Special Interest Group 13 - Swallowing and Swallowing Disorders (Dysphagia)

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Dysphagia in Practice: Thickening Practices, Family-Centered Care, & Early Intervention
Format(s): SIG Perspectives
This collection of SIG 13 articles addresses popular topics in dysphagia care throughout the life span regarding thickening practices, family-centered care, and early intervention. Jane Mertz Garcia, Edgar Chambers IV, and Anna Boyer utilized a survey to re-examine practice patterns for thickened liquids and provided a comparison of past practices with current to provide insight into contemporary themes that have previously not been considered. Doreen Benson and George Barnes explore the utility of a mathematical prediction model (Bayes theorem) in dysphagia management. Samantha E. Shune, Deanna Linville, and Ashwini Namasivayam-MacDonald address maximizing treatment effectiveness by using an approach with family resiliency and adaptation. Drawing from the principles of family systems theory and the biopsychosocial-spiritual framework, they use a case study as a tutorial to explore the application of family-centered care models to dysphagia management. Stephanie C. Cohen and Karen Dilfer focus on the definition of pediatric feeding disorder (PFD) and the multifaceted needs of families and children in early intervention, support for use of responsive feeding in treatment of PFD, alignment of responsive feeding strategies with early intervention principles, and barriers limiting access to consistent, high-quality early intervention services for children with PFD.
Considerations for Dysphagia Intervention in the Hospital: Adult and Pediatric
Format(s): SIG Perspectives
This SIG 13 collection of astute articles provides information regarding managing and treating dysphagia in the hospital for both adult and pediatric patients. Nalia GurgelJuarez and colleagues explore the frequency of oral care based on staff adherence to oral care policies. Rebecca Smith et al. investigate the quality-of-life impacts of dysphagia and its interventions on mealtimes using the Swallowing Quality of Life Questionnaire and the Eating Assessment Tool. Jessica L. Rice and Maureen A. LeftonGreif review high-flow nasal cannula mechanisms of action, its use in specific populations and settings, and what is known about initiation of feeding during this therapy. Finally, Donna Edwards and colleagues explore the impact of COVID-19 on modifications in clinical practice related to pediatric feeding disorders and dysphagia via telehealth.
Adult Dysphagia Management: Diet, Sleep Apnea, Intensive Care Unit, and Dementia
Format(s): SIG Perspectives
This quartet of SIG 13 articles provides information regarding managing and treating dysphagia in the adult population. Caileen Harvey, Rachel Flemming, Julia Davis, and Victoria Reynolds investigate International Dysphagia Diet Standardisation Initiative implementation issues by surveying health care professionals in health care facilities in rural Upstate New York. Ankita M. Bhutada, William A. Broughton, Brenda L. Beverly, Dahye Choi, Sandip Barui, and Kendrea L. (Focht) Garand aim to identify the prevalence of dysphagia and reflux reported symptoms in patients with obstructive sleep apnea syndrome and determine associations between symptoms and demographic and clinical variables. Stevie Marvin summarizes published research on screening, evaluating, and treating post-extubation dysphagia in the intensive care unit. Rebekah Guastella, Stefania Oppedisano, Luis F. Riquelme, and Ashwini M. Namasivayam-MacDonald study bolus location at swallow onset, stage transition, pharyngeal transition duration, pharyngeal response duration, and pharyngeal phase duration between cued and uncued swallowing conditions in patients with dementia.
Dysphagia Revelations: What We Know We Don’t Know and What Is Normal for Swallowing
Format(s): SIG Perspectives
This trio of SIG 13 articles provides information regarding unique factions of dysphagia intervention. Sophia Werden Abrams, Harmonie S. J. Chan, Jasmeet Sikand, Heather Wilkie, and Kim Smith raise awareness for the importance of neurodegenerative disorder research involving dysphagia caused by oculopharyngeal muscular dystrophy. Michela Jean Mir and Karen Wheeler Hegland aim to shed light on the subjective use of cough assessment and the importance and interest in formal clinical cough assessment training. Kendrea L. (Focht) Garand, Mary Catherine Reilly, Dahye Choi, Rajarshi Dey, Julie Estis, and Grayson Hill evaluate community dwelling adults using Modified Barium Swallow Impairment Profile components for bolus hold type to assist in defining typical swallowing behaviors.
