Category: Assessment
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Advocating for Instrumental Assessment
Many speech-language pathologists (SLPs) forgo instrumental assessments for dysphagia due to lack of access and facility policies. This can lead to misdiagnosis and increased healthcare costs. Advocating for instrumental evaluations is crucial, as they can reduce unnecessary dietary modifications and rehospitalizations, ultimately improving patient outcomes and saving money.
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What the Heck is the MBSImP?
The Modified Barium Swallow Impairment Profile (MBSImP™) standardizes the interpretation of Modified Barium Swallow Studies (MBSS) through a clear, evidence-based protocol. Developed by Dr. Bonnie Martin-Harris, it focuses on assessing and treating dysphagia by quantifying impairments, guiding rehabilitation, and enhancing clinical understanding of swallowing dysfunction.
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Laryngeal Palpation in Swallowing Evaluations: Feel It to Believe It?
As the patient swallows, the SLP feels for hyolaryngeal movement to judge the speed and completeness of elevation. It’s a technique that’s been around for a while—but how reliable is it?
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Cervical Auscultation
Cervical Auscultation (CA) uses a stethoscope to listen to swallow sounds, aiding in assessing swallowing and airway function. However, a systematic review reveals insufficient reliability and validity for diagnosing dysphagia in adults and children. CA should not be a stand-alone diagnostic tool, as sound patterns do not consistently correlate with physiological events.
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Go With the (Peak) Flow
Insurance companies prioritize objective data, making it vital to incorporate measures like Peak Expiratory Flow (PEF) in Clinical Swallow Evaluations (CSE) to assess cough strength and airway protection. PEF demonstrates a strong correlation with aspiration risks, thereby enhancing dysphagia management through reliable and quick assessments, allowing for better documentation and therapy tracking.
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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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“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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Food Chaining
The post discusses Food Chaining as a therapeutic approach for managing dysphagia and feeding aversions in both children and adults, particularly those who are NPO. It outlines strategies for pre-chaining, treatment goals, and the importance of sensory exploration. A clinical case illustrates Food Chaining’s effectiveness, highlighting its relevance for diverse patient groups.
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Dysphagia Ramblings 