Hope and Healing Across the Globe

The Biber Protocol® NMES for Dysphagia  


The Biber Protocol® is a method designed to restore swallow function using true NMES.

"The goal of swallowing rehabilitation is to restore swallow function to the highest level possible in order to prevent further complications and promote optimal quality of life." (Biber 2008)  

The Biber Protocol® has been successfully implemented with over a million treatment sessions worldwide with consistently excellent outcomes. Teresa Biber LoMonte is known for her passion, innovation and compassion. She functions with a singular mantra in mind; a life lived to help others is a life worth living. Her mission is to lead the way in the advancement of rehabilitation tools to restore function to the highest level possible to improve the quality of life for all patients. She believes clinicians and patients alike should have access to the most effective therapy options in a global market. Teresa puts the care back in Healthcare!


The Biber Protocol® is a program designed to train speech-language pathologists in a method which utilizes the fundamental electrophysiological principles that have been successfully implemented for over thirty years in neurorehabilitation. Participants will learn how to apply these principles for the treatment of dysphagia across the lifespan.  


Developed in 1999 by Teresa Biber LoMonte, The Biber Protocol® is a method for using NMES as an adjunctive modality to a well designed rehabilitation protocol for dysphagia. The Biber Protocol® can be used to promote improved strength, timing and reeducation of swallowing musculature.

Description and Course Objectives


The course will teach underlying key scientific principles including electrophysiology, neuroplasticity, neuromuscular retraining and biofeedback and the anatomy/physiology of the swallowing mechanism. The course will also include etiological concerns, efficacy data supporting treatment outcomes and step by step details of treatment. Hands-on practice will be provided with one-on-one instruction as needed with practical considerations and presentation of case studies.  The impact of NMES treatment on cortical re-organization from pre/post neural imaging data will also be presented.

An analysis of the historical and current evidence will also be reviewed. Participants will see how NMES meets the criteria for evidence based practice. 

This highly efficacious treatment technique is safe, affordable, painless and can prevent the occurrence of deadly complications. NMES is an excellent tool for the clinician with hopes of affecting a positive change in swallow function.


  • Define electrotherapy and learn about the science behind the modality
  • Differentiate NMES from other electrical stimulation protocols and describe its unique properties and biological effect
  • Identify appropriate candidates for which NMES is indicated for the treatment of dysphagia
  • Discuss and demonstrate the application of The Biber Protocol®  for the treatment of dysphagia
  • Provide a rationale for the inclusion of swallowing exercises in conjunction with NMES
  • Explain how each adjustable electrical stimulation parameter functions to maximize therapeutic outcomes
  • Demonstrate and articulate effective patient education regarding the purpose and use of NMES  
  • Recognize the preponderance of evidence that supports the use of NMES for dysphagia

Teresa Biber LoMonte has developed, trademarked and copyrighted all intellectual property associated with The Biber Protocol®. Her protocol is often imitated but never duplicated. Trust the original and be aware of fraudulent imitators. 

This course has been previously offered for 1.35 ASHA CEUs 

(Advanced level, Professional area)

Resubmission to ASHA in process for 2018

Click here to request course offerings

The Creator of The Biber Protocol®


Teresa Biber LoMonte, M.S, CCC-SLP

Mrs. Biber LoMonte is an internationally recognized Speech-Language Pathologist and authority on electrical stimulation and dysphagia.   Teresa developed the Biber Protocol® in 1999 and has been teaching clinicians and patients all over the world since 2001. She has extensive training in the evaluation and treatment of individuals with head and neck cancer and is a leading expert in the use of neuromuscular electrical stimulation and swallowing treatment. She is cross-trained in a multitude of Physical Therapy techniques and has developed additional innovative protocols for voice and swallowing disorders. She has utilized manual therapy in treatment since 2000 and subsequently developed The LoMonte Technique. 

She is also an actress, director and filmmaker and has written and produced many short educational films including a documentary on head and neck cancer.  She received her Masters of Science from Nova Southeastern University where she was student of the year.  She is dedicated to constantly advancing her knowledge and is a seven time recipient of the ACE award. She is a member of the Dysphagia Research Society as well as many other organizations and was recently recognized as a professional woman of the year by the National Association of Professional Women. She also served as the electrotherapy consultant on a large multi-center randomized placebo controlled clinical trial funded by the NIH. She is currently working with a European company to develop a prototype of an EEG based swallowing rehabilitation system. 

Teresa is known for her passionate devotion to helping others and is a active supporter and volunteer in many charitable organizations including: The National Foundation of Swallowing Disorders, The Swallows, Curadis, The Voice and Swallow Center non-profit, Support for People with Oral and Head and Neck Cancer (SPOHNC), Karma Tribe, Habitat for Humanity and The Global Orphan Project. 


Financial: Mrs. Biber LoMonte receives compensation as a course instructor

Non-Financial: No relevant non-financial relationships 

Course Policies


Course Cancellations

If it becomes necessary for The Biber Protocol® to cancel or reschedule a course, the participant will be contacted via email and phone and offered a full refund or a transfer to another course. When the participant opts to transfer to another course, the full amount of the cancelled class funds will be applied to the new course. If the new course fee is less than the cancelled course, a refund will be issued for the difference.  If the new course fee is greater than the cancelled course, The Biber Protocol® will cover the additional cost.

Participant Cancellations

Participants may cancel a course registration up until 14 days prior to the course date to receive a refund or transfer to another course. Cancellations received after the 14-day window are only eligible for a refund in the presence of extenuating circumstances such as illness, family emergency or serious accident. Refunds after the 14 day window will be considered on a case by case basis.


The course is offered via webinar format with both visual and audio components.  Accommodations provide an alternative way to accomplish the course requirements by eliminating or reducing disability-related barriers. If you need to request accommodations, please email teresa@thebiberprotocol.com or call 954-621-2900.

