Syllabus Design And Clinical Competency: A Review Of Dysphagia Training Graduate Speech-Language Pathology Programs Across North Carolina, R. Jordan Hazelwood, Kasey M. Clift, Paige H. Bradford

Appalachian Student Healthcare Research Review

Background

Despite the critical role of dysphagia management in speech-language pathology education, limited research has examined how graduate-level curriculum design and learning experiences influence clinical preparedness and competency development. The purpose of this study is to examine the relationships between instructor characteristics, syllabus design features, and the inclusion of dysphagia management competencies in graduate speech-language pathology (SLP) dysphagia course syllabi across North Carolina (NC).

Method

Instructor information and dysphagia syllabi from all accredited graduate SLP programs across NC were collected and rated. The New Dale-Chall Readability Calculator was used to evaluate syllabus readability and content complexity. The Four Dimensions of …

Experience And Barriers In Pediatric Dysphagia Rehabilitation: A Quantitative Survey Study, François-Xavier Brajot, Ai-Ju Wu, Pao-Chuan Torng

Rehabilitation Practice and Science

Purpose: Despite an important need for health care services targeting pediatric dysphagia, there exist a number of barriers to doing so, including workforce competence. The current study surveyed practicing Speech-Language Pathologists to determine (1) the importance of pediatric dysphagia in their caseload, (2) the adequacy of existing educational resources, and (3) perceived barriers to providing quality care in Taiwan.

Methods: An anonymous survey was completed by Speech-Language Pathologists working in Taiwan. Responses were analyzed with respect to current work setting, experience, preparation, and perceived barriers.

Results: Survey results from 122 respondents indicated that the pediatric dysphagia caseload is unexpectedly low …

Impact Of A Novel Hybrid Computer-Based Simulation Adult Dysphagia Training On The Confidence And Clinical Knowledge Of Speech-Language Pathology Graduate Students, Jaime Bauer Malandraki, Jennine Bryan, Dawn Wetzel, Allison Schaser, Bruce A. Craig, Georgia A. Malandraki

Teaching and Learning in Communication Sciences & Disorders

The purpose of this project was to examine the impact of a novel hybrid computer-based dysphagia simulation training on student confidence and clinical decision-making in the area of adult dysphagia. We developed a pilot SBT database, including computer-based simulations utilizing real-life actors who simulated standardized adult patients with dysphagia. Students completed a comprehensive bedside swallowing evaluation and analysis of a videofluoroscopic swallow study (VFSS) as part of the training. We evaluated confidence and clinical decision-making through the following outcome measures: student self-rated confidence levels using a self-efficacy survey and agreement levels with our gold standard rater on clinical evaluation forms. …

Case-Based Learning For Dysphagia Continuing Education: Participant Perceptions On Facilitators And Barriers, Kalea Jones, Sarah Szynkiewicz, Grayson Hill, Courtney Broadfoot, Kendrea L. Garand, Memorie M. Gosa

Teaching and Learning in Communication Sciences & Disorders

Case-based learning (CBL) is a valuable approach to healthcare education, fostering deeper learning, clinical reasoning, and decision-making skills, especially in complex medical conditions such as dysphagia. For speech-language pathologists who manage dysphagia, a CBL approach provides interactive hands-on learning opportunities. We examined the benefits and challenges of a CBL approach to dysphagia continuing education using participant feedback. Twenty participants who attended the Alabama Dysphagia Collective Conference in September 2023 in Tuscaloosa, AL completed a Likert-style survey evaluating attitudes and opinions toward a CBL conference design. Participants also provided open-ended feedback on the facilitators, barriers, clinical practice implementation, new skills learned, …

Long-Term Changes In Bolus Parameters During Swallowing Post-Chemoradiation Treatment., Brittany Rebecca Smiley

