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Speech-Language Pathologists (SLPs) as the Preferred Providers for Dysphagia Services

Prepared by The Professional Advocacy Committee Special Interest Group 13 Swallowing and Swallowing Disorders (Dysphagia) American Speech-Language Hearing Association

SLPs have extensive experience in providing dysphagia services. According to the ASHA 2005 Health Care Survey, 45% of the time SLPs spend working with adults and 16% of the time SLPs spend working with children is devoted to swallowing and feeding disorders.

The overall knowledge and skills obtained by SLPs in their professional training provides an exemplary and essential foundation for successful evaluation and treatment of dysphagia in children and adults associated with medical problems such as stroke, head and neck cancer and cerebral palsy.

  • Anatomy and physiology of oral, pharyngeal and laryngeal function and the aerodigestive tract
  • Development of respiratory control, oral, pharyngeal and laryngeal skills in infants and children
  • Aging and its effects on swallowing and swallowing disorders
  • Swallowing and swallowing disorders across the life span

The major texts on oropharyngeal swallowing and swallowing disorders have been written by SLPs.

SLPs developed and disseminated best practices instrumental and clinical procedures for evaluating oropharyngeal swallowing and feeding disorders.

  • Key search terms include: deglutition, deglutition disorders, dysphagia, swallowing
  • Search terms may be combined with specific conditions, e.g. deglutition + stroke.

SLPs, working alone and in collaboration with clinicians and scientists in other professions, have conducted much of the research on normal oropharyngeal swallowing function and dysphagia treatment efficacy and effectiveness including:

  • Temporal measures of normal and abnormal oropharyngeal swallowing
  • Relationships between pressure generation and structural function in oropharyngeal and cervical esophageal swallowing
  • Impact of viscosity, texture and volume of bolus on normal and abnormal oropharyngeal swallowing physiology
  • Effect of compensatory strategies (postures, maneuvers, bolus variables)
  • Effect of exercise
  • Clinical trials with specific patient populations to assess effects of treatment methods on health outcomes
  • Tests for measuring the outcomes of treatment programs

The American Speech-Language and Hearing Association (ASHA) has included swallowing disorders in their studies of treatment outcomes in children and adults.

ASHA has a well developed program of support for SLPs involved in dysphagia.

  • Policy documents (e.g., Preferred Practice Patterns, position statements, technical reports, guidelines, knowledge and skills) on swallowing and feeding disorders, videofluoroscopic swallowing studies, endoscopic evaluation of swallowing, and swallowing disorders in schools)
  • Special Interest Group for swallowing and swallowing disorders
  • Continuing education programs and materials
    • Self-study programs
    • Conferences
  • Requirements for ASHA’s Certificate of Clinical Competence include knowledge and skills in swallowing and swallowing disorders

SLPs are conducting programmatic, peer-reviewed grant funded research in swallowing and swallowing disorders.

  • University based
  • Hospital/medical school based
  • Laboratory based (e.g. National Institutes of Health)

Clinical specialty certification in swallowing and swallowing disorders is available for SLPs who meet the stringent requirements of the American Board of Swallowing and Swallowing Disorders. These clinicians are designated as a Board Certified Specialist (BCS) in Swallowing and Swallowing Disorders and may use the initials, BCS-S, following their name.

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