The overall objective of this pilot study is to determine blue dye test validity and reliability for the identification of aspiration of secretions, food, and/or drink in ventilator- dependent and/or tracheostomized individuals. Determining the validity and reliability of the blue dye test will facilitate effective and timely patient-care decisions and efficient use of payor funds. It will additionally increase clinician confidence in the results obtained with this test and subsequent recommendations for changes in patient management. This is a prospective study in which the results of simultaneously administered blue dye and modified barium swallow tests will be tested for degree of correlation.