Podcasts about swallowing disorders

How much do you really know about your tongue? Could a simple touch or stretch transform your vocal performance? In this episode, we reconnect with manual therapist Walt Fritz to explore the fascinating world of tongue awareness, self-stretching techniques, and how understanding sensation and shared decision making in the studio can reshape singing.WHAT'S IN THIS PODCAST?2:45 Are humans just wonky?4:02 What is the power of shared decision making?7:24 How do singers describe pain, fatigue and tension?11:30 How do we know when awareness has improved?23:14 How do we know when the tongue is functioning well?26:15 What does the size and shape of a tongue imply?35:32 What materials do we need for stretching the tongue?42:35 A guiding in tongue exercise and stretchAbout the presenter click HERERELEVANT MENTIONS & LINKSSinging Teachers Talk - Ep.74 Understanding Manual Therapy with Walt FritzNATs Chat Oct '24 - Discovering Your Voice: Stretching Tips to Expand Your Range (and Mind)Iopi MedicalTongueometerKerrie ObertSinging Teachers Talk - Ep.59 Top Tongue Tips for Boosting High Frequency EnergyJennie MortonSinging Teachers Talk - Ep.40 Integrated Skills: Teaching Singing to DancersSinging Teachers Talk - Ep.97 Elevate Your Performance Through Anatomical EfficiencySinging Teachers Talk - Ep.149 Part One & Ep.150 Two: Finding the Best Posture and Alignment for SingingNewcastle Voice ConferenceTommaso GeriDISCOUNT CODE: BAST2025ABOUT THE GUEST Walt Fritz, PT, has worked as an educator in the manual therapy field since the mid-1990s and expanded into voice, swallowing, oral motor, and airway issues in 2013. He is considered a content expert and teaches his Foundations in Manual Therapy: Voice and Swallowing Disorders internationally. Though manual therapy is typically described as a passive modality that remediates local tissue-based problems, Walt has evolved manual therapy explanations to be seen as another form of communication. His workshops challenge learners to look beyond what they were taught and know the potential of multifactorial impacts and drivers throughout the therapeutic process. Walt's approach leans strongly on shared decision-making instead of one-sided clinician perspectives, with the principles embodied in his approach applicable across the spectrum of therapeutic models.In addition to teaching, Walt maintains a private practice in Upstate New York.Walt is the author of the book, "Manual Therapy in Voice and Swallowing: A Person-Centered Approach," and is a contributing author to the forthcoming book, "The Oxford Handbook of Voice Pedagogy" and "The Vocal Athlete." Walt recently published the paper "The mechanism of action for laryngeal manual therapies: the need for an update."Website: waltBAST Training helps singers gain the confidence, knowledge, skills & understanding required to be a successful singing teacher. "The course was everything I hoped it would be and so much more. It's an investment with so much return. I would recommend this course to any teacher wanting to up-skill, refresh or start up." Kelly Taylor, NZ ...morebasttraining.com | Subscribe | Email Us | FB Group

For people who have swallowing issues, eating can be a challenge but that doesn't mean what they eat can't be nutritious and delicious. Question is, how can family members do that safely? And does taste matter as long as they're getting their necessary nutrients? Here to answer those questions and more, are speech-language therapist Tay Chia Yi and dietitian Tan Xin Yi. Image credit: Shutterstock

