Adult Medical Swallowing and Language Research Lab

About Our Lab

What do we do?

The Adult Medical Swallowing and Language Research Lab (AMSL) at the Medical University of South Carolina focuses on advancing research and providing education in swallowing disorders (dysphagia) and language impairments (aphasia).

Our Mission

Our mission is to improve understanding, diagnosis, and treatment for individuals affected by dysphagia and/or aphasia. Through research, education, and collaborations, we aim to enhance patient care and quality of life.
Our work is driven by curiosity, compassion, and a commitment to translating research discoveries into real-world clinical impact. We believe that research should directly inform patient care — and that collaboration between researchers, clinicians, and patients is essential for meaningful progress.

Our Vision

We envision a future where every person with a swallowing or language disorder can access innovative, evidence-based care that meets their unique needs.

What is Aphasia?

Aphasia is a language disorder caused by damage to the brain’s language centers, often caused by stroke or head injury. It affects a person’s ability to understand, speak, read, or write. Aphasia can range from mild communication difficulties to severe impairments. Rehabilitation efforts focus on helping individuals regain their language skills through therapies and innovative techniques.

What is Dysphagia?

Dysphagia refers to difficulty swallowing, which can impact the ability to safely move food or liquids from the mouth to the stomach. It may result from conditions such as stroke, Parkinson’s disease, or head and neck cancer. Dysphagia can lead to complications like malnutrition, aspiration pneumonia, or choking. Our lab investigates the underlying mechanisms of dysphagia and develops strategies for effective management.

Team

Co-Directors

Terry Hopkins-Rossabi, Ph.D., CCC-SLP, BCS-S

Theresa HopkinsRossabi Dr. Terry Hopkins-Rossabi brings over 30 years of clinical experience in medical speech-language pathology to her research on swallowing disorders (dysphagia). Her primary focus thus far in the MUSC SLP program has been as an instructor in Adult Swallowing, Cognitive Communication Disorders in Adults, Trach and Ventilatory Patients, Assessment, Intro to Research, and Counseling. Her research projects have focused primarily on adult swallowing disorders and the importance of instrumental evaluation of swallowing. These projects have resulted in presentations, including SLP master’s students at national and state conferences as well as a publication in the Dysphagia journal. She is a national leader in dysphagia education, clinical care, and research, with a special interest in adult swallowing. When not teaching or involved in projects in the lab, Dr. Rossabi will be hiking, kayaking, skiing, or spending time with her husband, two children, and their partners.

Dr. Rossabi’s publications

Janina Wilmskoetter, Ph.D., CCC-SLP

Dr. Janina Wilmskoetter is a certified and licensed speech-language pathologist (SLP) and researcher specializing in the neuroanatomical correlates of dysphagia and aphasia and its recovery after stroke. As an Assistant Professor in the SLP Division, she researches post-stroke dysphagia, teaches Dysphagia and Aphasia in the SLP graduate program, and provides clinical care in acute care and neurological specialty clinics. Dr. Wilmskoetter is passionate about training future SLPs, educating practicing clinicians, and translating research into clinical practice to help individuals with dysphagia and aphasia achieve their best possible recovery. When she’s not in the lab, you’ll probably find Dr. Wilmskoetter out for a run, on a yoga mat, or chasing the wind while kiteboarding. She never says no to chocolate — and has a serious case of wanderlust.

Dr. Wilmskoetter’s publications

Lab Staff

Program Manager, Stephanie Cute, M.A., CCC-SLP

Stephanie Cute, is an ASHA-certified and licensed speech-language pathologist (SLP) and research program manager. She graduated with a B.S. in Speech-Language Pathology and Audiology from Miami University in 2008 and an M.A. in Communication Science and Disorders from the University of Pittsburgh in 2010. She has previously worked in hearing and aging research and in research and clinical intervention related to Dyslexia. Stephanie worked clinically in pediatrics for 10 years but has loved returning to the neuro-rehab research world! She currently works on research studies related to aphasia and dysphagia outcomes post-stroke. In her free time, Stephanie loves tennis and golf (both playing and watching), reading, and trying new restaurants in Charleston.

