Frequently Asked Questions About Electrical Stimulation
Does ASHA recommend the use of electrical stimulation or specific products for this technique?
ASHA is strongly committed to evidence-based practice and urges members to consider the best available evidence before utilizing any product or technique. ASHA does not endorse any products, procedures, or programs and therefore does not have an official position on the use of electrical stimulation. ASHA has developed "Questions to Ask When Evaluating Any Treatment Procedure, Product, or Program" to help clinicians evaluate and make informed decisions about new programs, products, or techniques.
What information is available about electrical stimulation for swallowing?
The body of literature about electrical stimulation for swallowing is growing and additional studies are underway to further the knowledge about this technique and its implications for dysphagia treatment. In an effort to consider evidence-based practice, it is important to critically evaluate research in terms of research design, subject selection criteria, methodology, etc.
Available resources include:
Evidence-Based Systematic Review
Special Interest Group 13 (Swallowing and Swallowing Disorders [Dysphagia]) developed a resource summarizing what is known about the use of electrical stimulation with pediatric populations:
Is the use of electrical stimulation within the Scope of Practice for speech-language pathologists?
The Scope of Practice in Speech-Language Pathology outlines what an SLP can do in general terms, but does not identify specific techniques. Electrical stimulation is promoted as a treatment technique for speech and/or swallowing disorders, both of which are recognized in the Scope of Practice. It is advisable to check your state licensure regulations to determine if any restrictions on the use of electrical stimulation exist at the state level.
Do SLPs need specific training or certification to use electrical stimulation?
ASHA recognizes only one certification, the Certificate of Clinical Competence. The Code of Ethics requires that "individuals shall provide all services competently" (Principle I, Rule A). How one attains and maintains an appropriate level of competency is at the discretion of the individual clinician and her supervisor, director, or administration. In the case of electrical stimulation, no training guidelines have been established by ASHA and no specific "certification" is required.
What does FDA approval of an electrical stimulation device mean, and what is involved in securing FDA approval?
There are a number of electrical stimulation devices on the market. These devices are often considered Class II non-exempt medical devices, according to the Food and Drug Administration (FDA). Prior to marketing and selling a device such as this, the manufacturer must file a premarket notification [510(k)] with the FDA. As part of this 510(k) application, methodology and results of any studies conducted to design a device or determine the use of devices must be described. The FDA determines the safety and effectiveness of a device by reviewing information from these studies.
If premarket approval is granted for a 510(k) application, a device is "cleared to market" by the FDA. This clearance means that the device is substantially equivalent to other similar devices and can be marketed as such.