I'm Ellen Bernstein-Ellis, Program Specialist and Director Emeritus for the Aphasia Treatment Program at Cal State East Bay and a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their aphasia care through a variety of educational materials and resources. I'm today's hosts for an episode that will feature Jocelen Hamilton and Theresa Yao from Stanford Healthcare. We will discuss how adapting the A-FROM to swallowing disorders can offer a person-centered approach to assessing and treating a person with dysphagia.   Guest Bios     Theresa Yao is a licensed speech language pathologist at Stanford healthcare and a lecturer at San Jose State University. Her clinical and research interests include head and neck cancer rehabilitation, voice disorders, dysphagia, and aphasia. She is passionate about serving people from diverse backgrounds with communication and swallowing disorders. She was a fellow for life of the Albert Schweitzer Fellowship program, and co-founded the Bay Area's Swallowing Support group. She has been actively volunteering in community groups for stroke survivors who need communication support. She has always been a strong advocate for her patients and profession. Jocelen Hamilton has practiced as a licensed speech language pathologist for 19 years. She specializes in management of communication and swallowing disorders in adults with head and neck cancer. She began her career at the University of Iowa Hospitals and Clinics, and then joined the Stanford Outpatient Head and Neck Clinic in 2020. She also previously served as a clinical assistant professor for the University of Iowa's Communication Sciences and Disorders department with a focus on supervising graduate students and helping individuals with strokes and brain injuries. Her current clinical interests center around the development of frameworks to facilitate whole person care for individuals with swallowing disorders.   Listener Take-aways Think creatively about how to apply the A-FROM to other communication disorders, like swallowing Learn how dysphagia can impact the participation, environment and personal domains Consider some PROs that help to capture the impact of dysphagia on quality of life of both the patient and the caregiver Explore some ways to adapt EMRs to incorporate A-FROM or Swal-FROM into your daily notes Show notes edited for conciseness and clarity Ellen Bernstein-Ellis So I'm excited to have both of you here today. Thank you and welcome, Theresa.   Theresa Yao  00:55 Thank you, Ellen. I'm glad to be here.   Ellen Bernstein-Ellis  00:57 And Jocelen you too.   Jocelen Hamilton  00:59 Yes. Thank you so much for having us.   Ellen Bernstein-Ellis (Interviewer)    Welcome both of you, again, to this podcast. And as our listeners get to know you, we like to open with a fun icebreaker question. I'm going to pose two different questions that you've selected for today. So, Theresa, let's start with you.   I guess for full disclosure, I want to admit that, I will share--I don't have to admit, I am sharing that I had the honor and pleasure of being your supervisor at Cal State East Bay in the Aphasia Treatment Program (ATP). So I know that may come up today. I just want to let our listeners know that we've known each other for a while. I have been really fortunate in that relationship and seeing you emerge and thrive as such a wonderful contributor to our field.   So Theresa, could you please share one experience or role that has been meaningful to you as an aphasia ambassador?   Theresa Yao  03:22 Thank you, Ellen. It was great experience when I was in the Aphasia Treatment Program at Cal State East Bay. So that's actually one of the experiences I wanted to share as an opening, because I was at the Aphasia Treatment Program as a co-director for the choir, Aphasia Tones. And that was one of the best memory in my life. And I remember one time, one of our members who had more of a severe expressive aphasia, and usually has minimum verbal output, and we all know him. But whenever he starts singing, Can't Help Falling in Love, this particular song, you can hear that those beautiful words just came out right out from his mouth, fluently, beautifully. He was always so happy every time that he heard the music, and he just enjoy singing along.   That was just a really amazing moment for me to realize that people with aphasia with minimum verbal output, they can still enjoy and participate in choir, and can still communicate that way. It's just showed me how powerful it was to use the Life Participation Approach to Aphasia. And in our choir at that time, we have all different levels of severity. All members join together, and then they all enjoy and engage in this choir experience. So that's really meaningful. Whenever I think of LPA, I think of him, I think of this song, and I think of Aphasia Tones.   Ellen Bernstein-Ellis  04:54 Thank you for sharing that. And Theresa, it was wonderful to have you as a co-director. And see you step up to the challenge of leading the choir. And you're right, we really have a strong motto of participation at every level. And you really worked hard to make sure that happened. So thank you for sharing that. And yes, that's one of my favorite topics, so I loved hearing about that.   And Jocelen, I'm also excited to ask you to share with the listeners something about one of your experiences. So would you like to share an Aphasia Access, favorite resource or moment? What comes to mind for you?   Jocelen Hamilton  05:28 Yes, well, this is really neat for me to be on this podcast, because it is this podcast that is a favorite of mine, and a major “aha” for me.   Ellen Bernstein-Ellis Well, thank you, just thank you.   Jocelen Hamilton I worked with patients with head neck cancer for about nine years. I then did a major shift and then worked in a graduate training clinic at the University of Iowa. And during that time, previously, when I was at the hospital with a very heavy caseload and working with individuals with dysphagia. And so then switching over and working with individuals with strokes and brain injuries, that was much more communication focused.   And I had this caseload I was taking over with the graduate students and learning about all the current treatment principles and treatment options and all the research that had been developed. It had been probably close to 10 years since I had worked regularly with individuals with neurogenic communication disorders.   I had knew nothing about LPAA. I knew nothing about Aphasia Access, the organization. And I was thinking about this recently, of how I even came across it. But I think probably I was searching one of these treatment modalities, and a podcast came up. So I listened to some of the other podcasts and I was like, oh my goodness, this totally resonated, LPAA. And the podcasts and other resources through the website, totally resonated with me, and helped me better understand what my frustration was within an impairment only based approach, which was in my training and my background, and things like that, to like see a whole different way. So I learned as much as I could. And I tried to share all of that with my students, we were all learning together of how to implement this. So it's really neat to now be a part of this podcast and participate.   Ellen Bernstein-Ellis  07:32 We're so glad you agreed. And I just want to thank you. If there was ever a wonderful plug for membership to Aphasia Access, I think you just gave it. Thank you so much. for that.   Well, let's dive in a little bit more to our topic of the day. We're going to be talking about how and why you both decided to adopt the A-FROM or the Framework for Outcome Measurement of Aphasia by Kagan and Simmons-Mackie to your work with head and neck cancer patients. So I know we usually focus on aphasia, but we're taking this really important tool and talking about how you adapt it. So many listeners are, of course already familiar with the A-FROM. But can you briefly describe the social model framework for our listeners?   Theresa Yao  08:16 I can start with just a brief introduction. I think everyone, if you're listening to this podcast, you are already very familiar with A-FROM, which is based on the World Health Organization's ICF model. They address a few health and social domains such as body structure, function, activities, participation and contextual factors like personal and environmental factors. And like Ellen mentioned before, Dr. Kagan and colleagues, adapted this ICF model to create a very user-friendly framework for the outcome measurement in aphasia. And this becomes the Living with Aphasia Framework Outcome Measures the A-FROM and it has the domain of aphasia severity, which is the body function or impairment level, and then also participation, environment, personal factor. So these are the core concepts of the LPA approach. Thats what we are based on using this A-FROM to adapt it to this Swallow-SWAL-FROM, we call it. The Living with Swallowing Difficulties framework of measures.   Ellen Bernstein-Ellis  09:22 So let's talk a little bit more about this. Jocelen, do you want to share your story as an SLP and how you came to introduce the A-FROM into your work at Stanford in the head and neck cancer clinic?   Jocelen Hamilton  09:37 Sure. So after about a year and a half of working with individuals with aphasia and applying LPAA and using the A-FROM with clients, I then changed gears back to working with people who had neck cancer and we moved to California and I joined the Stanford team and I was back into primarily working with individuals with dysphagia. I just kept thinking about how can I take this model the A-FROM and apply that to working with individuals with dysphagia.   How I would previously use the A-FROM is that Venn diagram. I would just draw it on a piece of paper and start writing my notes on that as I was maybe doing an intake or working with a client. I started doing some of that model just in my note taking and looking at these different domains that might be impacted. And this was just kind of over a series of months, and even a year, where I was thinking about how to apply this and shared it with my patients. Here are some of the things that I'm seeing and what you're sharing with me that shows your participation is being impacted.   Then I ended up talking with our director, Heather Starmer, about an idea of a project—like how can I move this ahead. Theresa had recently joined our team and Heather said, you might want to talk to Theresa about that. She might be interested in doing a presentation on this. And so it was great, because Theresa and I had not yet talked about our aphasia backgrounds together. It was really neat to then work together and begin to apply this with more of our patients. Initially, we kind of struggled with what the environmental domain look like for somebody with dysphagia. And it was neat to talk through different cases with each other to see how it could apply. And then that's where the Swal-FROM came from.   Ellen Bernstein-Ellis  11:39 Wow, that's wonderful that the two of you were at the right place at the right time. And I always feel that the expression “stronger together” seems really fitting in this situation. But Theresa, do you want to share how you brought a life participation perspective into your work at Stanford?   Theresa Yao  11:57 Yes, sure. Because I've always been a big fan of the ICF model. When I was a student clinician in Aphasia Treatment Program, I learned so much from this model, from LPAA, and from Ellen, you. And also, of course, our members in our Aphasia Treatment Program. And I just could see the huge benefit from the LPA approach in the client's life.   So that's why once I started working in real clinics, I always think about this model. And when I started in at Stanford, I started working with the head neck cancer patients. I just feel like so many patients, they live with long term dysphagia, or a sore throat because of the neck cancer treatment they had. And they sometimes just can't get rid of it. They have to live with it. It's just like aphasia. They live with aphasia. And then it just clicked.  I just think that it's pretty similar to the situation that you're living with aphasia, and it's that same impact on patients quality of life, on their participation.   Then I just started thinking, maybe we can do something with this model to help our patients. And then, of course, Jocelen was there, and then we were just talking about her experience with aphasia treatment and LPAA. And we just clicked. That's why we came up with this (ASHA) presentation, and this idea of how to adapt this A-FROM to our Swal-FROM. And then also, we're talking about this because I also started a support group because I feel like people wanted to get connected. They wanted to engage like aphasia group.  They wanted that community to be able to participate, to be able to share. So that's why I think this also helped me to try to initiate this project, this group, so that we can help more people so that they can, they can help each other.   Ellen Bernstein-Ellis  13:56 I really love that you saw the power of group therapy, and you then were able to bring it into a different treatment arena. I really don't remember hearing too much about separate support groups for people with swallowing disorders. I don't know how common they are. But it sounds wonderful that you started one, Theresa. So very exciting. What do we know about the incidence of dysphagia in stroke survivors, and then people in skilled nursing, and from there, head and neck cancer? The reason I ask because I think there's overlap. I mean, you're seeing the dysphagia in head and neck cancer, but we know that it occurs frequently. Do you have any numbers to share about the incidence in stroke survivors?   Jocelen Hamilton  14:39 Yes, so it's about 45% of individuals with strokes experience, some degree of dysphagia and there's been research that's shown 40 to 60% of older individuals in nursing homes have dysphagia. There's even some research out there that one in 25 adults will experience dysphagia. Then when we look at individuals with head and neck cancer, and this could be on the lower range, but one of the particular statistics is 45 to 50% of individuals with head and neck cancer experience dysphagia.   Ellen Bernstein-Ellis  15:11 The importance of considering the whole person (for dysphagia tx) is really going to affect a lot of people that we might be seeing as therapists. And the two of you saw that there was a strong impairment focus in dysphagia management.  Can you give an example?   Theresa Yao  15:27 I can talk a little bit about this. When I was in grad school, I know that most of the things we learned was how to identify the impairment of dysphagia. We learned all kinds of treatments and exercises for dysphagia. We learned like how to modify diet, how to look for aspiration, penetration. Almost everything we learned, and also what we've been practicing in our clinical practice are heavily focused on the deficit and impairments. That's basically how we trained to assess and treat the physiological changes or the deficit. It just, to me, sounds like it's really technical.   