Byline: Melody Sheldon, M.A.,CCC-SLP owns and operates Southwest Rehabilitation, a private practice in Coos Bay, Oregon. Since 1989, she has been providing services to acute care hospitals, extended care facilities, hospice, home health agencies, transitional homes, and to pediatric and adult patients in her clinic. In an effort to provide continuity, Melody Sheldon developed the Dysphagia Complaint Scale, which she and her staff use with patients and their families to rate the severity level of the problem throughout an episode of care. continue reading →
Written by Karen Sheffler, MS, CCC-SLP, BCS-S of www.SwallowStudy.com (revised April 25, 2017). Reposted on the NFOSD website with the author’s permission. See Karen’s Biography at the end of this article.
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In 2015, KRSD Communication Tools published “Educational Video for Individuals with Dysphagia: Exercises and Maneuvers to Help with Swallowing Difficulties,” a home therapy program created by three speech-language pathologists (Dondorf, Fabus, and Gatzonis) for use by both clinicians and patients.
By: Mary Spremulli, CCC-SLP. Ms. Spremulli is the owner of Voice Aerobics, LLC, a Speech-Language Pathology Private Practice, located in SW Florida. She holds a speech-language pathology license in Florida, Ohio, and North Carolina, and a nursing license in Florida. She is a faculty member of Parkinson Place in Sarasota, FL, and a member of the Education Committee of the World Parkinson Program. Ms. Spremulli has been a Clinical Consultant with Passy-Muir, Inc. for over 20 years providing education to professionals and patients, and she has published articles on the topic of patient education. Since 2013, Ms. Spremulli has hosted a monthly podcast, focusing on topics related to living well with Parkinson’s and other neurological diseases.
Applications for Patients with Dysphagia
Description: Swallow RehApp is the newest mobile-hosted application designed to be a natural and effective complement to the traditional swallowing rehabilitation regimen. It harnesses the power of mobile technology by providing patients with consistent exposure to their dysphagia exercise plan and related dysphagia education. Clinicians are able to customize the program in a manner that is specific to their patients’ deficits and track progress towards their goals.
Pros: The app contains a dedicated education section that allows patients to better understand their swallowing disorder. Contains nutritional resources including a 7-day dysphagia diet with recipes and pre-made shopping lists.
Cons: The app must be opened to see the alert to perform the exercises. It may be beneficial to set an additional alert/alarm on the phone using the “Clock” app to remind patients of when to perform exercises.
Availability: Compatible with iPhone, iPad, and iPod Touch; requires iOS 8.2 or later. Compatible with Android OS; requires 4.0 or later.
*Must be at least 17 years old to download the app.
Disclosure: The Swallow RehApp was developed by Endo-Education, which is an NFOSD corporate sponsor.
Description: This application provides a list of 50 pre-recorded phrases for patients and clinicians to choose from to describe a patient’s eating/drinking equipment, level of meal assistance required, diet modifications, how to take medications, and compensatory swallowing techniques. It also contains four demonstration videos of how to perform compensatory swallowing techniques.
Pros: The application allows the patient or clinician to choose the voice settings as either male or female. Phrases can be easily reset based on the patient’s needs. Each phrase includes text, audio, and a supplemental picture. This app would be useful for someone with communication or memory impairments.
Cons: Initially time consuming to delete the phrases not required by the patient under “Settings.”
Availability: Requires iOS 7.0 or later. Compatible with iPhone, iPad, and iPod Touch
*Compensatory swallowing techniques and diet modifications should be determined by a qualified swallowing clinician
Description: This application provides reminders to swallow for patients who have difficulty managing their saliva, which is sometimes a challenge for patients with a variety of neurological conditions. This simple app allows patients to set the frequency of the reminders to swallow, ranging from every 1 second to every 6 minutes. The patient can set reminders either as a tone or a vibration.
Pro: The newest version allows patients to connect to a Bluetooth headset. May help patients develop a more frequent automatic swallow pattern.
Con: This app tends to quickly drain your device’s cell phone battery. Adjusting the settings of the device to “Stand By” mode allows the device to preserve battery longer.
Cost: $0.99 (Apple), $1.49 (Android)
Requires iOS 8.0 or later. Compatible with iPhone, iPad, and iPod Touch
Requires Android 4.1 or later
Applications For Swallowing Clinicians
Description: This new application, released at the end of October 2015, is designed to help clinicians assess swallowing disorders and determine appropriate rehabilitation options. It consists of four sections: Assessment, Treatment, Therapy Finder, and Resources. This apps contains information about swallowing anatomy and physiology, the cranial nerves, treatment options, and downloadable patient handouts.
Pros: Once you become familiar with the app, you can design a treatment program for a patient and easily export this as a PDF or text file that includes instructions for the patient, sent directly to their email. There are over 45 swallowing management techniques that are included, which can be filtered by type of option (e.g., exercise, strategy, etc.).
Cons: Although you can export the recommended therapy options to a PDF/text file, you cannot add a specific regimen to each option (for example, adding “perform 10 reps three times a day”). This may be something that could be added in future updates, but you can currently work around this by adding information in the exported PDF/text file.
Availability: Compatible with iPad/iPad mini/iPhone/iPod touch; requires iOS 7.0 or later; .Compatible with Android OS; requires 4.1.03 or later
*Must be at least 17 years old to download the app.
Description: This application serves as a visual tool to help clinicians educate patients about swallowing disorders using animated videos. The video control options allow users to control the speed, pause the video, and view frame-by-frame. The application contains ten videos: 2 normal and 8 abnormal videos demonstrating the anatomy and physiology of swallowing.
Pro: Visuals help to give patients a better understanding of what is happening when they swallow. This app has the potential to improve patient’s buy-in to treatment by providing the patient with a more concrete understanding of their swallowing impairment(s).
Con: The videos of the abnormal anatomy and physiology depict only one specific impairment, which rarely exists in most patients. Videos only depict adult – not child – anatomy/physiology.
Availability: Requires iOS 8.0 or later. Compatible with iPhone, iPad, and iPod
Description: This clinician-focused app allows swallowing clinicians to quickly document observations and data relevant to swallowing evaluations at the bedside. You can record results of the oral mechanism examination and bedside swallow trials. You can also document recommendations for diet and positioning modifications, treatment, and follow up. The information entered into this app can be exported as an editable report, printed, or e-mailed. Information can be saved on the app for later reference.
Pro: This app reduces the need for paper note-taking and charting. Provides a detailed template for clinicians to follow during swallowing assessment. Clinicians can save data on the application to use for later reference.
Con: If the device (iPad) is not protected with a password, the information stored in the application is not compliant with HIPAA standards. If printing or emailing the report, users must assure that they are using a secure connection.
Availability: Requires iOS 8.0 or later. Compatible with iPad only.
*Clinicians should check with their IT Department if they are unsure if the app and device is HIPAA compliant prior to entering sensitive data.
Continuing Education Opportunity
If you are a clinician interested in learning more about swallowing apps, please visit Endo-Education’s website to view the online course: “iPhone Apps for Voice & Swallowing Disorders.” This course is $25 and upon completion, you can receive .05 CEUs. This course was designed to offer information to clinicians on how emerging technology can impact the delivery of treatment for voice and swallowing disorders. Endo-Education is a partner of the National Foundation of Swallowing Disorders.
Are We Missing Any?
If you are aware of other dysphagia apps for patients or clinicians, please share these with us in the “Comments” section below. We will review and add them to our list. If you use any of the apps listed above, we invite you to share your feedback below.