Research Coordinator, Roland Cote, BS

Roland Cote is a research program coordinator. He graduated from Rutgers University with a B.S. in Exercise Science and Sport Studies in 2017. His previous experience includes working as a rehab tech in both acute care and outpatient clinics. Before joining the AMSL Lab, he worked in a spinal cord injury research lab as a program coordinator. Roland is also a Certified Strength and Conditioning Specialist. In his free time, he enjoys working out, spending time in nature, and playing rugby.

Students & Research Assistants

Research Assistant, Gaby Katz, BS

Gaby Katz is a graduate student in the SLP program and supports data collection and study procedures in the AMSL Lab as a research assistant. Gaby graduated with a B.S. in Human Development and Family Sciences at the University of North Carolina at Chapel Hill in 2023, where she also played on the women’s softball team. Gaby has worked under Dr. Janina Wilmskoetter on multiple projects and has presented her research at MUSC Research Day and the SCSHA Annual Conference. In addition to her research, she has completed multiple clinical rotations in adult acute care and has developed a strong interest in dysphagia. She will complete her clinical externship at the Hospital of the University of Pennsylvania and, upon graduation, will complete her clinical fellowship at the University of Wisconsin in adult acute care with a concentration in swallowing. When she’s not in the classroom or the lab, you can find Gaby in the gym or on the pickleball court.

Research Assistant, Lauren Nelson, BS

Lauren Nelson is a graduate student in the SLP program and supports data collection and study procedures in the AMSL Lab as a research assistant. Lauren has gained valuable experience by observing SLPs in a variety of settings, including children's clinics, elementary schools, acute care, and skilled nursing facilities. Her interests within the field of SLP are primarily focused on neurogenic rehabilitation. In her free time, Lauren enjoys surfing, traveling, practicing yoga, and enjoying the live music scene of Charleston.

Research Studies Conducted in the AMSL Lab

Neuroanatomical correlates of dysphagia after stroke

We investigate how stroke lesions are associated with swallowing impairments to identify the neural circuitry that supports swallowing function after stroke. Beyond lesion-related damage, we are also interested in understanding how age-related neuroanatomical changes contribute to post-stroke dysphagia. Our overarching goal is to establish a theoretical framework for the neural control of swallowing after stroke. Through this work, we aim to improve early-stage risk prediction and patient counseling following stroke. Ultimately, our findings may help identify neuroanatomical targets for intervention and support efforts to prevent complications of dysphagia.

woman teaching two students in front of monitor — Dr. Wilmskoetter and two former lab students, Jenna Clinger and Emma Tracy, are discussing the impact of stroke lesions on the brain network that controls swallowing.

Dr. Wilmskoetter has received funding from the National Institutes of Health to support this line of research.
https://reporter.nih.gov/project-details/11047167

group of people standing outside a building — The NIH-funded project is conducted at MUSC and the University of South Carolina. The interprofessional team at MUSC includes (from left to right): Bethany Wolf, Ph.D. (biostatistician), Christine Holmstedt, DO, FAHA (neurologist), Stephanie Cute, CCC-SLP (speech language pathologist and project manager), Janina Wilmskoetter, Ph.D., CCC-SLP (speech language pathologist), LuAnne O’Connor, CRA (grants administrator), Roland Cote, BS (project coordinator), and Vittoria Spampinato, M.D. (radiologist, not pictured). At USC, the team includes Heather Bonilha, Ph.D., CCC-SLP (speech language pathologist), Leonardo Bonilha, MD, Ph.D. (neurologist), and Souvik Sen, MD, MPH (neurologist).

Therapy for people with aphasia after stroke

In collaboration with the Center for the Study of Aphasia Recovery (C-STAR) at the University of South Carolina, we investigate how individuals recover from aphasia following stroke. As part of this work, we are conducting clinical trials to evaluate how aphasia therapy can enhance communication abilities and improve the quality of life for people with aphasia. Our goal is to deepen our understanding of how to personalize aphasia treatment based on each individual's unique profile, ultimately optimizing recovery outcomes.

posed group of women — Dr. Wilmskoetter (left) and former post-doctoral scholar Dr. Deena Schwen Blackett (right) led a group of lab students (from left to right: Kelly Criscitiello, Emily Tecco, Alena Joyce, Amy Roesch, Lennox Bradshaw) in conducting discourse analyses for people with aphasia.