I recently just look up the ASHA NOMS, the National Outcomes Measurement System-- that's what we usually use as judgment of whether the patient is making progress or not. They use this particular functional communication measures to see there's like different levels. If you're really looking at this national measurement system, you can see that the wording and the definition of each level is pretty much impairment focus. They mention diet level, safety, efficiency of swallowing, compensatory strategies, or cues, etc. So these are really heavily focused on impairment, but you don't really see like things that relate to participation, quality of life, environment, and those factors. So the consequences that if all the clinicians are just looking at the impairments and not looking at other factors, then you are missing a lot, you're not treating the whole person.   Ellen Bernstein-Ellis  17:11 Well, that's perfect, because that leads me to my next question. Why is it important to go beyond the impairment level measurement with dysphagia?       Jocelen Hamilton  17:24 I would say, because dysphagia is more than a physical difficulty. That's our name for that physical impairment. But it influences more, just like we know, with aphasia, that it's not just how much they can say, what they understand in the different modalities, but how a change in this function in the body influences everything.   So one of the analogies that I can relate to, that I've heard before in terms of looking at accessibility, has to do with like, physical impairments. So if somebody is paralyzed, they can't move their legs, well, the physical therapists are going to look at their legs and see the range of motion, their strength and all of that. But they're also going to think about how are they going to get into their house? And how are they going to move around?   Well, sometimes what can happen with dysphagia, as Theresa already talked about, we're looking just at how does that epiglottis move? What is the airway invasion like? But then are we going to talk about well, what's going to happen? We just had the holiday with Thanksgiving and the holidays now. What are family meals going to look like? I think one of the things that sticks out to me is what would my day to day life and social life be like if I couldn't drink with ease and comfort, I couldn't eat with ease and comfort, if I needed to have special food and special liquids and special strategies? So this impacts so many things within a social realm, and personal realm as well. We'll get into that in more detail as we go. But it's not just about the change in a physical function. How does that influence the rest of our lives? And it really does. There's been research that shows about burden and quality of life and psychological health.   Ellen Bernstein-Ellis  19:08 Well, this really hits close to home for me. I'm going to share with our listeners a personal story, because I've always been very passionate about our field and an advocate for speech language pathologists, but being on the other side of the table, when my husband was diagnosed with terminal cancer, did nothing but increase my own respect and appreciation for the role we play in supporting our clients and their loved ones.   Through this process, specifically with dysphagia, and I want to give a shout out to my husband's speech pathologist at Stanford, Heather Starmer, (and another congratulations to her because she just was made a 2023 ASHA fellow), but I'll just always remember the day that we came in. I know that Heather was set with her treatment plan-- I could already guess what we needed to do for the day. And that plan went out the window because we both signaled, Steve and I, that he was just feeling an increasing burden of trying to manage all of the home tasks we were supposed to do for both PT and speech, and it was just really impacting how he was feeling. And so instead, Heather focused on the personal impact and the quality of life issues that we were bringing up. Steve wanted to be compliant. He wanted to be the best patient there was. But she really listened to him carefully. She brought her best counseling skills to the table that day, and helped us come up with a plan that we could manage in a way that would help us sustain his quality of life as best as possible.   So I really saw, personally, I mean, I saw day in and day out how his dysphagia from his head neck cancer really impacted, hugely impacted, his participation with our family, and his quality of life. I am grateful for this work that you're doing and the passion you feel for looking at the whole person as you assess and treat dysphagia. And thanks to you, I've been reading, since dysphagia is not usually in my wheelhouse as much these days, but thanks to preparing for this particular episode, I was able to read some articles by Rebecca Smith and her colleagues that showed me that there's some amazing work being done looking at this whole topic, so thank you for that. Okay, and taking a deep breath, because that's a story I've been thinking about for quite a bit.   Back into our next question. What is the speech pathologist's role in assessing and addressing health related quality of life and the associated mealtime quality of life? That seems to be talked about a lot in the literature right now. Jocelen, is that you again?   Jocelen Hamilton  21:57 I'm glad you mentioned Rebecca Smith's work. There are actually three papers, I think, that that group, she and colleagues, put out in 2022. And specifically, I'll share a few quotes from their paper The True Cost of Dysphagia and Quality of Life:  The Views of Adults with Swallowing Disability, but in a way, there's a call to action, and she's not the first to mention it. But for us to include social participation, and their overall well-being, as part of our dysphagia intervention. To make that routine, and then to also ask questions: How are you doing? How are the holidays? How are these social settings with eating? I like to ask patients and their family members, and ask them separately, not meaning like individually, within the same session: Are you participating in doing this, the same things that you did before your diagnosis? Or how is that looking? Are you going out to eat as much? What do you miss now that is different and you're experiencing changes in your swallowing.   And it's interesting, because sometimes the partner will say that they miss going out to eat, and they need to navigate feelings like, “Well, I don't feel comfortable eating this in front of my loved one who has difficulty swallowing. I feel conflicted about I get to eat ribs, and they don't.” Those kinds of things. The importance of eliciting these stories, so we can really see what are their challenges, because then we can, like LPAA teaches us, we can engage in this creative problem solving and how we can help navigate through some of these challenges. I think those are a couple of important things that we can look at to support people.   Ellen Bernstein-Ellis  23:45 Thank you. And I just wanted to let our listeners know that we're putting all these references into our show notes. I took some from your ASHA presentations that I attended. So those will all be cited in the show notes.   Well, to expand to the participation, environment, and personal domains, you started to think about using patient reported outcomes or PROs for assessment. Why don't we go through the domains and discuss potential tools and interventions to fill out this framework a little bit more. So what might it look like if you consider participation?   Jocelen Hamilton  24:24 When we're looking at participation, we're looking at these meaningful activities may or may not involve oral intake, but looking at their current levels of participation compared to their pre cancer status. So how often, and in what ways, is someone with swallowing challenges participating? I kind of already talked about that a little bit. And how are the family members doing?   Here's one of the interesting things that I've had patients share here. Sometimes, one of the swallowing strategies that a patient needs to complete is a purposeful throat clear, and a re-swallow, or some patients do naturally their throat clearing, or maybe they're coughing when they're eating and drinking. This is an area where it calls attention to them when they're doing this. And then during the pandemic, we were all super hyper aware is somebody clearing their throat? Is somebody coughing? I've had some patients where they really don't feel comfortable because it calls attention. And people ask, how are they doing?   And also, another challenge being that when swallowing is hard, talking and swallowing is extra hard. When swallowing is challenging, most people need to just do that, where we take for granted that meals are a very social time. So some of those issues can be really challenging. There's also some individuals where their difficulty with swallowing has to do with loss of the bolus coming out and so there's almost changes in appearance, where they may not feel it. Their lip, their chin might be numb, and they don't know that liquids are dripping out, or they have a piece of food sitting there. So, they might be hesitant to go out and participate in different social settings. Even sometimes we have patients where they don't feel comfortable eating with their own family members, where they will eat completely separate from their spouse.   Ellen Bernstein-Ellis  26:28 I am just really struck again about the overlap of some of the things in your head neck cancer patients with clients I see with aphasia. It's really striking. So should we take a moment and discuss how this might look if you consider the environment?   Jocelen Hamilton  26:44 I really didn't address a PRO at all.   Ellen Bernstein-Ellis  26:46 Oh, it's not too late. We can still do that.   Ellen Bernstein-Ellis  26:52 Why don't you go ahead?   Jocelen Hamilton  26:55 Sure. Okay. So we're looking in this interview, right, like gathering information, learning how these things are challenging for them. For patient reported outcomes, PROs, Theresa, and I both looked into different ones. And oh, this one has these questions. And this would fall within this domain. So I'll touch base on a few of them here. And then some of them, they have questions that actually apply to  all of the domains.   So for these, there's one the Swal-QOL, this is probably the most broad in terms of looking at all of the domains that are within this Swal-FROM. It has 10 different quality of life concepts that it has specific questions for. So for this one, there's one subset that's all about social functioning. Some of the questions, they're rating from either strongly agree five point scale to strongly disagree, One of the questions, for example, is “I do not go out to eat because of my swallowing problem.” That really tells you where they're at with that participation, or “Social gatherings like holidays or get togethers are not enjoyable because of my swallowing problem.” So that really hones in on that challenge.   Within our specific area of practice with individuals with head neck cancer, there's a scale called the Performance Status Scale Head Neck Cancer, PSS-HN. Now you might think, how might I use this? I encourage people to be open minded, even though this wasn't validated. And some of these are not validated on individuals who have dysphagia from a different cause other than head neck cancer. It doesn't mean that you can't use it as a way to gather information, engage, and perhaps re administer.   I'm also a big fan of, as people fill this out, having a conversation about their responses as they go to gather information. But with this, the Performance Status Scale, there's a specific rating scale about public eating. So zero means always eats alone. And 100 is no restriction of eating for any place food or company. So they would eat out at any opportunity. Where in-between might be one point on the scale, “eats only in the presence of selected persons and selected places”, or they would eat out but there would be another option,  “eat out, but be more selective about the diet textures and things they would consume in a social setting”, which is common. Some individuals will specifically choose different foods when they're when they're in a social setting.   There's also another PRO, the Dysphagia Handicap Index. So with this one, it's a 25 item questionnaire and it does specifically look at physical, functional and emotional aspects of dysphagia. And so a couple of questions from there that would fit with the participation domain include, “I'm embarrassed to eat in public” and “I don't socialize this much due to my swallowing problem”. Those could give some insight into these areas by selecting some of those questions.   Ellen Bernstein-Ellis  30:08 Well, I'm really glad you caught me. I think I was so struck about the overlap that, thank you for coming back and talking about those PRO's. Are we good? Can we transition to the environment next? What would this look like? What does the Swal-QOL look like if you consider the environment.   Theresa Yao  30:29 When you talk about the environment, it can be factors such as the availability of the appropriate food textures, and oral liquid consistencies across different social settings. For example, if you go out to the restaurant, are there any easier food texture that's available for people with dysphagia? And that's one of the environmental factors.   And then there's a new article from ASHA leader that just came out about dining with dysphagia. So that's actually a pilot program from University of Cincinnati that try to help restaurants to expand their menu options so that they have more choices for people with swallowing disorders.   Ellen Bernstein-Ellis That's amazing.   Theresa Yao Also, another factor that related to the environment is the attitude and level of acceptance or support the people with dysphagia can get from their family, their friends, or even just strangers in their eating situation. So just like Jocelen mentioned, if you're coughing or clearing the throat, what the reaction from other people will be like, -- if they're supportive, or if they're not so. Sometimes these factors can make a patient uncomfortable eating out because of those environmental factors. And then also, the attitude from people around usually can be impacted by culture. Which type of textures they prefer to consume, and how they consume. If you go to a different type of restaurant, they may have different types of food textures, that are specifically for that culture, so that's also another factor.   And then also, on the broader spectrum, is the attitude from the healthcare professionals or the public, because the attitude from healthcare professionals is basically, because dysphagia is invisible, and when you are in the hospital, not everyone can see it. If you have leg injury or arm injury, people can see it. But if you have dysphagia, you can't see it. And then when the health care provider is, prescribing your pills, and if you can't swallow, how can they take the pill? They probably are not aware of this, this type of disability, so they may not prescribe you the right pills.   These are the things that we can consider as environmental factors. And of course, even larger scale, there's health care policies, the service systems, that may impact the people with a dysphagia too, because insurance may not pay all the dysphagia services, or how often can people get dysphagia support or service? So those are all the environmental factors that we may consider.   Ellen Bernstein-Ellis  33:21 I think the importance of this framework is helping us as clinicians to continue to think just broader and more widely about what's impacting the person in front of us. I mean, wow, you are giving us a lot of factors, from the very personal to the broader social policy. And I want us to take a moment and also talk about personal factors, that whole domain.   