Interesting Discoveries in Adult Dysphagia Intervention: Screening, Evaluation, and Telehealth
Format(s): SIG Perspectives
This assemblage of articles provides information on interesting topics encountered in adult dysphagia practice. Aarthi Madhavan, Nicole Shuman, Claire Snyder, and Nicole Etter provide insight on the comparative consistency of the Eating Assessment Tool and Sydney Swallow Questionnaire scores for self-reported swallowing difficulties in a group of community-dwelling older adults completing both questionnaires. Georgina Papadopoulos-Nydam, Jana Maureen Rieger, and Gabriela Constantinescu evaluate the usability of a mobile health (mHealth) system designed for dysphagia exercise in persons with a history of stroke. Renata Mancopes, Fernanda Borowsky da Rosa, Lidia Lis Tomasi, Adriane S. Pasqualoto, and Catriona M. Steele demonstrate concern for people with chronic obstructive pulmonary disease (COPD) and share information regarding dysphagia in people with COPD, synthesizing knowledge both from the literature and from studies performed in the context of a multidisciplinary clinical pulmonary rehabilitation program abroad. Additionally, Talia H. Schwartz brings to light the importance and utility of the clinical swallow evaluation while caring for patients with COVID-19.
A Myriad of Dysphagia Interventions: NICU, Cultural Humility, Instrumentation, Nursing, Tracheostomy Tubes, and Technology
Format(s): SIG Perspectives
This collection of articles presents clinicians with evidence on a variety of topics in dysphagia that can be utilized in practice immediately. Alaina Martens and Emily Zimmerman offer insight regarding changes to feeding patterns in infants diagnosed with bronchopulmonary dysplasia after prolonged oxygen therapy in the newborn intensive care unit. Paula Leslie and colleagues provide a framework of health and illness and how food and drink are much more. They stress the importance of clinician appreciation as a cultural guest in our patients’ lives. Bonnie Martin-Harris and colleagues stress the importance of instrumentation with a thorough review of available practice guidelines and appropriateness criteria issued to date, revealing a deficit of up-to-date, comprehensive, evidence-based information on the diagnosis and evaluation of oropharyngeal dysphagia. Specifically, a lack of quality guidance on the ordering, performance, and reporting of the modified barium swallow study has hindered efforts to improve standardization and ensure quality continuity of care. Naomi Gurevich and colleagues stress the need to clarify guidelines and increase interprofessional education between both professions to improve patient care. George Barnes and Nancy Toms highlight speech-language pathologists’ need for a solid foundation of knowledge when it comes to patients with highly complex disease processes and care plans. Deirdre Muldoon and colleagues conduct a review of published literature regarding management of feeding difficulties at the oral phase of feeding in children with autism spectrum disorder and/or developmental disability. Finally, Paul M. Evitts and colleagues reveal a potential way to track aspiration in healthy adults using an app.
Evaluating Dysphagia Across the Life Span
Format(s): SIG Perspectives
The assemblage of articles presents clinicians with information on a variety of topics in dysphagia that can be utilized in practice. Laura L. Madhoun, Laura C. Merrell, Amanda Smith, Emily Snow, and Kristen M. Cherosky stress the importance of individualized and comprehensive feeding management for craniofacial anomalies through interdisciplinary collaboration. Lena G. Caesar and Meretu Kitila study clinicians’ perceptions and confidence with dysphagia service delivery. Aliaa Sabry, Amanda S. Mahoney, Shitong Mao, Yassin Khalifa, Ervin Sejdic, and James L. Coyle point out an objective way to assess laryngeal vestibule closure and opening at beside. Marie Jardine, Anna Miles, Jacqui Allen, and Rebecca Leonard give an interesting take of assessment of the aging swallow. Kelsey L. Thompson and Wanqing Zhang provide description and examples of mixed method research to comprehensively and holistically report of pediatric feeding disorders.
Value-Based Health Care Relating to Management of Dysphagia
Format(s): SIG Perspectives
This collection of articles presents information currently relevant to caring for patients. Firstly, Cara Donohue and James L. Coyle, and Christina Kang and David Lott, share service delivery focusing on the diagnoses of amyotrophic lateral sclerosis and muscle tension dysphagia, respectively. Samantha Shune and Ashwini Namasivayam provide systematic strategies to better support patients’ informal caregivers. Rinki Varindani Desai and Ashwini Namasivayam-MacDonald describe the practice patterns of speech-language pathologists managing dysphagia in persons with dementia. Lastly, Nancy Swigert and Ashley Wright describe effectiveness and efficiency as the key components of a value-based health-care system.