Requirements for Course Completion

To receive credit for completion of the course, participants must pay course fee, attend the entire course offering, and complete ASHA participant form, post-test, and post course evaluation. Each participant must also demonstrate basic competence in explaining the procedure, placing electrodes, setting up device, determine optimal output, assessing for contraction and changing parameters. No partial credit will be awarded.

Target Audience

The target audience for this course includes speech-language pathologists with a foundational knowledge of dysphagia and a desire to improve outcomes.  There are no prerequisites for this course.  Additional professionals are also welcome to attend, but CEUs are only available through ASHA at this time.

Complaint Policy

The Biber Protocol® greatest desire is to ensure that each participant has a positive and enlightening experience with the instructor and course offering.  Constructive criticism is always welcome. Any concerns, complaints can be sent to teresa@thebiberprotocol.com.   Participants may also call 954-621-2900 to provide feedback or discuss any concerns.

Course Policies


Fair and Equitable Treatment for All

The Biber Protocol® promises to uphold the highest standards of professional conduct and will not discriminate against course participants on the basis of gender, age, socioeconomic or ethnic background, sexual orientation, or disability. We are all created equal.

Intellectual Property

Teresa Biber LoMonte is the author and creator of The Biber Protocol®. The Biber Protocol® has been registered with the US Patent and Trademark Office. The intellectual property presented in this course representing The Biber Protocol® has been registered and is protected by the US Copyright Office. The first public presentation of the copyrighted material was in 2001. 

Section 106 of the copyright law provides the owner of copyright in a work the exclusive right:

• To reproduce the work in copies;

• To prepare derivative works based upon the work;

• To distribute copies of the work to the public by sale or other transfer of 

   ownership, or by rental, lease, or lending;

• To perform the work publicly;

• To display the copyrighted work publicly;  

• In the case of sound recordings, to perform the work publicly by means of a    

   digital audio transmission.

Section 501 of the copyright law states that “anyone who violates any of the exclusive rights of the copyright owner ...is an infringer of the copyright or right of the author.”

Generally, under the law, one who engages in any of these activities without obtaining the copyright owner's permission may be liable for infringement.

Manual Therapy Course


Why Manual Therapy?

  • Many patients present with muscular tension, fascial restrictions, fibrosis, edema and other connective tissue problems that inhibit the structures necessary for normal speech, swallowing and voice.                                                 
  • These tissue deficits will often interfere with our ability to utilize standard interventions and subsequently prevent optimal outcomes. 


What is Manual Therapy?

  • Manual therapy is a method of using skilled touch to assess and provide specific movements of joints and soft tissue to improve tissue extensibility; increase range of motion; induce relaxation; mobilize or manipulate soft tissue and joints; modulate pain; and reduce soft tissue swelling, inflammation, or restriction.                                                
  • There are many types of manual therapy techniques such as manual lymphatic drainage, myofascial release, massage, stretch, mobilization/manipulation, and passive range of motion. 


The LoMonte Technique

  • This intimate hands-on training will provide those working with speech, voice and swallowing disorders an introduction to some basic manual therapy techniques to analyze and address the tissue problems that may be interfering with normal sensory and movement patterns.    
  • This will in turn allow for a better designed intervention plan and result in overall improved outcomes.                                      
  •  This course is a must for anyone treating NPC or other head and neck cancer patients.

Course Topics and Objectives


Course Outline

  • Speech, Swallowing and Voice:    Understanding the mechanism of dysfunction 
  • Soft tissue Anatomy and Physiology:      Understanding Normal and Abnormal
  • Fibrosis, Edema and Myofascial Restriction
  • Posture: Alignment and Flow
  • Introduction to Manual Therapy 
  • Review of Scientific Literature, evidence and examples
  • Demonstration and Hands-on Lab 1: Establishing the   foundation for assessment and determining intervention
  • Introduction to Tools for tissue anomalies
  • Demonstration and Hands-on Lab 2: Practice with various techniques and tools
  • Demonstration and Hands-on Lab 3: Establishing  competency from start to finish, developing a home program
  • Case Studies with Final Questions and Answers

Learning Outcomes

  • Explain the different mechanisms of dysfunction that can have an effect on normal speech, swallowing or voice
  • Understand the anatomy and physiology of soft tissue and it’s relationship to the systems involved in speech, swallowing and voice
  • Describe abnormal pathophysiology and the different types of soft tissue dysfunction and the consequences on the affected systems       
  • Identify postural deficits and the impact on the mechanism of dysfunction 
  • Demonstrate assessment and basic manual therapy skills for the treatment of speech, swallowing and voice disorders
  • Review the evidence for the benefits of manual therapy
  • Understand when and how manual therapy should be included in a treatment plan

Course Requirements

You will experience manual therapy as a clinician and a patient. This course will provide training for hands-on touch to the head, face, jaw, neck, upper shoulders and upper chest. 

Please wear comfortable clothes that will allow you to confidently lie down and get back up repeated times. Gym clothes or leggings are most appropriate. You must also wear a shirt that allows for skin contact of the shoulders and upper chest. A tank top or athletic top is best. You must feel comfortable with placing your hands on others in a therapeutic manner and likewise having others place their hands on you. 

You will need to bring a yoga mat and either a large towel or flat sheet to lie on.

The benefits of touch are many, from soothing a hypersensitive nervous system, to improving sleep patterns, and boosting the immune system. You will not only learn how to provide such an important therapy to your patients but you will also receive an extra benefit from experiencing the therapy first hand.

Space is limited to 10 participants. 

This course is designed for health care professionals who are providing therapy for patients with speech, swallowing and voice disorders