Theresa Yao  33:41 Personal factors can also be very, very important. And  a lot of things can be involved. So we know that the person was dysphagia may not be the same person, have the same hobbies or same traits, as before their treatment. So that may cause anxiety, or they may feel embarrassed because of their eating habits, or the change of their eating habits. Because we know that eating and drinking is very individualized. Some people, if they're born as a slow eater, they probably are okay with their dysphagia diet or if we ask them to eat slowly and take smaller bites, that's totally fine. But if some people are born as a fast eater, they will have a huge challenge with, if you give them the strategy to eat slow, taking small bites, because that's just not them anymore. They just feel like they're a different person and then they feel disappointed or frustrated if they can't eat as fast as they used to.   And I always share this in my clinic. I  see two patients with similar procedures. One person can feel really happy with their diet. They feel okay because they're always eating soft foods or soups. And then another person just with a little bit of impairment of mouth opening, they feel like it's just really frustrating because they can't bite their sandwiches and burgers. And that just makes a huge difference. But if you're only looking at their swallow study, it's the same, they probably don't have any major impairment, but the impact on the quality of life on their participation, environment, and also personal factor. It's so different. So that's why I think considering a personal factor is really important.     Ellen Bernstein-Ellis  35:38 So you're giving us examples of the things we should be thinking about, you're giving us examples of some of the PROs that might help us measure. But if many of the EMRs, the electronic medical records are set up for impairment focused measures, how can you adapt the documentation to include these other domains? That's always a barrier, or can be maybe, not always, can be.   Jocelen Hamilton  36:00 I think sometimes it can be a barrier. If sometimes the entry is just you have to click certain things, there's not a lot of room for free text. With the EMR that we have, we can have a set template, but we can copy and paste anything in there. So what I did is I took the A-FROM--actually, in the same paper that put out the A-FROM, they put the FROM, Framework for Outcome Measurement, and actually suggest that you could use it for individuals with TBI and called it TBI-FROM.    I took that and put it into a template and have the citation for it there and then added a title. It gives a visual for other individuals reading the note of what I'm talking about. ‘Survivorship beyond body function domain: Dysphagia's impact on personal, participation, environmental domains', so I have that as a title. I have it as this set, we use epic, so I can do dot phrases (Smart Phrases). I can drop that into a note. And then as I go through and document, I have the subtitles of body function, participation, environment, personal factors in as I'm collecting this information. That's how I can organize my note.   I don't do it every single time with every single patient. Sometimes some of our sessions are more impairment focused, like we need to for safety reasons focus on this. Sometimes it's more a whole session all about how are they doing with their personal domain? I had a patient in the clinic today, and he is depressed, and we just had this quick talk of, “Okay, what do we need to do? Can you talk to your primary care doctor? This is common, many individuals with head neck cancer have depression.” But I'll organize my note, getting back to the notes, with those subtitles and putting the information in there. It also is a cue for me, because I keep needing cues and reminders to come back and broaden that focus, instead of always being in on the impairment and you monitor, document, and then monitor, as I'm reviewing back on their notes to see how they're doing across these different domains.   Ellen Bernstein-Ellis  38:19 That is a beautiful example of how you can adapt something. I'm sure a lot of our listeners really appreciate you describing it so carefully, and hopefully will inspire some of them to see what they can do to adapt their EMRs.   A little bit earlier, you mentioned the importance of getting perspective from both the client and the care partner. How does the caregiver or care partner experience fit into the Swal-FROM?   Theresa Yao  38:47 Caregiver or care partners, they play a really important role in this whole journey with individuals with dysphagia. And I'm sure Ellen, you probably were in that role before. Most of the time, it's the caregiver making the meals for the spouse. Making the meals for the patients with dysphagia can be very challenging. Because just the texture, you have to take care, and the taste. I have caregivers talking to me. They told me that they tried their best to make all the foods but the patient didn't eat at all or didn't like it at all. Then they feel super frustrated. These are all the challenges that the caregivers may face.   Dr. Samantha Shune and colleagues, they did a lot of work on this caregiver burden topic. Their study said increased caregiver burden has been associated with the degree of impact that dysphagia is having on mealtime logistics. Family members also report increased anxiety and fear and frustration, stress, embarrassment and social isolation. So these are very two critical things to consider when we're thinking about whole person care, because we can't just care for one person, the patient. But if the caregiver is also experiencing all the stress, all the anxieties, we also need to consider that factor.   Researchers in Australia, Professor Nund and colleagues, they also pointed out that this specific caregiver burden is third party disability. And it's the consequence of that person's impairment, which impacts the functioning and ability of their family members or significant others. That's why we want us to fit this caregiver experience into this Swal-FROM framework. Just adding the family caregiver in all the different domains to support patients with dysphagia. And caregiver can influence four domains. But at the same time, also, we need to take care of, examine, the four domains of the family member or the caregiver--going to check their participation, their environment, and their personal factors. Those are really important, because their health and well-being can be affected by being in the journey of taking care of people with dysphagia. So they're super tied closely. That's why we wanted to fit this framework as well.   Ellen Bernstein-Ellis  41:21 One of the clinical tools I've learned is available is a PRO measure called the CARES, developed by Shune and colleagues, and we'll again put the citation in our show notes. Theresa, could you describe that a little bit more?.   Theresa Yao  41:37 So this is a wonderful screening tool that developed by Dr. Shune and colleagues. It's full name is called Caregiver Analysis of Reported Experiences with Swallowing Disorders. It has 26 items in the questionnaire. And then there's two parts that explore a different aspect of dysphagia's impact on the caregiver. One is a checklist on the behavior and functional changes, and one is a checklist of the subjective caregiver stress. Basically, it's a simple yes/no questionnaire. You can give it to the caregiver and they can just circle yes or no. Then from that, you can figure out what area you may address as an SLP. Or you may want to refer them to a specific team or professionals to address that, because we have limited scope of practice, we can't do everything. But if we can help them to identify the issue and then point them in the right direction, to the right team. That may help a lot.   Ellen Bernstein-Ellis  42:43 In your ASHA presentation you also mentioned the Rome Foundation is a resource and another website that offers skill building around managing serious illness conversations. We're going to put both of those resources into the show notes for people, but we don't have time right now to go into them fully.   But Jocelen, can you address or share what benefits you've seen by adopting this framework? Does it help with goal setting? Does it help with acceptability of recommendations? What have you seen?   Jocelen Hamilton  43:12 I think it's helped me and I feel like it's helped patients and our families have a little more clarity about, okay, these are the areas that are challenging. And again, I'm a visual person, so if I write it out with them, and they're telling me things, and I'm explaining, I get excited about the diagram, and I'm like, you know, see, this seems like an area of challenge. Is there something that you're interested in doing in this area? Are you willing to talk with another person who's gone through this?   So I feel like it really can give clarity, I think, for myself, what you know that A-FROM does, and Swal-FROM now is to not, I professionally can get really hung up on the impairment. And I can't always change that, right? We can't always change it to the degree that we would like. Of course, we would like everybody to have complete resolution, right? And so there can be this frustration and powerlessness with that. And obviously the patients and our family members can be experiencing that also.   And with this broader view, we can say but here's what we can focus on what can we do to have you participate that would make you feel better? What can we do that would help you with your personal feelings? So I feel like it addresses things that matter and we can have more conversations about how is their day to day life being impacted? What are some small steps we can take in a direction that might help them and their families.   Ellen Bernstein-Ellis  44:43 That's beautiful. Thank you so much, Theresa and Jocelen. It has been a pleasure  and I've learned so much from both of you, listening to you apply this framework and look deeply and carefully at quality of life for people with dysphagia. I really appreciate it. Is there anything else you want to add?   Theresa Yao  45:03 I just wanted to add a little bit. So I think it's really important as clinicians to listen to our patients and caregivers, because we need to learn from their experiences, their perspective. And, like we mentioned dysphagia is invisible. I wanted to share one of the quotes from one of the dysphagia support members. He says,  “dysphagia is a label you carry with you inside.” And that's really just so true, because it's hidden. If you go outside, people see like you what you can walk, you can talk, but they don't know that this disability is hidden inside. And I think it's so important to address not just the impairment, but also listen to the patient's perspective. And then help them to address all the domains. I always think that you become a better clinician because what you learn from your patient. So that's all we need to do.   Ellen Bernstein-Ellis  46:08 I can't think of a better way to close this interview. Even though I could ask you several more questions, we could be here for another hour, I just want to thank you for bringing that patient's voice, a client's voice, into the discussion today, so beautifully. And let's end on that note of really learning from our patients' perspectives. So I want to thank you both. And I want to thank our listeners for listening today. And for the references and resources mentioned in today's show, please see our show notes. They're available on our website at www.aphasiaaccess.org. And there you can also become a member of our organization.   Jocelen Hamilton Yes, yes, Do it!   Ellen Bernstein-Ellis Thank you! Browse our growing library materials and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@AphasiaAccess.org For Aphasia Access Conversations, I'm Ellen Bernstein-Ellis. And thanks again for your ongoing support Aphasia Access   Resources and References Ariadne Labs: Serious Illness Care Program https://www.ariadnelabs.org/serious-illness-care/serious-illness-care-program/ The Rome Foundation https://theromefoundation.org/   Chen, A. Y., Frankowski, R., Bishop-Leone, J., Hebert, T., Leyk, S., Lewin, J., & Goepfert, H. (2001). The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the MD Anderson dysphagia inventory. Archives of Otolaryngology–Head & Neck Surgery, 127(7), 870-876. Hamilton, J., Yao, T. J. (2023). Framework to Guide Whole-Person Care for Individuals with Dysphagia. 2023 ASHA Convention, Boston, MA. Hamilton, J., Yao, T. J. (2022). Shifting to Whole-Person Care for Head Neck Cancer Survivors Living with Dysphagia. 2022 ASHA Convention, New Orleans, LA. Hickey, E. and Douglas, N. (2021) Person-Centered Memory and Communication Interventions for Dementia: A Case Study Approach. Plural Publishing, Inc. Howells, S. R., Cornwell, P. L., Ward, E. C., & Kuipers, P. (2021). Client perspectives on living with dysphagia in the community. International Journal of Speech-Language Pathology, 23(2), 201-212. Kagan, A., Simmons‐Mackie, N., Rowland, A., Huijbregts, M., Shumway, E., McEwen, S., ... & Sharp, S. (2008). Counting what counts: A framework for capturing real‐life outcomes of aphasia intervention. Aphasiology, 22(3), 258-280. List, M. A., D'Antonio, L. L., Cella, D. F., Siston, A., Mumby, P., Haraf, D., & Vokes, E. (1996). The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy‐head and neck scale: a study of utility and validity. Cancer: Interdisciplinary International Journal of the American Cancer Society, 77(11), 2294-2301. McGinnis, C. M., Homan, K., Solomon, M., Taylor, J., Staebell, K., Erger, D., & Raut, N. (2019). Dysphagia: interprofessional management, impact, and patient‐centered care. Nutrition in Clinical Practice, 34(1), 80-95. McHorney, C. A., Bricker, D. E., Kramer, A. E., Rosenbek, J. C., Robbins, J., Chignell, K. A., ... & Clarke, C. (2000). The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia, 15, 115-121. Nund, R. L., Scarinci, N. A., Cartmill, B., Ward, E. C., Kuipers, P., & Porceddu, S. V. (2016). Third-party disability in carers of people with dysphagia following non-surgical management for head and neck cancer. Disability and rehabilitation, 38(5), 462–471. https://doi.org/10.3109/09638288.2015.1046563 Shune, S. Moving beyond the isolated swallow: Dysphagia in the context of the shared mealtime. https://dysphagiacafe.com/2015/03/19/moving-beyond-the-isolated-swallow-dysphagia-in-the-context-of-the-shared-mealtime/ Shune, S., Davis, C., & Namasivayam-MacDonald, A. (2021). Contributors to Dysphagia-Related Burden Among Spousal Caregivers of Stroke Survivors. Archives of Physical Medicine and Rehabilitation, 102(10), e65. Shune, S. E., & Namasivayam-MacDonald, A. (2020). Dysphagia-related caregiver burden: Moving beyond the physiological impairment. Perspectives of the ASHA Special Interest Groups, 5(5), 1282-1289. Silbergleit, A. K., Schultz, L., Jacobson, B. H., Beardsley, T., & Johnson, A. F. (2012). The dysphagia handicap index: development and validation. Dysphagia, 27, 46-52. Smith, R., Bryant, L., & Hemsley, B. (2023). The true cost of dysphagia on quality of life: The views of adults with swallowing disability. International Journal of Language & Communication Disorders, 58(2), 451-466. Smith, R., Bryant, L., & Hemsley, B. (2022). Dysphagia and quality of life, participation, and inclusion experiences and outcomes for adults and children with dysphagia: A scoping review. Perspectives of the ASHA Special Interest Groups, 7(1), 181-196.

