Purpose: Speech and language pathologists (SLP) are frequently consulted for guidance on the management of oral solid medications. However, the extent to which SLPs consider solid medication intake during swallowing examination remains unclear. The present study endeavoured to find out whether and how SLPs assess patients' ability to swallow solid dosage forms (SDF) in clinical settings, with a specific focus on stroke units. Methods: An online cross-sectional survey was conducted among SLPs in German-speaking countries. The questionnaire was targeted at SLPs working in hospitals and distributed through both direct outreach and passive dissemination on social networks. Results: Of 200 returned questionnaires, 147 were eligible for inclusion. Of these, 108 (73.5%) evaluated the swallowing ability of solid oral medications and were further analysed. During clinical swallowing examination, the patient's own medication is most frequently used (63.9%). 92.6% of the 108 SLPs stated that they regularly offer guidance on altering SDFs. SLPs' decision to recommend modified SDFs or pause them is influenced by oral cavity retention of SDFs, pharyngeal phase disorders and SDF intake-related coughing. Additionally, SLPs employ textures that were determined to be safe for accompanying boluses, with fruit puree and water being the most preferred types. Responses of SLPs working on stroke units did not differ significantly from those working on other wards. Conclusion: SLPs commonly evaluate the swallowing ability of SDFs. Typically, they utilise the patient's own medications for testing purposes and previously trialled consistencies as accompanying boluses. Specific evaluation and educational programs are needed to enhance the management quality of oral SDFs.