Publications

Publications from the AMSL lab

Complete Bibliography

Pubmed listed publications from Dr. Hopkins-Rossabi
https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Hopkins-Rossabi+T&cauthor_id=39214883

Pubmed listed publications from Dr. Wilmskoetter:
https://pubmed.ncbi.nlm.nih.gov/?sort=date&term=Wilmskoetter+J&cauthor_id=33719732

Selected publications (in chronological order):

Hopkins-Rossabi, T., Brubaker, A., Carter, S., Hardy, C., and Temple, S., (2024). Analysis of patients’ dietary status/restrictions following instrumental swallow evaluations in skilled nursing facilities, Dysphagia, 1-13. https://doi.org/10.1007/s00455-024-10750-x

Wilmskoetter, J., Bonilha, H., Wolf, B. J., Tracy, E., Chang, A., Martin-Harris, B., Anne Holmstedt, C., & Bonilha, L. (2024). Cerebral small vessel disease is an independent determinant of dysphagia after acute stroke. NeuroImage. Clinical, 44, 103710. https://doi.org/10.1016/j.nicl.2024.103710

Hannan, J., Wilmskoetter, J., Fridriksson, J., Hillis, A. E., Bonilha, L., & Busby, N. (2023). Brain health imaging markers, post-stroke aphasia and Cognition: A scoping review. NeuroImage. Clinical, 39, 103480. https://doi.org/10.1016/j.nicl.2023.103480

Wilmskoetter, J., Busby, N., He, X., Caciagli, L., Roth, R., Kristinsson, S., Davis, K. A., Rorden, C., Bassett, D. S., Fridriksson, J., & Bonilha, L. (2023). Dynamic network properties of the superior temporal gyrus mediate the impact of brain age gap on chronic aphasia severity. Communications biology, 6(1), 727. https://doi.org/10.1038/s42003-023-05119-z

Busby, N., Wilmskoetter, J., Gleichgerrcht, E., Rorden, C., Roth, R., Newman-Norlund, R., Hillis, A. E., Keller, S. S., de Bezenac, C., Kristinsson, S., Fridriksson, J., & Bonilha, L. (2023). Advanced Brain Age and Chronic Poststroke Aphasia Severity. Neurology, 100(11), e1166–e1176. https://doi.org/10.1212/WNL.0000000000201693

Wilmskoetter, J., Roth, R., McDowell, K., Munsell, B., Fontenot, S., Andrews, K., Chang, A., Johnson, L. P., Sangtian, S., Behroozmand, R., van Mierlo, P., Fridriksson, J., & Bonilha, L. (2023). Semantic Categorization of Naming Responses Based on Prearticulatory Electrical Brain Activity. Journal of clinical neurophysiology: official publication of the American Electroencephalographic Society, 40(7), 608–615. https://doi.org/10.1097/WNP.0000000000000933

Garand, K. L., Bhutada, A. M., Hopkins-Rossabi, T., Mulekar, M. S., & Carnaby, G. (2022). Pilot study of respiratory–swallow coordination in amyotrophic lateral sclerosis. Journal of Speech, Language, and Hearing Research, 65(8), 2815-2828. https://doi.org/10.1044/2022_jslhr-21-00619

Roth, R., Wilmskoetter, J., & Bonilha, L. (2022). The role of disrupted structural connectivity in aphasia. Handbook of clinical neurology, 185, 121–127. https://doi.org/10.1016/B978-0-12-823384-9.00006-2

Wilmskoetter, J., He, X., Caciagli, L., Jensen, J. H., Marebwa, B., Davis, K. A., Fridriksson, J., Basilakos, A., Johnson, L. P., Rorden, C., Bassett, D., & Bonilha, L. (2022). Language Recovery after Brain Injury: A Structural Network Control Theory Study. The Journal of neuroscience: the official journal of the Society for Neuroscience, 42(4), 657–669. https://doi.org/10.1523/JNEUROSCI.1096-21.2021