Unique Current Issues in Dysphagia Management
Format(s): SIG Perspectives
This collection of articles presents clinicians with information on some of the most timesensitive topics in dysphagia care of utmost relevance, particularly in the current COVID- 19 pandemic. Firstly, Liza Blumenfeld, Lisa Evangelista, Maggie Kuhn, Kristen Linnemeyer, Nogah Nativ-Zeltzer, and Heather Starmer provide best practice recommendations on the management of patients with head and neck cancers from the speech-language pathology perspective amid COVID-19. Authors Hema Desia and Jennifer Raminick then provide recommendations for safer feeding of infants on high flow oxygen therapy due to acute respiratory failure. Lastly, authors Grainne Brady and Justin Roe, Kellyn Hall and Leslie Johnson, and Annette Askren and Marnie Kershner discuss different aspects of clinician–patient collaborated dysphagia care delivery models and their impact on successful outcomes.
Palliative Care Perspective on Dysphagia Management
Format(s): SIG Perspectives
These Perspectives (SIG 13) presents clinicians with information across many aspects of feeding and swallowing. Firstly Kendrea Garand, Taylor Thomas, and Rajarshi Dey discuss the physiology of laterality in the clearance of boluses from the pharynx. Next, Jennifer Wilson, Amanda Simmons, and Jillian McCarthy then take us through an interesting description of speech-language pathologists’ experiences and education in pediatric dysphagia and encourage the incorporation of intensive education in this high-risk topic, via various avenues. In the final three articles, Pamela Smith, Jinxu Bridget Xia, and Claire Radford et al., present an in-depth and elaborate perspective on managing patients with dysphagia through a palliative care lens, across the lifespan.
Dysphagia and Continuum of Care
Format(s): SIG Perspectives
These Perspectives (SIG 13) include a variety of topics in dysphagia across the age continuum and across the many settings that speech-language pathologists (SLPs) address dysphagia. Parker Huston, Robert Dempster, and Lauren Garbacz provide readers with an overview of common evidence-based psychological techniques used in the treatment of adolescents with feeding disorders, including motivational interviewing and cognitive behavioral techniques. The goal of this paper is to provide a high-level overview of these concepts so that providers outside of psychology may utilize some of these techniques in therapy, when referral to a behavioral specialist or psychologist is not feasible. Next, authors Lauren Madhoun and Robert Dempster discuss the psychosocial aspects of feeding in the neonatal intensive care unit NICU and immediately following NICU discharge. Joanne Patterson extends the discussion to the adult population by describing a biopsychosocial intervention that combines cognitive behavioral with dysphagia therapy, termed Cognitive-Behavioral Enhanced Swallowing Therapy (CB-EST) and its application in managing head and neck cancer patients with dysphagia. Finally, authors Kortney Eng, Maria Jose Flores, Elisabeth Gerrity, Nupur Sinha, Katherine Imbeau, Laddie Erbele, and Cary Yeh share details from their study investigating the effect of high-flow nasal cannula (HFNC) on swallow physiology in healthy adults. We hope these articles will be of significant value to practicing clinicians and to students learning about dysphagia.
Assessment and Treatment Approaches for Dysphagia Management Across the Lifespan
Format(s): SIG Perspectives
These Perspectives (SIG 13) articles present clinicians with useful information to help assess and treat feeding and swallowing disorders in a variety of patient populations across the lifespan. Daniel Croake and Vrushali Angadi provide an overview of evidence regarding prophylactic and reactive gastrostomy tubes in individuals with head and neck cancer, to better facilitate joint decision-making of percutaneous gastrostomy (PEG) tube timing with the patient and care team. Hema Desai and Audrey Lim extend the discussion to pediatric dysphagia by summarizing the application of neurobehavioral interventions as part of feeding treatment for infants with congenital heart defects.
Neuromuscular Electrical Stimulation and Other Topics in Dysphagia SIG 13
Format(s): SIG Perspectives
These Perspectives (SIG 13) articles review the functional anatomy underlying different pharyngeal swallow mechanics and swallowing performance goals, discuss the application of neuromuscular electrical stimulation in the treatment of dysphagia, and provide critical information to help clinicians build assessment skills and provide evidence-based options for mothers who breastfeed their infants.
High-Resolution Pharyngeal Manometry in Dysphagia SIG 13
Format(s): SIG Perspectives
These Perspectives (SIG 13) articles discuss the use of high-resolution pharyngeal manometry in the assessment and treatment of dysphagia in pediatrics and adults. Additionally, we present an educational piece discussing considerations in clinical decision-making concerning the initiation of safe oral alimentation in patients on high-flow nasal cannula.

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