Electronic Theses and Dissertations

Current treatment for oropharyngeal cancer involves chemoradiation, which can have profound effects on swallowing function. Submental muscle activity is critical for airway protection and bolus transit but is highly susceptible to radiation-related swallowing impairments. This study examined whether chemoradiation targeting the submental muscles leads to measurable changes in esophageal distension during swallowing in a rodent model. We hypothesized that rats receiving chemoradiation would exhibit aberrant esophageal distension compared to chemotherapy-only controls. Twenty male rats underwent four cycles of cisplatin concurrently with either radiation or sham radiation. High-speed videofluoroscopy swallow studies were conducted pre- and post-treatment with thin liquids to analyze …

Feeding And Swallowing Disorders In Children With Autism: What Caregivers Need To Know, Olivia Hopkins

Undergraduate Publications

This study investigates the complex topic of feeding and swallowing disorders in children with autism, highlighting the significant challenges they pose, particularly related to sensory sensitivities and oral motor difficulties, and the persistent lack of understanding. We examine diagnostic criteria, risks, familial impacts, cultural nuances, and evidence-based intervention strategies, with a focus on practical guidance for caregivers, to equip them with resources for navigating these challenges (Schulz & Eden, 2016). Despite the prevalence of these disorders, many remain unaware of the struggles, underscoring the urgent need for targeted investigations and supportive measures. Specifically, this paper aims to provide Speech Language …

Practice Patterns In Pediatric And Adult Dysphagia: Implications For Clinical Training, Jane Grothaus, Kaitlyn Hill, Marlee Nebesniak, Anastasia Raymer

Speech-Language Pathology Faculty Publications

Objective: Most speech language pathologists (SLPs) receive training to work with patients with swallowing disorders in graduate school, focusing primarily on adult dysphagia. Although SLPs share common foundational knowledge and skills for adult and pediatric dysphagia populations, there are considerable differences in these two specialized areas of practice. We aimed to query SLPs’ practice patterns for dysphagia assessment and management for adults and pediatric populations to consider differences and guide training efforts.

Methods: We distributed two comprehensive anonymous surveys to explore practice patterns of SLPs who provide assessment and management of dysphagia for adult or pediatric populations. The 118 respondents, …

A Survey Of Early-Career Speech-Language Pathologists: Determining Perceived Readiness For Clinical Management Of Adults With Dysphagia After Completing Graduate School, Christine A. Lee, Ashwini Namasivayam-Macdonald, Zuleikha Wadhwaniya, Juliana Mclaren, Rebecca H. Affoo

Teaching and Learning in Communication Sciences & Disorders

Several studies have identified a recurring trend that speech-language pathologists (S-LPs) in countries such as the United States (Caesar & Kitila, 2020), South Africa (Singh et al., 2015), and Malaysia (Kamal et al., 2012) report lower levels of confidence in dysphagia management, whether in comparison to other practice areas or in certain skill areas within the specialty of dysphagia. No data currently exists exploring self-perceptions of Canadian S-LP graduates with regards to clinical management of adults with dysphagia. Therefore, the purpose of this study was to determine the self-reported readiness of recently graduated Canadian S-LPs who manage dysphagia. Our survey …

Exploring The Use Of An Interprofessional Education Session For Speech-Language Pathology And Pharmacy Students, Sophia Werden Abrams, Heather Macphee, Linnea Hodge, Justine Hamilton, Ashwini Namasivayam-Macdonald

Teaching and Learning in Communication Sciences & Disorders

Interprofessional education (IPE) occurs when students are provided the opportunity to learn with and from others of related professions to improve the potential for future collaboration. The aim of this study was to explore the perceptions of students about working with professionals from different disciplines before and after their engagement in an interprofessional learning activity and determine any changes in their willingness to work in interprofessional teams.

