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CA can only be considered reliable if there are clear distinctions in the acoustic and perceptual swallow sound profiles between swallow sounds associated with and without aspiration. We aimed to determine whether the acoustic and perceptual swallow sound profile differs between swallows associated with and without aspiration in preterm neonates. We simultaneously recorded video and swallow sounds during videofluoroscopic swallow studies. We used the Penetration-Aspiration Scale to define aspiration. Acoustic parameters were obtained using a Python program. Two SLPs independently rated the presence\/absence of perceptual parameters from 1\u00a0s audio wavefiles. Differences between swallow types were analyzed using mixed linear regression modelling to account for clustered data, and a test of two proportions for acoustic and perceptual parameters, respectively. Penalized logistic regression analysis was used for perceptual sound predictors of aspiration. A total of 293 swallows (7 aspiration, 286 no aspiration) from 13 preterm neonates [69%; median birth gestation 31 (range\u2009=\u200924\u201336 weeks)] were analyzed. There were significant differences between these two swallow types for both acoustic and perceptual swallow sound parameters. Combinations of perceptual sound parameters (wet\/stridor pre-swallow sounds; quick, loud, initial discrete sound, bolus transit sound, final discrete sound, glottal release sound during swallow sounds; and wheeze post-swallow sounds were most predictive of aspiration (area under the curve, 0.82: 95%CI0.60\u20131.00). In conjunction with a clinical feeding examination, CA-obtained sound features can likely help guide SLP\u2019s evaluation of aspiration risk in preterm neonates.<\/jats:p>","DOI":"10.1007\/s00455-026-10981-0","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:11:30Z","timestamp":1784700690000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acoustic and Perceptual Parameters of Swallow Sounds Associated with and Without Aspiration in Preterm Neonates: A Pilot Study"],"prefix":"10.1007","author":[{"given":"Thuy T.","family":"Frakking","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Humphries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda","family":"Schwerin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelise","family":"Kyriakou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Mahon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"So","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SUPERB collaborative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"3","key":"10981_CR1","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s00455-006-9070-3","volume":"22","author":"C Bateman","year":"2007","unstructured":"Bateman C, Leslie P, Drinnan MJ. 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Arch Dis Child. 2021;106(Suppl 1):A275\u2013A275.","journal-title":"Arch Dis Child"}],"container-title":["Dysphagia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-026-10981-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00455-026-10981-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00455-026-10981-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:11:32Z","timestamp":1784700692000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00455-026-10981-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":51,"alternative-id":["10981"],"URL":"https:\/\/doi.org\/10.1007\/s00455-026-10981-0","relation":{},"ISSN":["0179-051X","1432-0460"],"issn-type":[{"value":"0179-051X","type":"print"},{"value":"1432-0460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"3 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Swallowing sounds data described in this study were used to contribute to developing algorithms that automatically identify and detect aspirating swallowing sounds in preterm neonates, infants and children. TTF, SS and BS have an Australian provisional patent (AU2025902147) on this work.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}