Dr Cath Gregory chats about the latest evidence in Functional Neurological Disorders and the speech-language pathologist's role when working with people with Functional Neurological Communication and Swallowing Disorders. Key Takeaway: (1-2 sentences of the main theme.) Functional neurological disorder (FND) is a problem with the ‘software' of the brain that can occur across the lifespan. No longer classed as ‘psychogenic', this disorder is now known to follow a biopsychosocial model of illness. It is essential that a positive diagnosis, rather than a diagnosis of exclusion, occurs. Clear education about the disorder and the use of distraction to help access more autonomic pathways is the current consensus treatment for communication and swallowing disorders. A multidisciplinary approach is always required for people with more complex needs. Check out the show notes on https://www.speechuncensored.com/podcastepisodes/163

In this episode, we look at what artificial intelligence (AI) might mean for people with swallowing disorders, as part of our continuing series of conversations about AI's influence on audiology and speech-language pathology.Vanderbilt University's Cara Donohue shares her experience with this burgeoning technology before discussing implications and practical applications. Hear why she considers the roles of engineers and interprofessional collaboration to be essential.

Calling all peds med SLPs! Are you and the pediatricians who serve your young clients BFFs?  No? Then this episode is for you!  In the latest episode of the Swallow Your Pride Podcast, Michelle Dawson, MS CCC-SLP, CLC and Tessa Gonzalez, MD discuss the importance of collaboration and communication among healthcare professionals when working with medically complex children and their families. Tessa Gonzalez, a pediatrician and mother, believes that finding the right team of professionals to care for a child with complex medical needs is crucial. She emphasized the importance of trusting the professionals on the child's care team and finding the right people to make decisions. Michelle Dawson, MS, CCC-SLP, CLC, a speech-language pathologist in Staunton, VA, is the acclaimed host of “First Bite: Fed, Fun, Functional” a weekly Speech Therapy Podcast that addresses “all thangs” Pediatric Speech Therapy and is presented by SpeechTherapyPD.com. Michelle authored, "Chasing the Swallow: Truth, Science, and Hope for Pediatric Feeding and Swallowing Disorders". She is an accomplished lecturer; traveling across the nation delivering courses on best practices for evaluation and treatment of the medically complex infant, toddler, and child with respect to their pediatric oropharyngeal dysphagia, pediatric feeding disorder, as well as language acquisition within the framework of Early Intervention. She stressed the need for improvement in interprofessional education and practice and praised the Council of Academic Programs for Communicative Sciences and Disorders for their efforts in this area. Collaboration in Medical Practice [00:11:23] The speakers discuss the importance of collaboration and communication between medical professionals and specialists, as well as the benefits of multidisciplinary clinics. Importance of Referrals [00:15:48] Tessa Gonzalez emphasizes the importance of knowing who to call and when to refer patients to other professionals in order to provide the best care possible. Finding the Right Team [00:18:06] Tessa Gonzalez, a pediatrician and mother, shares her experience of finding the right team of physicians, therapists, and teachers to help make decisions for her child with multiple medical complexities. Requesting Referrals and Access to Healthcare [00:19:08] Michelle Dawson, a speech pathologist, discusses the challenges of requesting referrals and finding the right specialist for a child with feeding disorders, and the unique barriers to access to healthcare in different parts of the country. Handling Professional Disagreements [00:23:07] The speakers discuss how parents can handle disagreements between professionals when there are discrepancies in how to handle a specific child or case, and the importance of finding the right fit for the family. Early intervention [00:26:04] The importance of early intervention in pediatric feeding and swallowing disorders, and the emotional intelligence needed to work with families. State interpretation of IDEA Part C [00:30:32] The differences in interpretation of IDEA Part C between states and the need for more standardized practices in pediatric care. Empowering Caregivers [00:38:05] The importance of empowering caregivers, especially those from historically disadvantaged backgrounds, is discussed, with examples of programs like the Power of Two from Feeding Matters. Care Coordination [00:39:25] Discussion on the importance of care coordination and how it is a crucial part of the state regulations for license professionals. Collaboration with Families [00:41:09] The role of educating families on how to advocate for their child and how parents are professionals on their kids. Acknowledging their role as professional caregivers to their children and collaborating with them as part of the team.

