org\/10.1080\/17549507.2020.1800090.","journal-title":"Int J Speech Lang Pathol"},{"issue":"3","key":"10949_CR31","doi-asserted-by":"publisher","first-page":"920","DOI":"10.17826\/cumj.840796","volume":"46","author":"M Kavakci","year":"2021","unstructured":"Kavakci M, Tanr\u0131verd\u00ed M, Barmak E, Kapan N. Turkish normative data for the Test of Masticating and Swallowing Solids (TOMASS). Cukurova Med J. 2021;46(3):920\u20136. https:\/\/doi.org\/10.17826\/cumj.840796.","journal-title":"Cukurova Med J"},{"issue":"6","key":"10949_CR32","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1080\/09297040701233875","volume":"13","author":"AJ Bridges","year":"2007","unstructured":"Bridges AJ, Holler KA. How many is enough? Determining optimal sample sizes for normative studies in pediatric neuropsychology. Child Neuropsychol. 2007;13(6):528\u201338. https:\/\/doi.org\/10.1080\/09297040701233875.","journal-title":"Child Neuropsychol"},{"issue":"9","key":"10949_CR33","doi-asserted-by":"publisher","first-page":"2282","DOI":"10.1007\/s11999-008-0346-9","volume":"466","author":"DJ Biau","year":"2008","unstructured":"Biau DJ, Kern\u00e9is S, Porcher R. Statistics in brief: the importance of sample size in the planning and interpretation of medical research. Clin Orthop Relat Res. 2008;466(9):2282\u20138. https:\/\/doi.org\/10.1007\/s11999-008-0346-9.","journal-title":"Clin Orthop Relat Res"},{"key":"10949_CR34","doi-asserted-by":"crossref","unstructured":"Zachary RA, Gorsuch RL. Continuous norming: implications for the WAIS-R. J Clin Psychol. 1985;41(1):86\u201394. https:\/\/doi.org\/10.1002\/1097-4679(198501)41:1<86::AID-JCLP2270410115>3.0.CO;2-W.","DOI":"10.1002\/1097-4679(198501)41:1<86::AID-JCLP2270410115>3.0.CO;2-W"},{"issue":"1","key":"10949_CR35","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1017\/S1355617709990750","volume":"16","author":"B Parmenter","year":"2010","unstructured":"Parmenter B, Testa S, Schretlen D, Weinstock-Guttman B, Benedict R. The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J Int Neuropsychol Soc. 2010;16(1):6\u201316. https:\/\/doi.org\/10.1017\/S1355617709990750.","journal-title":"J Int Neuropsychol Soc"},{"issue":"2","key":"10949_CR36","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1177\/1073191115580638","volume":"23","author":"H Oosterhuis","year":"2016","unstructured":"Oosterhuis H, van der Ark LA, Sijtsma K. Sample size requirements for traditional and regression-based norms. Assessment. 2016;23(2):191\u2013202.","journal-title":"Assessment"},{"key":"10949_CR37","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1177\/1073191110370116","volume":"18","author":"W der Van Elst","year":"2011","unstructured":"der Van Elst W, Hoogenhout E, Dixon R, De Groot R, Jolles J. The Dutch Memory Compensation Questionnaire: psychometric properties and regression-based norms. Assessment. 2011;18:517\u201328.","journal-title":"Assessment"},{"key":"10949_CR38","volume-title":"Clinical evaluation of language fundamentals \u2014 Screening test (CELF-4 screening test)","author":"E Semel","year":"2004","unstructured":"Semel E, Wiig EH, Secord WA. Clinical evaluation of language fundamentals \u2014 Screening test (CELF-4 screening test). 4th ed. Toronto: The Psychological Corporation\/A Harcourt Assessment Company.; 2004.","edition":"4th ed"},{"key":"10949_CR39","volume-title":"Snijders-Oomen non-verbal intelligence test: Part I Motivation","author":"P Tellegen","year":"2011","unstructured":"Tellegen P, Laros JA. Snijders-Oomen non-verbal intelligence test: Part I Motivation. Amsterdam: Hogrefe; 2011."},{"key":"10949_CR40","doi-asserted-by":"publisher","unstructured":"Dinga R, Fraza CJ, Bayer JMM, Kia SM, Beckmann CF, Marquand AF. Normative modeling of neuroimaging data using generalized additive models of location scale and shape. Jun. 2021;14. https:\/\/doi.org\/10.1101\/2021.06.14.448106.","DOI":"10.1101\/2021.06.14.448106"},{"issue":"4","key":"10949_CR41","doi-asserted-by":"publisher","DOI":"10.3390\/math9040299","volume":"9","author":"J Pinilla","year":"2021","unstructured":"Pinilla J, Negr\u00edn M. Non-parametric generalized additive models as a tool for evaluating policy interventions. Mathematics. 