Doctor of Pharmacy students from the University of Manitoba and Master’s speech-language pathology students from McMaster University participated in an online inter-university and inter-provincial education module. Students were invited to complete the Interprofessional …

Neural Control Of Swallowing In Infants: White Matter Tracts Associated With Swallow Function, Heather Christine Mcghee

MUSC Theses and Dissertations

This dissertation investigates innovative approaches to improve feeding and swallowing outcomes in infants, particularly those born prematurely or with brain injury. It focuses on understanding the neural networks involved in sucking and swallowing by utilizing diffusion kurtosis imaging (DKI), a more sensitive neuroimaging technique than traditional MRI, and the BaByVFSSImP, a standardized tool for assessing swallow function. Additionally, the research explores the use of transcutaneous auricular vagus nerve stimulation (taVNS) as a neuromodulation technique to enhance oral feeding skills. The study found no adverse effects from taVNS on airway protection or swallowing physiology. Furthermore, there were some possible associations between …

Bridging The Gap Between Clinical Practice And Evidence For Hyolaryngeal Excursion Assessment During A Clinical Swallow Evaluation, Kelsey Murray

Dissertations, 2020-current

This study investigated current practices of subjective hyolaryngeal excursion (sHLE) assessment during a clinical swallow evaluation (CSE) among speech-language pathologists (SLPs) using a survey-based approach. A sample of 77 SLPs in the United States completed an online survey rating their perceived importance and practice of sHLE assessment during a CSE. Additionally, the survey inquired about inferred interpretations from assessing sHLE. Results indicated a strong positive correlation between the rated importance of sHLE assessment and the reported frequency with which it is completed, r_s(46) = .720, p < .001. However, the findings also suggested that some SLPs are not assessing sHLE during a CSE. This offers valuable insight into the prevailing practices of HLE assessment among SLPs, considering the limited evidence for HLE assessment and interpretation. Interpretation and generalizations of the findings is limited due to the small sample size. Findings, however, do support the need for future research investigating the validity of sHLE assessment performed during a CSE, with the aim of providing evidence to guide clinical best practices.

Keywords: hyolaryngeal excursion, speech-language pathologist, clinical swallow evaluation, dysphagia, palpation

Abstract …

Tongue-Tie: Impact On Oropharyngeal Function During Swallow., Kolbie A. Vincent

Electronic Theses and Dissertations

Swallowing is an intricate process involving over 50 muscle pairs and numerous nerves, with dysphagia resulting from deficits in various stages (Hennessy & Goldenberg, 2016). Lingual restriction may adversely impact swallowing function, affecting bolus preparation, size, and overall efficiency. Tongue-tie can pose challenges to speech, chewing, and swallowing (Becker & Mendez, 2022; Chaubal et al, 2011; García-Pola, M. J., et al., 2002). This pilot study seeks to determine how tongue-tie affects swallowing function in an adult male, and whether surgical revision of a submucosal lingual tether leads to measurable changes in oropharyngeal swallow function. Results showed inconsistent changes in diameter …

Advancing Dysphagia Screening: A Comparison Of Patient-Reported Outcome Measures And Bolus-Driven Screenings In Aspiration Prediction, Arica Amie Rusco

Theses and Dissertations--Communication Sciences and Disorders

It is known that dysphagia impacts an individual’s health and quality of life. Due to this, early identification of dysphagia is crucial. There are many different dysphagia screening tools with no consensus. This study aimed to compare the two most frequently used dysphagia screenings, a patient-reported outcome measure (PROM), the EAT-10, and bolus-driven swallow screening, the Yale Swallow Protocol, to determine if one tool is superior in aspiration prediction on a videofluoroscopic swallow study (VFSS). This study also aimed to discover the best cutoff score on the EAT-10 for aspiration prediction. A total of 66 participants were recruited after physician …

The Effects Of Exercise-Based Voice Therapy On Swallowing Outcomes: A Pilot Study Framework, Jenna F. Johnson

Theses and Dissertations--Communication Sciences and Disorders

In a 2019 study analyzing dysphonic patients in relation to coexisting dysphagia, approximately 11.8% of clients receiving treatment for voice disorders reported difficulty swallowing. However, the literature exploring the use of voice exercises to improve swallow function is limited to a small amount of voice treatment approaches, which does not reflect the wide range of evidence-based treatment approaches that may be prescribed for treatment of one’s voice complaints. This project proposes a descriptive study that would identify if completion of prescribed voice therapy exercises has implications on swallowing function in clients with co-occurring voice and swallow impairments. A pilot study …