Drs Lin Chang and Douglas Drossman discuss the history of IBS, the gut-brain axis, and the role of trauma and stress in IBS, and share pearls for implementing biopsychosocial care in the clinic. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/987258). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources IBS and Chronic Constipation https://www.medscape.com/resource/ibs The Need for a New Medical Model: A Challenge for Biomedicine https://pubmed.ncbi.nlm.nih.gov/847460/ The Irritable Bowel Syndrome https://pubmed.ncbi.nlm.nih.gov/892385/ Rome IV Criteria https://theromefoundation.org/rome-iv/rome-iv-criteria/ William E. Whitehead, PhD https://www.med.unc.edu/ibs/about-us/faculty-biographies/william-e-whitehead/ Program Treats Complex GI and Swallowing Disorders https://hscweb3.hsc.usf.edu/blog/2012/01/04/program-treats-complex-gi-and-swallowing-disorders/ Post-infection Irritable Bowel Syndrome https://pubmed.ncbi.nlm.nih.gov/34024451/ Psychosocial Factors in Gastrointestinal Illness https://pubmed.ncbi.nlm.nih.gov/8416089/ To Be a Great Physician, You Must Understand the Whole Story https://pubmed.ncbi.nlm.nih.gov/17435659/ Validation of Symptom-Based Diagnostic Criteria for Irritable Bowel Syndrome: A Critical Review https://pubmed.ncbi.nlm.nih.gov/20179688/ Effect of Abuse History on Pain Reports and Brain Responses to Aversive Visceral Stimulation: An FMRI Study https://pubmed.ncbi.nlm.nih.gov/18242208/ Toward a Biobehavioral Model of Visceral Hypersensitivity in Irritable Bowel Syndrome https://pubmed.ncbi.nlm.nih.gov/9859851/ A Review of the Evidence and Recommendations on Communication Skills and the Patient-Provider Relationship: A Rome Foundation Working Team Report https://pubmed.ncbi.nlm.nih.gov/34331912/ Rome Foundation — Johannah's Story https://theromefoundation.org/johannahs-story/

Even if you're not a SLP, this episode is still for you! There's a little bit about business, a little about mindset, and a lot about pivoting when you see a need for change regardless of which profession you're in.  Theresa is a medical speech-language pathologist and Board Certified Specialist in Swallowing and Swallowing Disorders.  She previously owned a mobile FEES company that serviced over 100 skilled nursing facilities across 4 states. Joe and Theresa discuss how Theresa chose SLP as a career, and how she started in the school system, and then transitioning to swallow evaluations.  Then pivoting to starting two businesses doing FEES, and eventually selling her business and pivoting again.  Now, Theresa has a thriving blog, podcast, and additional businesses including a non-profit! Listen in to see how Theresa's story can ignite you to pivot if you so choose!   If you'd like to watch this interview on our FitBUXYouTube channel: click here.   *-* Useful Links *-* https://theresarichard.com/ The Swallow Your Pride Podcast: https://podcast.theresarichard.com/ Theresa's Instagram: @theresarichardslp; @MedSLP_Collective & @medslped Theresa's Facebook: https://www.facebook.com/theresa.richard.503

Get ready to dive into the inner workings of swallowing on the latest episode of Neurocareers: Doing the Impossible! Our guest, Corinne Jones, PhD, CCC-SLP, is a speech and language pathologist and neurotechnology expert who is making a big splash in the field of swallowing disorders. As the head of the Swallowing Modulation Lab at The University of Texas at Austin, she is working to improve our understanding of motor control of swallowing, objective assessment techniques, and therapeutic methods for treating dysphagia in neurodegenerative diseases. Whether you're a neuroscience enthusiast or just looking to learn more about this intriguing topic, this episode is sure to be a feast for the mind. So grab a drink (but not too quickly!) and join us as we explore the brain and swallow with Dr. Jones. About the podcast guest: Corinne Jones, PhD, CCC-SLP, is a speech and language pathologist specializing in swallowing disorders and highly knowledgeable in the neuroscience and neurotechnologies behind these topics. She is the head of the Swallowing Modulation Lab at The University of Texas at Austin, where she is working to improve our understanding of motor control of swallowing, objective assessment techniques, and therapeutic methods for treating dysphagia in neurodegenerative diseases like multiple sclerosis and Parkinson's disease. You can learn more about Corinne and her work by visiting her faculty bio page at https://slhs.utexas.edu/faculty/corinne-jones or by checking out her research spotlight published by UT at https://moody.utexas.edu/news/research-spotlight-corinne-jones. You can also watch her TEDx talk at https://www.youtube.com/watch?v=WrKckwirsFA or her Dance Your PhD entry at https://www.youtube.com/watch?v=er6hjdlh6oY. You can contact Corinne directly via email at corinne.jones@austin.utexas.edu. About the podcast host: The Neurocareers podcast is brought to you by The Institute of Neuroapproaches (https://www.neuroapproaches.org/) and its founder, Milena Korostenskaja, Ph.D. (Dr. K), a neuroscience educator, research consultant, and career coach for students and recent graduates in neuroscience and neurotechnologies. As a professional coach with a background in the field, Dr. K understands the unique challenges and opportunities facing students in this field and can provide personalized coaching and support to help you succeed. Here's what you'll get with one-on-one coaching sessions from Dr. K: Identification and pursuit of career goals Guidance on job search strategies, resume and cover letter development, and interview preparation Access to a network of professionals in the field of neuroscience and neurotechnologies Ongoing support and guidance to help you stay on track and achieve your goals You can always schedule a free neurocareer consultation/coaching session with Dr. K at https://neuroapproaches.as.me/free-neurocareer-consultation. You can also find additional support in the Your Support Station podcast with Dr. K at https://www.neuroapproaches.org/podcast-2.

Guests: Donna Edwards, MA CCC-SLP, BCS-S, F-ASHA, Memorie Gosa, PhD, CCC-SLP, BCS-S, & Georgia Malandraki, PhD, CCC-SLP, BCS-S, F-ASHA - The guests hold a crucial conversation regarding the ethical utilization of social media as it correlates to pediatric feeding and swallowing disorders. We have all had those moments when we are scrolling on our phones and seen a post that either made us leap for joy, or stare in disbelief. We've seen new accounts that present as “specialists” within the PFD community, but the reel that they share make us scratch our heads and question their validity. Maybe you've seen an announcement of a new research article being published… and been filled with an overwhelming sense of hope for our patients and their caregivers and the trajectory of our field. For better, or worse, social media influences how we practice with our patients…but we need expert guidance in how to be consumers and purveyors of this medium while still adhering to our professional code of ethics. That's what this hour is planning to do: guide your decision-making, infuse you with discernment, and leave you optimistic that you too can master the art of social media consumption and production within the frame of pediatric feeding and swallowing disorders.

Angela Mansolillo is a speech-language pathologist and Board Certified Specialist in Swallowing and Swallowing Diorders who works at Cooley Dickenson Hosptial, Northampton MA. She is a clinical supervisor and adjunct faculty member at Elms College Department of Communication Sciences and Disorders. She is the author of Let's Eat! A Clinical Guide to the Management of Complex Pediatric Feeding and Swallowing Disorders. I have encountered a number of children who have developed a fear of choking and consequently become very cautious eaters. Choking is of course a very frightening thing to happen and can be rather traumatic.  Interestingly, there a some children who have a reason to be worried about choking because of the mechanics of their eating. In this interview, Angela Mansolillo talks about how sometimes a fear of choking and cautious eating can be the result of a problem in motor component of eating. This leads to an additional approach in dealing with a fear of eating where the mechanics of eating are addressed. 

SLP – this podcast may help you meet your continuing education requirements. Access Relias Academy to review course certificate information.   Do you know the current status of providing dysphagia services through telepractice? Are you confused about licensure, reimbursement, and client selection for this part of your practice? In this episode, we talk with Dr. Lesley Edwards-Gaither, Ph.D., CCC-SLP, about the provision of dysphagia evaluations and treatments through telepractice. Practical suggestions explain how to plan, prepare, and implement dysphagia telepractice services.   (01:50) Telepractice Terminology  (05:02) Dysphagia and Telepractice  (07:47) Lessons Learned: Scope of Practice  (08:37) Lessons Learned: Licensure  (11:38) Lessons Learned: Reimbursement  (14:07) Technical vs. Practical Knowledge  (18:01) Who Benefits from Telepractice?  (19:39) Client Candidacy  (22:44) Impact of COVID-19 Pandemic on Dysphagia Telepractice  (25:39) Planning Stage for Dysphagia Telepractice  (27:51) Preparing Stage for Dysphagia Telepractice  (29:10) Practical Stage for Dysphagia Telepractice  (32:03) Lessons Not Yet Learned  (34:36) Practical Strategies for Equipment, Lighting, Positioning  (40:08) Practical Strategies for Facilitators  (45:47) Practical Strategies for Cranial Nerve and Oral Mechanism Examinations  (48:45) Practical Strategies and Considerations for Treatment  (52:44) Future Aspirations  (56:03) How to Remain Current  (57:52) Conclusion  The content for this course was created by Lesley Edwards-Gaither, Ph.D., CCC-SLP. The content for this course was created by Susan Almon-Matangos, MS/CCC-SLP. Here is how Relias can help you earn continuing education credits:  Access your Relias Library offered by your employer to see course certificate information and exam;   or   Access the continuing education library for clinicians at Relias Academy. Review the course certificate information, and if eligible, you can purchase the course to access the course exam and receive your certificate.  Learn more about Relias at www.relias.com.    Legal Disclaimer: The content of Stretch: Relias Rehab Therapy Education is provided only for educational and training purposes for healthcare professionals. The educational material provided in this podcast should not be used as medical advice to treat any medical condition in either yourself or others.  Resources  American Board of Swallowing and Swallowing Disorders: https://www.swallowingdisorders.org/   American Telemedicine Association: https://www.americantelemed.org/   American Speech-Language-Hearing Association (ASHA) telepractice resources: From the practice portal: https://www.asha.org/practice-portal/professional-issues/telepractice/ Systematic review (Weidner & Lowman, 2020): https://pubs.asha.org/doi/pdf/10.1044/2019_PERSP-19-00146 Dysphagia Research Society: https://www.dysphagiaresearch.org/   Flow chart from Soldatova et al. (2020): https://journals.sagepub.com/doi/pdf/10.1177/0194599820931791   Mid-Atlantic Telehealth Resource Center: https://www.matrc.org/what-is-telehealth/   Purdue I-EaT Lab resources: https://www.purdue.edu/i-eatlab/telehealth-recommendations-for-dysphagia-management-during-covid-19/