Alkhuwaiter, M., Davidson, K., Hopkins-Rossabi, T., & Martin-Harris, B. (2021). Scoring the Penetration–Aspiration Scale (PAS) in Two Conditions: A Reliability Study. Dysphagia, 1-10.
https://doi.org/10.1007/s00455-021-10292-6

Hopkins‐Rossabi, T., Armeson, K. E., Zecker, S. G., & Martin‐Harris, B. (2021). Respiratory‐swallow coordination and swallowing impairment in head and neck cancer. Head & Neck, 43(5), 1398-1408. https://doi.org/10.1002/hed.26609

Chang, A. J., Wilmskoetter, J., Fridriksson, J., McKinnon, E. T., Johnson, L. P., Basilakos, A., Jensen, J. H., Rorden, C., & Bonilha, L. (2021). Cortical microstructural changes associated with treated aphasia recovery. Annals of clinical and translational neurology, 8(9), 1884–1894. https://doi.org/10.1002/acn3.51445

Wilmskoetter, J., Fridriksson, J., Basilakos, A., Phillip Johnson, L., Marebwa, B., Rorden, C., Warner, G., Hickok, G., Hillis, A. E., & Bonilha, L. (2021). Indirect White Matter Pathways Are Associated With Treated Naming Improvement in Aphasia. Neurorehabilitation and neural repair, 35(4), 346–355. https://doi.org/10.1177/1545968321999052

Hopkins-Rossabi, T., Rowe, M., McGrattan, K., Rossabi, S., & Martin-Harris, B. (2020). Respiratory– swallow training methods: Accuracy of automated detection of swallow onset, respiratory phase, lung volume at swallow onset, and real-time performance feedback tested in healthy adults. American Journal of Speech-language Pathology, 29 (2S), 1012-1021. https://doi.org/10.1044/2020_ajslp-19-00201

Hopkins-Rossabi, T., Curtis, P., Temenak, M., Miller, C., & Martin-Harris, B. (2019). Respiratory phase and lung volume patterns during swallowing in healthy adults: A systematic review and metaanalysis. Journal of Speech, Language, and Hearing Research, 62(4), 868-882. https://doi.org/10.1044/2018_jslhr-s-18-0323

Garand, K. L., Strange, C., Paoletti, L., Hopkins-Rossabi, T., & Martin-Harris, B. (2018). Oropharyngeal swallow physiology and swallowing-related quality of life in underweight patients with concomitant advanced chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease, 2663-2671. https://doi.org/10.2147/copd.s165657

Resources for Patients and Families

We provide resources designed to support patients and caregivers navigating aphasia and dysphagia.

Support Groups:

Connect with others facing similar challenges.

Charleston Communication Connection (CCC) is a group for adults with acquired communication disorders like aphasia or apraxia. The group meets monthly for a variety of educational and therapeutic activities as well as conversation and support. Past events have included watching and discussing a documentary on aphasia, hearing from a 911 operator and police officer about access to emergency services, and participating in an art therapy session. Speech-language pathology graduate students from MUSC also join the group each month to learn from the group members. The group meets the last Friday of each month (January through October) from 2:30pm-3:30pm in the Garden Room at MUSC Midtown- 1600 Midtown Avenue, 29464. For more information, contact Stephanie Cute at cute@musc.edu.

Clinical Trials:

We are actively recruiting participants for our ongoing treatment study “TERRA.”

The purpose of this Telerehabilitation for Aphasia (TERRA) research study is to assess the effectiveness of telehealth aphasia therapy visits compared to aphasia therapy administered in person at our clinic.

Study participants will:

Complete several tests that assess your speech and language abilities.
Receive a magnetic resonance image (MRI).
Receive a total of 30 speech therapy sessions, randomly assigned to be delivered either in-clinic or via teletherapy.

You may be eligible to participate if you:

Have a left hemisphere ischemic or hemorrhagic stroke at least 12 months ago
Are between 21 and 80 years of age
Are compatible with MRI (e.g., no metal implants, not claustrophobic)
Are not currently enrolled in or receiving speech-language therapy provided by a licensed therapist

For more information or to see if you qualify, contact Stephanie Cute at cute@musc.edu.