Clin-STAR Journey Story

From Paper Plates to Dinner Plates: A Speech Language Pathologist Helps Patients with Dysphagia

Raele Robison, PhD, CCC-SLP is currently a postdoctoral fellow in the Department of Medicine at the University of Wisconsin-Madison. But seeds of her career were planted in high school: “It all started with a paper plate,” she said. After school one day, she found a paper plate stuck in her doorway with a note on it. Her neighbor was retiring from her speech-language pathology position in the local schools, and she asked Raele to help her sort through 30 years of materials. As the two of them worked on organizing, Raele could see the joy and pride her neighbor felt by helping myriad children over the years through speech language pathology. Right then, Raele knew, “I also wanted this kind of a professional purpose—one that was both fulfilling and joyful.”

With this beginning and deciding that she was more interested in the medical side of the field, Raele worked at a local hospital as a patient safety assistant. She cared for hospitalized patients who were confused, agitated, or going into or coming out of surgery. Because she worked from 3 to 11 pm, her shift included dinnertime. She remarks, “When I witnessed the profound and emotional effects that being unable to eat had on patients, I became determined to study swallowing and dysphagia.”

She set off for Florida without much of a plan, thinking that “it will all work out with a senior researcher who was active in the dysphagia field.” Remarkably, it did, with Raele first joining the lab of Dr. Emily Plowman and later as a postdoc securing a place in the lab of Dr. Nicole Rugus-Pulia, Director of the Swallowing and Bioscience Laboratory, who remains Raele’s primary mentor to this day. Raele worked with patients who had amyotrophic lateral sclerosis and earned her PhD in the University of Florida rehab sciences program. NIH funding covered some of her predoctoral and postdoctoral research, during which time she developed an interest in geriatric medicine, functional reserve, and frailty. Her current research project involves investigating the relationship between frailty and swallowing. Through this project and working in geriatric medicine, she came to understand the need for health equity research in the field of dysphagia. She says, “When we evaluate swallowing, much depends on the environment and environmental resources, good social support, good grocery stores, and transportation. This includes looking for opportunities and ways to not only contribute to geriatric medicine but also to incorporate health equity, which has been overlooked in the world of dysphagia.”

Dr. Robison’s introduction to Clin-STAR was when she joined the Frailty Research Interest Group. Speech-language pathologists are already familiar with a lot of the frailty instruments, although they are usually performed by someone else. The Interest Group has allowed her to think and talk about frailty in a more holistic way, interfacing with others in the fields of geriatrics and gerontology. She is also involved with a collaborative paper being prepared by members of the Interest Group.

Dr. Robison is now a Clin-STAR Health Equity Scholar and co-chair of the new DEIA Research Interest Group. She is excited to be “on the front line” and has found that DEIA research is challenging because of the need to form so many collaborative partnerships. Because her background is in a nontraditional field, she feels that having access to the larger Clin-STAR community, which includes clinicians from many other fields, has been greatly beneficial. She notes, “Networking with others in the DEIA space and building community have been wonderful experiences. Everyone is very welcoming, and willing to hear new perspectives.”

Dr. Robison continues, “We need to become more integrated. You can’t separate people’s lived experiences from research. Our discussions on DEIA principles and patient-centered approaches that focus on older persons have been highly informative; we need to bring this into dysphagia research.”

Likewise, she has been invigorated by being able to learn from clinician investigators in disciplines outside of speech language pathology. Learning how tools are used in other disciplines has been invaluable, as has been the experience of stepping outside of her comfort zone and learning how to bridge gaps between disciplines. She hopes that someday she will be one of many speech-language pathologists in the Clin-STAR community, all working toward a more integrated health system that can better care for older patients. She says, “Everyone has something to bring to the table!”