[Editor’s Note: The NFOSD’s intent in publishing this material is to provide the dysphagia community with information about treatment options; it is not an endorsement of the products, companies, or therapy approaches. This content is provided for informational purposes only and should not be used as a substitute for consultation with an appropriate health care professional, as each individual’s medical situation is unique. It is important that you consult with your medical professional (e.g., physician, SLP) prior to implementing any course of treatment.]
Byline: Tiffany Turner, MS, CCC-SLP, Owner, Swallowing and Neurological Rehabilitation, www.tulsasnr.com. Tiffany founded a dysphagia focused outpatient center in 2014 to serve the northeastern Oklahoma region and fill a gap in her community, as she feels adult speech pathology services are often misunderstood and underutilized. She is also an author and publishes resources for other SLPs to use with their patients which have been downloaded by over 2,000 speech-language pathologists worldwide.
Dysphagia, or difficulty swallowing, affects up to 15 million adults in the United States. According to past publications, 1 in 25 people will experience some form of dysphagia in their lifetime, including 22% of those age 50 and older (ASHA, 2008; Bhattacharyya, 2014). People at the greatest risk for swallowing impairments include individuals who have had strokes, those with neurological conditions (such Parkinson’s disease), survivors of head and neck cancer, and the elderly. Despite the significant prevalence of dysphagia, this medical condition is often neglected, and many sufferers are never properly diagnosed or treated.
By: Nancy B. Swigert, M.A., CCC-SLP, BCS-S
Board Certified Specialist in Swallowing and Swallowing Disorders
Vesna Martich Kriss, MD
Pediatric Radiologist, Baptist Health Lexington
It has been recommended that your child undergo a video fluoroscopic swallowing evaluation, often called a modified barium swallow, to assess the pharyngeal phase of the swallow. This radiologic procedure exposes your child to x-rays which raises safety questions about the study. Here are some things parents should know about radiation safety and the video fluoroscopic swallowing exam (VFSS).
[Editors note. This is a follow on article to a two part mini-series on what to expect during “Your First Swallowing Assessment.”]
You may be thinking that the swallowing specialist already observed the way you swallow. While this is true, additional testing may be needed to determine why you may be having swallowing difficulties. This is because the timing, strength and coordination of swallowing is invisible to the human eye. Research has shown that many individuals aspirate (aspiration – when food or liquid enters the lungs) without coughing and cannot be diagnosed upon initial clinical swallowing evaluations, so further objective or instrumental examinations are ordered. (1)
[Editors note. This mini-series was a collaborative effort by Sharon C. Meier, MS CCC-SLP (Able Speech and Voice in Osprey, Florida), Jan Pryor, MA CCC-SLP BCS-S, and Ellen Conover, MS CF-SLP. Part one focused on swallowing disorder symptoms; this part, part two, focuses on what to expect during an initial swallowing assessment. NFOSD would like to thank each of our contributing authors.]
The first visit starts the minute we meet. Are you ambulatory (able to walk), alone or with another? As we walk toward the therapy room, dining room or kitchen table, we talk. I subjectively assess cognition (attention, memory, problem solving), vocal quality, pragmatics (social appropriateness in communication) and medical concerns. We discuss recent doctor visits. I assess posture, stature and proportional weight. We converse while establishing rapport. I ask if you are having eating, chewing and or swallowing issues.