2021;9(4):299. https:\/\/doi.org\/10.3390\/math9040299.","journal-title":"Mathematics"},{"issue":"5","key":"10949_CR42","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1016\/j.apmr.2020.11.014","volume":"102","author":"KB Ng","year":"2021","unstructured":"Ng KB, Jones RD, Hernandez EG, Macrae P, Huckabee M-L. Classification of stroke patients with dysphagia into subgroups based on patterns of submental muscle strength and skill impairment. Arch Phys Med Rehabil. 2021;102(5):895\u2013904. https:\/\/doi.org\/10.1016\/j.apmr.2020.11.014.","journal-title":"Arch Phys Med Rehabil"},{"key":"10949_CR43","unstructured":"Lewis N. The Test of Masticating and Swallowing Solids (TOMASS) and the Timed Water Swallow Test (TWST): Adult Normative Data for the ToMaSSApp, Unpublished Master\u2019s thesis, University of Canterbury, Christchurch, 2024."},{"key":"10949_CR44","unstructured":"Mills M. The Test of Masticating and Swallowing Solids Application (ToMaSSAppTM): Normative data for two crackers, Unpublished Masters Thesis, University of Canterbury, Christchurch, 2024."},{"key":"10949_CR45","unstructured":"Henderson A. Test of Masticating and Swallowing Solids: Sensitivity to Parkinson\u2019s disease severity., Master\u2019s thesis, University of Canterbury, Christchurch, 2015."},{"key":"10949_CR46","unstructured":"Lewis N. The Test of Masticating and Swallowing Solids (ToMaSS) and the Timed-Water Swallow Test (TWST): Adult Normative Data for the ToMaSSApp (2024). [Master's dissertation, University of Canterbury]."},{"issue":"2","key":"10949_CR47","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","volume":"15","author":"TK Koo","year":"2016","unstructured":"Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155\u201363. https:\/\/doi.org\/10.1016\/j.jcm.2016.02.012.","journal-title":"J Chiropr Med"},{"key":"10949_CR48","unstructured":"Team RC. R: A language and environment for statistical computing, R Foundation for Statistical Computing. [Online]. Available: https:\/\/www.r-project.org\/"},{"key":"10949_CR49","unstructured":"Golub G, Van Loan C. Matrix Computations. 3rd ed. Johns Hopkins University; 1996."},{"key":"10949_CR50","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4899-3242-6","volume-title":"Generalized Linear Models","author":"P McCullagh","year":"1989","unstructured":"McCullagh P, Nelder J. Generalized Linear Models. 2nd ed. Chapman and Hall\/CRC; 1989.","edition":"2nd ed"},{"key":"10949_CR51","unstructured":"Casella G, Berger R. Statistical Inference, 2nd ed. Duxbury, 2002."}],"container-title":["Dysphagia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-026-10949-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00455-026-10949-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-026-10949-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T23:03:41Z","timestamp":1792537421000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00455-026-10949-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10949"],"URL":"https:\/\/doi.org\/10.1007\/s00455-026-10949-0","relation":{},"ISSN":["0179-051X","1432-0460"],"issn-type":[{"value":"0179-051X","type":"print"},{"value":"1432-0460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"assertion":[{"value":"23 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 March 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have no conflicts of interest to declare. The study was approved by the appropriate university Human Research Ethics Committee (HEC 2021\/106\/LR Amendment 1). Data are available from the corresponding author upon reasonable request. The authors have no funding sources to declare.","order":1,"name":"Ethics","label":"Compliance with Ethical Standards","group":{"name":"EthicsHeading","label":"Declarations"}}]}}