Thresholds Of Quantitative Swallowing Measures Following Intensive Prophylactic Therapy In Head And Neck Cancer, Deirdre Larsen

LSU Doctoral Dissertations

This retrospective, case-controlled study sought to identify salient features of swallowing physiology in head and neck cancer (HNC) patients and the threshold for features associating with increased dysphagia severity or decreased functional status. Quantitative measures of videofluoroscopic swallow studies (VFSS) were taken during three graduating liquid boluses and a paste bolus. Fifteen HNC subjects that received high frequency swallowing exercises (2 - 5 weekly sessions) during (chemo)radiation were compared pre- and(n = 15) or normal (n = 15) swallowing. HNC subjects were also stratified to compare those attending only pre- and(n = 8) to those also returning with dysphagia complaints …

Speech-Language Pathology Graduate Student Clinicians’ Self-Perceived Competency In Dysphagia Management, R. Jordan Hazelwood, Erin D. Bouldin, Indigo R. Burford, Emily A. Steffen

Teaching and Learning in Communication Sciences & Disorders

Speech-language pathologists (SLPs) are the preferred healthcare providers for managing the direct clinical care of patients with dysphagia. By assessing self-perceived competency during academic training, SLP graduate student clinicians may increase their understanding of their skills in dysphagia management. We modified the Dysphagia Competency Verification Tool (DCVT) to use a 5-point ordinal scale to explore how SLP graduate student clinicians’ self-perception of competency in dysphagia management changes over time and to determine the impact of clinical practicum experiences. Seventy-two SLP graduate student clinicians rated their self-perceived competency for four DCVT domains. We used Generalized Estimating Equations (GEE) models to analyze …

Speech-Language Pathologists' Skills And Knowledge In Dysphagia Management In Long-Term Care Facilities, Madelyn Griffin

Honors Theses

An increasing amount of current research indicates the prevalence of oral and pharyngeal dysphagia in all age groups, with a higher number of cases present in the geriatric population. Dysphagia is common in age-related diseases such as Parkinson’s disease, Alzheimer’s disease, and Dementia. The purpose of this study was to investigate the knowledge and skills of speech- language pathologists (SLPs) working in long-term care, in the area of oral and pharyngeal dysphagia. Participating SLPs responded to a survey asking to self-identify their knowledge/skills in oral and pharyngeal dysphagia. The findings from this study revealed the variety of expertise of SLPs …

The Influence Of Side-Lying Position On Oropharyngeal Swallow Function In At-Risk Infants: An Exploratory Study, Julian White

Dissertations, 2020-current

Speech-Language Pathologists (SLP) are the primary healthcare providers responsible for the evaluation and treatment of infant feeding and swallowing disorders. At-risk infants, such as those born prematurely or with certain medical conditions, are more prone to swallowing impairments (i.e., dysphagia). Dysphagia in at-risk infants can have severe consequences such as chronic respiratory symptoms, pneumonia, progressive lung disease, undernutrition, and death. Therefore, it is important to have methods of examining an infant’s swallow functioning that are both safe and accurate. A leading method of evaluating infant swallowing is the Modified Barium Swallow Study (MBS). The works contained within this dissertation document …

Comparing In Vivo Versus Simulation Training For Transnasal Endoscopy Skills, Laura L. Wolford, George W. Wolford

Teaching and Learning in Communication Sciences & Disorders

Fiberoptic endoscopic evaluations of swallowing (FEES) is as important of a swallowing evaluation as the videoflouroscopic swallow study, but far fewer speech-language pathologists are competent in its use (Ambika, Datta, Manjula, Warawantkar, & Thomas, 2019; Brady & Donzelli, 2013; Pisegna & Langmore, 2016). One hurdle in FEES training is the necessity of practicing transnasal endoscopy on volunteers. The primary aim of this study was to compare the learning effectiveness of practicing transnasal endoscopy via simulation with practice in vivo for a student’s first passes of the endoscope. The end goal of this study was to determine the most cost-effective and …