A Medical SLP specializing in Swallowing Disorders shares her personal story of her son's autism diagnosis. Theresa Richards is an SLP, Podcaster, Author, and Autism mom of a son with a rare chromosomal abnormality. She shares their unique journey to diagnosis and finding the perfect therapy team. Theresa also shares some valuable knowledge on Medical SLPs and swallowing and how she is contributing to the field.

Louisa Ferrara, PhD, CCC-SLP, BCS-S, CNT is a Pediatric Speech-Language Pathologist with over 10 years of clinical experience working with neonates, medically-fragile infants and children with a myriad of complex medical/developmental needs. Dr. Louisa has worked in numerous pediatric settings, most recently as a Program Manager and Specialist in Feeding and Swallowing Disorders at NYU-Winthrop Hospital, in New York. Dr. Louisa developed the NICU Feeding Program in this Level III NICU. She has since stepped down from this clinical position and now manages their NICU Dysphagia Research Team. The team collectively strives to provide clinicians with more evidence to support their practices, with the ultimate goal of improved care for this most special population of infants. She is also an assistant professor at Molloy College on Long Island, NY. Dr. Louisa completed her Doctorate degree in Speech and Language Pathology in May 2018 from Adelphi University. She received her Board Certification in Swallowing and Swallowing Disorders in 2014 through ASHA. She has earned specification as a Certified Neonatal Therapist in 2018, through the "NTNCB" (Neonatal Therapist National Certification Board), which she is also a board member. Furthermore, she is a Clinical Advisor at Innara Health, developer of the NTrainer. Dr. Louisa has published in high-standing, peer-reviewed journals; her research has focused on the swallowing mechanism in neonates under various conditions (respiratory devices, liquid modifications, feeding strategies, etc.), as well as the use of various diagnostic tools. And finally, she lectures nationally on various topics related to feeding readiness in preterm infants, dysphagia management, swallowing-respiratory coordination and early feeding milestone acquisition in normal and developmentally delayed children. Dr. Louisa prides herself on living a fulfilled life where she gets to positively impact the lives of infants and families through her care, education and research, as well as by making enough time to cherish each beautiful moment with her family. She is a proud Mom to her son Mario, and dog Sadie, and is grateful to be married to her wonderful husband Joe, who keeps her smiling through it all.

Walt Fritz, PT is a specialist in manual therapy in voice and swallowing. He's worked with some of the pioneers in the myofascial release field and in 2013, he introduced The Foundations in Manual Therapy Seminar for Neck, Voice, and Swallowing Disorders; a program designed for speech-language pathologists and other voice professionals. In this episode, Walt shares a lot of insights about the inner workings of the voice and how a human-centered approach is very important in any physical therapy practice. Today's episode is sponsored by: Healinggroundmovement.com/resources Join the Movement! Healinggroundmovement.com Healing Ground Movement on Instagram Healing Ground Movement on Facebook Mentioned in This Episode: Waltfritzseminars.com Walt on Linkedin The Placebo Effect in Manual Therapy by Brian Fulton Listen to Dr. Nick Studholme's episode here on the Healing Ground Movement.Other references mentioned in this episode. Like what you learned? Donate to show your appreciation! Learn about some of our favorite healthy tools on our resources page.

Guest: Memorie Gosa, Ph.D., CCC-SLP, BCS-S - Seven weeks after we obtained access to the new PFD ICD-10 codes, the annual ASHA Convention will host its very first PFDs Feeding and Swallowing track. To honor this monumental event, today we are joined by Memorie Gosa who served as the chair of the inaugural 2021 Pediatric Normal and Disordered Feeding and Swallowing Topic Committee. Memorie Gosa is a world-renowned Pediatric Speech-Language Pathologist, Board Certified Specialist in Swallowing and Swallowing Disorders, and Associate Professor and Chair of the Communicative Disorders Department at the University of Alabama. In this episode, she joins us to walk us through the history of PFDs and dysphagia. She explains how the PFD world came to be, the progress of clinical training programs on dysphagia at a university level in recent years, and the evolving trends in evidence-based treatment. Tuning in you'll hear why treating pediatric dysphagia has to be multidisciplinary, expert advice for anyone wanting to engage in IPP, and insight into where you can find helpful resources for evidence-based treatments. With the ASHA 2021 Convention upon us, find out what you can expect and what master classes you should not miss. Tune in for all this and more!

En este capítulo, nos acompaña el Dr. Pere Clavé, Director of Research (R&D+I) and Academic Development en el Consorci Sanitari del Maresme y Presidente de la European Society for Swallowing Disorders. El Dr. Clavé es además autor del estudio sobre el efecto terapéutico, propiedades reológicas y resistencia a la a-amilasa en cuatro fenotipos de pacientes con disfagia orofaríngea y con él, repasamos sus principales resultados.

In this episode we're joined by Dr. Daniel DiMeo to tell us all about EndoFLIP.  MercyOne Children's Hospital is the first hospital in the state of Iowa to use this unique technology.   When patients have trouble swallowing, there are problems getting food and liquids from your mouth to the stomach. When kids have this condition, EndoFLIP can make it much easier to diagnose disorders!  Learn more about EndoFLIP in this blog post and on our website. Send us your feedback by emailing podcast@mercyhealth.com, or fill out the submission form at MercyOne.org/podcast Your Best Life – powered by MercyOne

Dysphagia (also known as difficulty swallowing) is a symptom of many different medical conditions. Cleveland Clinic Florida gastroenterologist Alison Schneider, MD joins Butts & Guts to discuss swallowing disorders as well as treatment and therapies that can improve quality of life for those suffering with these issues.

Guest: Dr. Georgia Malandraki, Ph.D., CCC-SLP, BCS-S - As we continue this amazing journey through our tricky yet important field, we are joined today by a real leader from the field! Dr. Georgia Malandraki, Ph.D., CCC-SLP, BCS-S, is an associate professor of Speech Language and Hearing Sciences at Purdue University and a Board-Certified Specialist in Swallowing and Swallowing Disorders. In her research, she focuses on investigating developmental swallowing neuroplasticity and developing rehabilitative and telehealth interventions for dysphagia. In addition to this, she is the research director of the Purdue I-EaT Swallowing Research Laboratory and Clinic and has served on editorial boards for ASHA journals, as an editor for the American Journal of Speech Language Pathology, and is the current president-elect of the Dysphagia Research Society. In this awesome conversation, we get to really go deep with Dr. Malandraki, talking about her most recent work on the developmental stages of the nervous system, some very helpful papers and resources that she recommends, muscle tone issues in infants, and the gaps that she has noticed in the pediatric care systems, that still persist today. For all this, and a whole lot more great insight, where it is so badly needed, listen in with us to hear what Dr. Malandraki has to say!

Georgia A. Malandraki, PhD, CCC-SLP, BCS-S, is Associate Professor of Speech, Language, & Hearing Sciences at Purdue University and a Board Certified Specialist in Swallowing Disorders. She investigates developmental and treatment neuroplasticity, and rehabilitative and telehealth interventions for dysphagia. Malandraki has 15 years of experience in telehealth for dysphagia management, and her work has been funded by the National Institutes of Health and several foundations. She is the President-Elect of the Dysphagia Research Society and was recently selected as a 2021 ASHA Fellow.

Approximately one in 25 adults in the US will experience a swallowing problem. That's difficulty or pain when swallowing or not being able to swallow at all—whether it's liquids, food or saliva. Getting treatment from a speech-language pathologist can help. In this episode, Dr. Angela Van-Sickle, assistant professor, at the TTUHSC School of Health Professions, explains what causes someone to have a problem swallowing, how to get treatment and what we can do now to try to prevent having this problem in the future.

