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by Sheryl C. Amaral, Emily M. Homer, and DeAnne W. Owre
In response to members' questions and requests for information on dysphagia in the schools, Vice President for Professional Practices in Speech-Language Pathology Celia Hooper formed a Coordinating Committee on "Dysphagia in the Schools" earlier this year in collaboration with Division 13, Swallowing and Swallowing Disorders; and Division 16, School-Based Issues.
Committee members include: Sheryl C. Amaral, Joan C. Arvedson, Emily M. Homer, Maureen A. Lefton-Greif, De Anne W. Owre, Justine Joan Sheppard (chairperson), Celia Hooper, (monitoring vice president), Lemmietta McNeilly (ex-officio), and Janet Brown (ASHA consultant). Members of this diverse group bring expertise and experience working in schools, medical facilities, and university/research settings.
The committee was given the charge of "determining the scope of service needs for students in schools with feeding and swallowing disorders (dysphagia); analyzing the needs of ASHA members practicing in school-based settings related to provision of services to children with dysphagia; recommending actions and strategies to address these needs; and developing a long-term plan to implement these recommendations."
Recommendations
On July 15-17, the committee held an intensive meeting at the ASHA's National Office, and discussed developing realistic recommendations for short- and long-term actions to assist ASHA in addressing school-based SLPs' needs related to the delivery of dysphagia services.
These recommendations fit into three major categories:
1) Legislation and Advocacy. Comments on proposed IDEA regulations were forwarded to ASHA's IDEA Committee. Comments included proposed language supporting the emphasis of the SLP's role as a provider of dysphagia services in the school setting. Comments also focused on "Educational Relevance" and the importance of dysphagia being clearly identified as a disorder that can affect a child's performance in school.
2) Survey and Demographic Data. Quantitative and qualitative information is needed to describe when and how dysphagia treatment is currently being provided in school settings and to describe the expanding populations that require dysphagia treatment in schools. These data are critical for identifying the training needs of future and current SLPs in pediatric dysphagia and creating programs to meet these needs. Examining the relationship between billing Medicaid and providing dysphagia treatment in the schools will also be relevant.
3) ASHA Resources to Promote Awareness and Education. Creation of an ad hoc committee was recommended to create policy documents that address and outline the key issues and scope of this growing area of practice. In addition, development of new networks to address national and state management, reimbursement, and advocacy issues was recommended. The committee recommended that ASHA offer school-based SLPs opportunities to enhance their competency in dysphagia through professional development programs and dissemination of information through journals, The ASHA Leader, Division newsletters, and ASHA's Web site.
Background and Rationale
Although interest and involvement of school-based SLPs in this specialty area has grown steadily, several recent events have accelerated the trend and elevated the importance of providing useful tools to members.
First, revisions of IDEA are being considered by Congress. Provisions in this law will continue to advance trends for mainstreaming children with special needs and integrating children within their own school districts. In addition, the dispersion of this population from special schools into urban and rural local educational agencies presents new challenges for SLPs.
And finally, the number of infants with congenital and early onset conditions and diseases known to have a high prevalence of dysphagia is increasing. This population will be moving through the schools and increasing the service demands for SLPs (Martin, et al., 2005).
For More Information
Committee members will present a short course at the ASHA Convention entitled, "Dysphagia in the Schools; It Can Be Done!" featuring a successful intervention model and case studies. The committee also plans to publish a series of articles for Language, Speech, and Hearing Services in Schools (LSHSS). For more information, contact Sheryl Amaral at sherylmrl@aol.com, Emily Homer at Emily.homer@stpsb.org, or De Anne Owre at dowre@aol.com.
Sheryl C. Amaral is a speech-language pathologist in the Cumberland School Department in Cumberland, RI.
Emily M. Homer is a speech-language pathologist and assistant coordinator of speech/language services for St. Tammany Parish Schools in Covington, LA.
DeAnne W. Owre is a speech-language pathologist in the Woonsocket School Department in Woonsocket, RI.
Reference
Martin, J. A., Kochanck, K. D., Strobino, D. M., Guyer, B., & MacDorman, M. F. (2005). Annual summary of vital statistics-2003. Pediatrics, 115, 619-634.
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