Ramblings from ASHA16

Another ASHA convention has come and gone.  ASHA, for me, is a time that I wait all year for those 5 wonderful days of randomly and sometimes it’s intentionally running into friends from all over the US.  It’s a time of vowing every year that I will make it through the entire exhibit hall and never do and will go to X number of courses.  

For many, the planning begins at the beginning of the year.  People write their abstracts, submit them to ASHA and then wait for months to find out if they’re presenting.  After a long wait, emails start flying in, either a congratulations or “we’re sorry to inform you”.  Registration and housing opens in August with the internet flooded with SLPs and audiologists trying to get the best and closest room available.  Then it’s wait again until November.

The first sign of ASHA is always going to the airport, getting on the plane and trying to figure out who will also be attending the convention.  Poster tubes and planners can be found all over as people are excited to present their poster or planning their sessions as they wait.  

I was fortunate to attend several live sessions and poster sessions this year.  

My favorite poster session, by far was by Brenda Arend and Vince Clark on Starting a FEES Program in your Healthcare Setting, The Benefits and Barriers.  They were a popular poster and a wealth of information!  If you are on Facebook and a member of the Dysphagia Therapy Group Professional Edition you can find the information on their poster session here.   If you are not a member of the group and would like to be, send us a request!

My favorite live session this year was the session by Dr Michael Crary, Dr Giselle Carnaby and Lisa LaGorio, Using MDTP (McNeill Dysphagia Therapy Program) to Rehabilitate Severe, Chronic & Treatment-Refractory Dysphagia: A Review of Multiple Complex Cases.  This course was most likely my most tweets at the convention.  Not on Twitter?  I’ll share them here.  

I took the MDTP course 4 years ago!  I can’t believe it’s been that long!!  You can find my post here.

Sometimes we do the different assessments but then treat each patient the same.

The exercise is actually swallowing.

Promotes continuity of care with specific timelines and advancement, regression.

Frequency and intensity are high while burden on the patient is low.

MASA, FOIS, VAS (Visual Analog Scale), weight, improved swallow efficiency to assess.

Physiology-Fluoroscopy, increased lingual-palatal pressure, hyolaryngeal excursion, pharyngeal contraction, more efficient swallow.

5 articles available on

 
No treatment should ever work for everyone.
 
Patient with history 5 years 6 months dysphagia. PEG and NPO. Dysarthria, lingual weakness, weak cough.
 
Case 1 aspiration with all consistencies.
 

Case 1 15 day program. Progress is not lineal. There is a model learning component to

130 to 150 swallows per session.

Accuracy is 8 out of 10 successful swallows.

Focus on enhancing the motor planning for patients when necessary.

Case 1 post Botox and still aspiration but also some swallows.

Success is not always “no aspiration”.

Can push diet and advancement with cognitive and motor planning treatment.

Severe motor planning deficits may take longer to rehabilitate.

Patient may needs to unlearn faulty behavior.

Ice chips are the beginning of the protocol.

Unexplained weight loss can be our nemesis in therapy.

Sometimes a FOIS level 5 may be functional for a patient.

Some patients are ok being a functional aspirator.

can be completed in acute care, rehab, outpatient. You may just need to start at ice chips and advance as cognition improves.

may be a replacement for traditional exercises in appropriate patients.

is working to put everything together for the patient.

The program is to challenge the system and wake it up.

Once initial fears subside in patient there was rapid progress.

A well performed careful assessment is everything.

Psycho social issues can reduce movement/swallow progress.

Mia information and lack of systematic progress can reduce progress.

Careful systematic therapy can succeed by supporting self practice.

A lot of techniques we have learned don’t always work.

 

Patients are not static. Sometimes patients “treat” themselves or don’t follow our recommendations.

New study, was superior to traditional therapy and to and NMES combined.

Here is MDTP in a nutshell or a series of Tweets.

Another great session was by a group of experts in the field, Joe Murray, Debra Suiter, Pam Smith and Jaqueline Hind titled The Practicing Dysphagia Clinician: What Are We Afraid of?

There was a lot of great conversation with this talk as they presented a case and allowed for audience participation and discussion.  One of the comments that brought about a lot of conversation was the topic of the diet waiver.  What do you think of the waiver and do you use them in your facility?  How do you feel we can better “cover our butts”?  

I still can’t believe the convention is over and I will have to wait another whole year to see my friends and speech family!!   

 

 

 

 

 

 

 

One thought on “Ramblings from ASHA16

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    Chicago Speech Therapy
    Practice Associate
    773-673-0100

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