pharyngeal transit times and P-A scale values for the thick and thin consistencies was not

supported by the data in this study. Pearson r correlations did not show significant

relationships between oral transit time, pharyngeal transit time, and/or tongue pumps with

P-A score. This is somewhat surprising given the strong relationship identified in this

study between consistency, increased oral transit and the number of tongue pumps, as

well as the strong relationship identified in prior research between thicker consistencies

and penetration/aspiration of the bolus. Further discussion on the variables which could

have possibly contributed to this result are to follow in the discussion of the study's

limitations.

Quality of Life

 It was hypothesized that persons with more impaired oral stages of swallow would

report more impaired quality of life, but no significant relationships were found between

swallowing quality of life and other dependent measures, including

penetration/aspiration. This may be explained by the "anosognosic" nature of persons

with PD. This population is often considered to have decreased insight into their own

behaviors and medical severity (Starkstein et al., 1996, Seltzer et al., 2001).

Interestingly, the oldest participant reported the best swallowing quality of life, although

both the oral and pharyngeal phases of this participant's swallow were no more or less

impaired than most of the other participants. This apparent reduced reliability of patients

with PD to recognize or quantify swallow impairment is important to note clinically.

This lack of insight may prove detrimental to health and safety in later stages of

dysphagia. It is therefore the responsibility of the clinician to judge a patient's insight

into their own disorder, be it through interview or more extensive neuropsychological

testing, in order to make wise decisions involving management of dysphagia. These