Author: Tiffani Wallace-SLP and Certified Nutrition Coach
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The Yale Swallow Protocol
The Yale Swallow Protocol, based on the 3-Ounce Swallow Test, provides a quick screening method for dysphagia, focusing on cognition and oral motor function. Administering involves giving a patient three ounces of water to drink while observing for signs of aspiration. This tool is easy to teach, though not suitable for all patients.
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Assessing the Swallow: A Guide to the Clinical Swallow Evaluation
A thorough swallow assessment is essential in managing dysphagia, uncovering both the “what” and “why” of swallowing difficulties. This guide details the Clinical Swallowing Evaluation (CSE), emphasizing the importance of clarifying referrals, conducting comprehensive patient interviews, and recognizing the need for instrumental assessments to develop effective treatment plans.
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Swallowing Without a Tongue: Let’s Talk Glossectomy
I’ve worked with a number of patients over the years who’ve had partial glossectomies—but recently, I’ve had two patients with total glossectomies. Let that sink in for a second. Total glossectomy. As in, no tongue. It sounds like a nearly impossible task: getting someone to eat or drink again when one of the primary driving…
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Pharyngocise
Patients with head and neck cancer must engage in early swallowing function preservation, ideally before treatment begins. A study demonstrated that the “Pharyngocise” approach provided better outcomes in muscle preservation and swallowing function compared to usual care. Consistent engagement in exercise during treatment can significantly benefit recovery post-therapy.
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3 Reasons You Should Never “Fake it Till You Make it” in Dysphagia
Faking it in dysphagia therapy poses significant risks. Confidence is essential, but without proper knowledge, misdiagnoses and harmful recommendations can occur. The ASHA Code of Ethics emphasizes honesty and competence. Professionals should seek education, mentorship, and prioritize patient safety, ensuring informed, evidence-based interventions in dysphagia care.
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My Top Five (Ok TEN+) Continuing Education Courses in Dysphagia
The author reflects on their extensive experience with continuing education in dysphagia, highlighting both enjoyable and frustrating courses. They recommend several impactful CEU programs that are evidence-based and practical for medical SLPs. The conclusion emphasizes that meaningful education can rejuvenate passion and enhance clinical skills in the field.
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The Cost of Thickened Liquids
Thickened liquids are commonly used in dysphagia management, but there’s a growing interest in alternatives that may offer safer options. While they can be effective, costs of thickening agents are significant and patient preferences vary. The focus should be on individualizing care to balance hydration, health, and quality of life for patients.
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“Aspiration Risk”
Dr. James Coyle emphasizes the need to rethink labeling patients as “aspiration risks” in dysphagia cases. This label can shape treatment decisions and does not accurately predict pneumonia risk. Various factors, including cognitive status and oral health, play a significant role in pneumonia, challenging the assumption that aspiration alone is a key risk factor.
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Not Nectar Thick: The Truth About Carbonated Beverages and Dysphagia
Carbonated beverages are being explored in dysphagia management as a sensory strategy to enhance swallowing safety, not as thickened liquids. Research indicates carbonation may stimulate the Trigeminal nerve, potentially improving swallow function for some patients. However, effectiveness varies individually, necessitating personalized assessment rather than substitution for thickened liquids.
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Compliance or Choice? Rethinking the “Noncompliant” Dysphagia Patient
The post discusses evolving perspectives on patient noncompliance in dysphagia management. It suggests reframing noncompliance as patient choice, emphasizing the importance of education and support rather than discharge. Highlighting that not all aspirators contract pneumonia, it advocates for individualized approaches in therapy that empower patients to make informed decisions about their care and safety.
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Dysphagia Ramblings 