When the patient is conscious and able to sit, the following training can be started. Training to improve the pharyngeal reflex can be done by repeatedly stimulating the patient’s soft palate and posterior pharyngeal wall with a frozen wet swab. Vocal closure exercises allow the patient to say “ah” out loud. This exercise trains the patient to close the vocal cords at will and is effective in preventing aspiration. Supraglottic swallowing This is a set of training actions that allows the patient to inhale fully, hold it, then slowly swallow saliva, then exhale, and finally cough. This is trained by using the principle of vocal fold closure when stopping breathing, and the final cough is to remove the remaining food around the larynx. It is suitable for patients in whom the process of swallowing causes misopharynx.