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and colleagues for patients treated for a tumour in the head and neck area, and it was validated and translated into Dutch by Speyer et al. (Speyer, Heijnen et al. 2011). The MDADI consists of 36 items, divided over 8 domains. The lower the score, the more problematic is the swallowing function. Another questionnaire (not validated for Dutch) is the Eating Assessment Tool (EAT-10) developed by Belafsky et al. (Belafsky, Mouadeb et al. 2008). This 10-item questionnaire was developed to identify problems in the oropharyngeal and oesophageal phases of the swallow.\u000DThe latest questionnaire developed for patients who have undergone a (total) laryngectomy is the Swallowing Outcome after Laryngectomy (SOAL) (Govender, Lee et al. 2012). This questionnaire contains 17 items, for which patients can indicate \u2018no\u2019, \u2018a little\u2019 or \u2018a lot\u2019. The aim of the questionnaire is to map out possible swallowing problems/reduced oral intake and their impact on quality of life for this patient group, ultimately aiming to start up tailored interventions (Govender, Lee et al. 2012).\u000D5.3.1.3 Swallowing therapy\u000DHead and neck cancer patients may be treated with surgery, radiation with or without concomitant chemotherapy. Each form of treatment has a negative impact on the swallowing function after treatment. The speech therapist has several rehabilitation methods at their disposal to reduce or remedy the swallowing problems that have arisen. Swallowing problems can be assessed through clinical swallowing tests, videofluoroscopy or FEES. The speech therapist can then prescribe various exercises, such as compensatory techniques, swallowing strategies and swallowing exercises, in order for the patient to regain their swallowing function as much as possible. Although the effectiveness of speech therapy exercises needs to be evaluated in randomised controlled trials, the Dutch Head and Neck Society (NWHHT) considers swallowing rehabilitation with various effective methods such as the Shaker method and the Mendelsohn manoeuvre to be essential components of the standard rehabilitation procedure within head and neck cancer treatment. In addition, a trend can be seen in starting up swallowing exercises before the onset of (organ preserving) treatment (preventive swallowing therapy), so as to prevent or minimise the (almost \u2018predetermined\u2019) swallowing problems. In other words, use it or lose it (van der Molen, van Rossum et al. 2009, Van der Molen, Van Rossum et al. 2014).\u000D5.3.1.4 Effectiveness of swallowing therapy\u000DThe negative effects of both (chemo-) radiotherapy and surgical resection on the swallowing function may be reduced through logopaedic exercises (Nguyen, Frank et al. 2008, Starmer, Quon et al. 2015). The question is, however, what would be the right moment for starting up therapy. In view of the currently known functional impairments resulting from CRT, various studies assessing the possible impact of preventive swallowing therapy have been published in the last few years (Kraaijenga, van der Molen et al. 2014). Several studies have indeed found benefits (fewer swallowing impairments, less feeding tube dependence) as a result of preventive logopaedic exercises (van der Molen, van Rossum et al. 2011, Carnaby-Mann, Crary et al. 2012, Kotz, Federman et al. 2012, Hutcheson, Bhayani et al. 2013, Ohba, Yokoyama et al. 2014, Van der Molen, Van Rossum et al. 2014, Peng, Kuan et al. 2015, Virani, Kunduk et al. 2015). In a study by Hutcheson et al., for instance, a group of 497 head and neck cancer patients treated with (chemo-) radiotherapy were analysed retrospectively on oral intake, feeding tube dependence and diet status (Hutcheson, Bhayani et al. 2013). Baseline measurements were compared with 6-12 months and 18-24 months after treatment. The total group could be divided into 6 subgroups; one group who had performed preventive exercises 4 times a day (a.o. Shaker exercise, jaw stretch, supraglottic manoeuvre, glissando, yawn, gurgle, Masako manoeuvre and\u000D106\u000D