The Impact Of Active Learning In A Speech-Language Pathology Swallowing And Dysphagia Course, Rebecca H. Affoo, Justin L. Bruner, Angela M. Dietsch, Ciara E. Nellenbach, Theresa M. Jones, Mark E. Lehman

Teaching and Learning in Communication Sciences & Disorders

The signature pedagogy in Speech-Language Pathology (SLP) higher education programs has been criticized for its instructor-centric lecture format and emphasis on the lower tiers of Bloom’s taxonomy (simply memorizing knowledge) at the expense of helping students develop the clinical problem-solving skills required for a lifetime of practice and learning. The purpose of this study was to examine the responses of a cohort of graduate speech-language pathology students to an active learning-oriented swallowing and dysphagia course design. A potential relationship between student perceptions of the active learning pedagogy and academic performance was also explored. The results suggest that active learning positively …

The Impact Of Temporal Resolution On Clinical Decision-Making For Individuals With Dysphagia, Shauna Corinne Murray

Speech and Hearing Sciences ETDs

INTRODUCTION: Dysphagia, or a disordered swallow, affects up to 1 in 25 individuals in the United States. The gold standard for assessing dysphagia is the videofluoroscopic evaluation of swallowing (VFES). This allows the clinician to observe the swallow anatomy in motion via an X-ray movie, which historically was recorded at 30 frames per second. In recent years VFES have been performed at less frames per second due to radiation concern. This project investigates the effect of using lower temporal resolutions on assessment of video-fluoroscopic swallow studies.

METHODS: In this investigation, 30 swallow studies, all acquired at 30 frames per second, …

Factors Of Dysphagia In The Overdose Population Post Extubation., Renee Brown

Electronic Theses and Dissertations

Post-extubation dysphagia (PED) has been studied in depth in a variety of populations including elective heart surgeries, trauma, critical illness, traumatic brain injury, and those requiring mechanical ventilation, but has not been researched in the overdose population (OD). This study aims to research factors of PED in the OD population. A retrospective study was conducted and found 24 participants who fit the inclusionary requirements. Correlation statistics were run between age and duration of intubation, age or duration of intubation and gender, and between intubation duration, age, and scores on Penetration-Aspiration Scale (P/A) (thin by cup and thin by straw). The …

Participant Accuracy And Impact Of Biofeedback On A Skilled Swallowing Task, Caris Giessler

Senior Honors Projects, 2010-2019

Biofeedback is as a visual way to self-assess muscle contraction, particularly during rehabilitative exercises. Speech language pathologists and otolaryngologists have investigated the use of visual biofeedback in swallowing therapy, especially for volitional swallowing rehabilitative exercises such as the effortful swallow, which requires the patient to maximally swallow with all their strength. In contrast to the effortful swallow, “effortful skilled swallowing” is the ability to swallow with a specific and precise amount of effort, which is an emerging topic in dysphagia research. Dysphagia, also known as disordered swallowing, can be an organic congenital disorder treated via feeding tubes, or an acquired …

Inspiratory Muscle Recruitment During Swallow And A Comparison Across Airway Behaviors., Allison V. English

Electronic Theses and Dissertations

During swallow, a negative esophageal pressure is present that, along positive pressure from the tongue, which works to move the bolus through the pharynx into the esophagus. This negative esophageal pressure is thought to be produced via recruitment of chest wall inspiratory muscles (diaphragm and parasternal). This current study aimed to examine respiratory muscle recruitment across behaviors which have known inspiratory muscle activity (eupnea, augmented breath and cough) and compare to swallow. It was hypothesized that there would be no significant difference in amplitude and muscle recruitment over 75 ms between swallow and eupnea, but cough and augmented breath would …

The Impact Of Master’S Level Education On The Assessment And Intervention Of Pediatric Swallowing, Andrea Seagren

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Purpose: Pediatric swallowing disorders is increasing in prevalence as medical advancements are made. This increase raises the need for more speech-language pathologists (SLPs) to be involved in the assessment and intervention of pediatric swallowing. However, discrepancies exist in the amount and level of education being provided during academic coursework in the area of pediatric swallowing.

Method 1: The investigation had a two-tier approach. Part one included a survey specifically targeting SLPs who graduated within the most recent accreditation standards (2014 to present) and masters level students in their second year of graduate school (n=100). Part two explored academic courses offered …

Dysphagia Practice Patterns Of Virginia Speech-Language Pathologists, Molly Kathleen Dailey

Theses & Honors Papers

Currently, there are a variety of screening tools, clinical, and instrumental assessments used by speech-language pathologists (SLPs) to diagnose dysphagia and plan for treatment. Anecdotal reports and empirical evidence suggest that dysphagia assessment and treatment practice patterns vary considerably across patient populations, work settings, and clinicians. Understanding the SLP assessment and treatment practices across settings and factors that may influence their decisions will help inform future directions in dysphagia education, training, and clinical practice components. These findings will enable the provision of quality care that will ultimately lead to positive patient health outcomes. Thus, this survey study was designed to …

Effectiveness Of Prophylactic Lingual Strengthening Exercises For Patients With Head And Neck Cancer A Systematic Review, Cassidy Pickens

Theses and Dissertations--Communication Sciences and Disorders

Radiation treatment for head and neck cancer has devastating effects on swallowing ability. Prophylactic swallowing exercises are often recommended. However, the evidence for these exercises is equivocal and information regarding critical components of an exercise program is lacking. The purpose of this systematic review was to examine the evidence regarding lingual strengthening exercises as a component of a prophylactic swallowing program.

The Impact Of Dysphagia And Gastrostomy On Quality Of Life In Caregivers Of Patients With Amyotrophic Lateral Sclerosis, Emily Clare Sither Goggin

Theses and Dissertations--Communication Sciences and Disorders

There is little research studying the relationship between caregiver quality of life and gastrostomy, a palliative intervention recommended to manage dysphagia and malnutrition in patients diagnosed with Amyotrophic Lateral Sclerosis (ALS). To facilitate a more comprehensive assessment of treatment effectiveness and to better guide patients and their families, this study investigated the relationship between gastrostomy, caregiver strain, and patient disease-related factors. Patients with bulbar-onset ALS and their caregivers were recruited regardless of their decision to accept or decline future gastrostomy. Caregivers completed the Modified Caregiver Strain Index (MCSI) to assess levels of caregiver strain as an index of quality of …

Pediatric Feeding Disorder: Consensus Definition And Conceptual Framework, Praveen S. Goday, Susanna Y. Huh, Alan Silverman, Colleen T. Lukens, Pamela Dodrill, Sherri S. Cohen, Amy Delaney, Mary B. Feuling, Richard J. Noel, Erika Gisel, Amy Kenzer, Daniel B. Kessler, Olaf Kraus De Camargo, Joe Browne, James A. Phalen

Speech Pathology and Audiology Faculty Research and Publications

Pediatric feeding disorders (PFDs) lack a universally accepted definition. Feeding disorders require comprehensive assessment and treatment of 4 closely related, complementary domains (medical, psychosocial, and feeding skill-based systems and associated nutritional complications). Previous diagnostic paradigms have, however, typically defined feeding disorders using the lens of a single professional discipline and fail to characterize associated functional limitations that are critical to plan appropriate interventions and improve quality of life. Using the framework of the World Health Organization International Classification of Functioning, Disability, and Health, a unifying diagnostic term is proposed: “Pediatric Feeding Disorder” (PFD), defined as impaired oral intake that is …

Let's Talk About Dementia: The Effects Of Dementia On Communicative Functions, Mary Kate Hoeve

Honors Projects

A general outline and presentation designed for a seminar setting aimed toward an audience of medical staff in skilled nursing facilities. The purpose of this training is to educate frequent communication partners of those with dementia about effective communication tactics, as well as, a brief definition of dementia. Additionally, a small portion is dedicated to dysphagia. The possible role of a speech-language pathologist in dementia care is also discussed throughout the training.