Most people have heard about lasting symptoms of COVID-19 months after the initial symptoms have subsided. Very few of us have heard about the impact of COVID-19 on swallowing. In this episode, I interview Avital Winer, speech and language pathologist and acting profession leader of speech-language pathology and audiology at the Ottawa Hospital, who explains to us how COVID-19 can impact one's swallowing ability and the many challenges that speech-language pathologists must face when caring for their patients. During the episode, we talk about a recent news article that was published, featuring the role of speech-language pathologists in the hospital setting as it pertains to COVID-19: "The speech pathologists helping COVID-19 patients learn how to swallow and speak again". Although speech-language pathologists have always been involved in the care of patients with swallowing difficulties (dysphagia), their role has not always been well understood by other healthcare professionals and the public.

Ed Steger tells his powerful story from head and neck cancer patient to becoming president of the NFOSD. The post 184 – From Patient to President of the National Foundation of Swallowing Disorders: Ed's Story- Edward Steger appeared first on Swallow Your Pride Podcast.

Ed Steger tells his powerful story from head and neck cancer patient to becoming president of the NFOSD. The post 184 – From Patient to President of the National Foundation of Swallowing Disorders: Ed’s Story- Edward Steger appeared first on Swallow Your Pride Podcast.

Parents often can see that their child is struggling with communication, but they don’t know exactly what to call it, or how to help.  I’m going to walk you through the different types of speech-language disorders and how to recognize them.   Hi, my name is Carol Edgel, and I’m a certified speech-language pathologist.  In my years of teaching, I’ve noticed that parents often can see that their child is struggling with communication, but they don’t know exactly what to call it, or how to help.  Even the child’s teachers might not know how to label it.  In this video, I’m going to walk you through the different types of speech-language disorders and how to recognize them.   SPEECH SOUND DISORDERS:  First there are Speech-Sound disorders.  These involve the child mispronouncing sounds.  We can divide speech-sound disorders into 2 general types:   Articulation Disorder – this is when the child has only a few errors. For example, the child may say, “free” instead of “three”.  F/TH is a fairly common error among young children.  Depending on the child’s age and how hard he is to understand, the child might need to be evaluated by a speech-language pathologist.  It is always better to begin treatment while the child is young, before he has had time to build up incorrect speech habits.   Phonological Disorder – this is when the child has many errors and is very hard to understand. The child is unable to understand the rules of sounds (phonology).  Here is an example of how a child with a phonological disorder would speak.  If the teacher says, “Tell me what you did last summer,” the child might respond, “We went to Talifonnia an wen to Ditneywan, an we wen to da beats an went surpin. Den we wen to Wedo Wan an Sea Wood an I saw sarts an pendins.  Den we tame home adin an dat’s all.” The child exhibited many substitution errors, as well as deletion and distortion of other sounds.  Rare condition -- Childhood Apraxia of Speech (CAS) -- this is when the child cannot coordinate signals between his brain and his speech articulators in order to form words correctly.  His errors will be inconsistent, and he may exhibit groping behaviors.  The cause of CAS is usually unknown, and it is different than apraxia in adults.   Because a child with CAS or a phonological disorder will probably have many errors that make the child hard to understand, he should be evaluated by a speech-language pathologist.   LANGUAGE DISORDERS:  There are many facets of a language disorder.  A child may have difficulties in one area or several.   Syntax/Grammar – this is when the child struggles with the rules of language and can’t put together a complete sentence correctly. He may struggle to use the right verb form or pronoun when he speaks or writes. Using the same vacation story above, a child with a grammar problem might say it this way:  “I go California, go see Disneyland, go at beach and do surfing. Then us see Lego Land and Sea World, I see sharks and penguins.  Then us go home, go home again and that’s all.” Notice how the child is pronouncing his sounds correctly, but is using the wrong verb tenses and pronouns, among other things.   Language Processing – this is when children are slower to interpret and respond to the language signals they receive.  It can take them longer to answer questions, follow directions, write a paper, or do anything involving language. It’s not that they don’t want to listen, or respond, or follow directions, it’s just that they can’t keep up with the rest of the class.  This is different than an attention disorder like ADD/ADDHD, although they can occur together.   An example would be a child who struggles to follow multi-step directions at home or at school.  Imagine if a first grade teachers is telling the class, “Take out your math book and turn to chapter 2, exercise 1.  That should be on page 54.”  Already the child will be struggling to follow the directions but the teacher will continue, “Now get out a piece of paper and write your name on the top right corner and number the paper from 1-10 down the left-hand side.”  By now the child will probably be asking the teacher, “What?  What do we do again?”  or turning to his neighbor and saying, “What page?  What do I put on the paper?”    Language Comprehension – this is where the child just doesn’t understand the language input. Even if they understand the meaning of words, they may not understand the subtleties of how changing the order of words in a sentence can change the meaning.  Or they may hear the words of a story but not understand the underlying message or theme of the story. For example, you may read your child the story of The 3 Little Pigs, and ask her, “What was the main idea of this story?”  She may answer, “Pigs!”  If you push her by saying, “Yes, there were pigs in the story, but what was the problem?” she may give up and say, “Umm… I don’t know.”   Language – Vocabulary – this is when children do not know the amount of words that they should know by their age. It interferes with their ability to understand others and to communicate what they want to say.  It may take them longer than average to learn and store the meaning of words, and so they might need help catching up.  This can be a particular problem if they don’t know ‘academic’ language, or language that is used in the classroom frequently, such as: title, author, absent, conclusion, community, arrive, exit, and many more.   If you suspect your child has a language disorder, she might need to be evaluated by a speech-language pathologist, depending on your child’s age and performance at school. As with speech-sound disorders, it is best to catch language disorders early and begin treatment when the child is young.  The child’s problems with language can become more evident as they get older and try to keep up with the increased demands of the upper elementary grades and beyond.   FLUENCY DISORDERS – this is when the child stutters or clutters. It is not related to what your child’s teacher might call fluency of reading, or how fast and accurately they can read.  Here we are talking about how smoothly your child can speak without multiple repetitions of sounds and words.   Stuttering – this is when the child is repeating sounds and words so frequently that it interferes with communication.  It may often cause stress and tension behaviors while the child is trying to get his words out – blinking, licking lips, fidgeting, groping mouth movements – anything to ease stress or postpone having to get the words out.   Most of us are familiar with what stuttering sounds like.  And most of us repeat our words or sounds on occasion.  When the amount of stuttering reaches a certain point, it becomes an issue.   For example, using the vacation story from earlier, the child who stutters might respond this way, “I–I-I - I went to Ca-Ca-Ca-Ca- California………….. We-We-, you know, we- went to D- d- d- Disneyland.  To Disneyland. ……And and and we went to Sssssss Sea World.”   Cluttering – this is when the child speaks unusually fast and in a somewhat disorganized way. It may sound as though they are speaking in rapid spurts, and the syllables in a word may blend together. We see cluttering less commonly, but it is worth mentioning here.  It can co-occur with stuttering.   It is not uncommon for children 3-4 years old to exhibit some  stuttering behaviors.  Often, they will grow out of it, but it’s hard to know who will and who won’t.  If your child has fluency symptoms that make it hard for family, friends and teachers to understand him, it may be time to have him evaluated by a speech-language pathologist.     OTHER DISORDERS – You may not be aware that there are other disorders that speech-language pathologists work with that may first occur in children or adults.   Voice Disorders – this is when there is an issue with the vocal cords.  Symptoms may include a very hoarse voice for an extended period with no known illness, or a voice having an unusual pitch or sound. Swallowing Disorders (dysphagia) – this may be a problem for newborns, or older patients who may have suffered a stroke. The patient is unable to use their tongue and other swallowing mechanisms correctly. TBI-related (traumatic brain injury) cognitive or speech disorders: A stroke, injury or illness might cause memory, executive functioning, or speech/language disorders in children or adults.  Aphasia, Apraxia, and Dysarthria are some speech conditions that might result.   I hope this mini-course was helpful to you.  Please check out our other courses at clarityspeechandlanguage.com.  Thanks and have a great day!

Parents often can see that their child is struggling with communication, but they don't know exactly what to call it, or how to help.  I'm going to walk you through the different types of speech-language disorders and how to recognize them.   Hi, my name is Carol Edgel, and I'm a certified speech-language pathologist.  In my years of teaching, I've noticed that parents often can see that their child is struggling with communication, but they don't know exactly what to call it, or how to help.  Even the child's teachers might not know how to label it.  In this video, I'm going to walk you through the different types of speech-language disorders and how to recognize them.   SPEECH SOUND DISORDERS:  First there are Speech-Sound disorders.  These involve the child mispronouncing sounds.  We can divide speech-sound disorders into 2 general types:   Articulation Disorder – this is when the child has only a few errors. For example, the child may say, “free” instead of “three”.  F/TH is a fairly common error among young children.  Depending on the child's age and how hard he is to understand, the child might need to be evaluated by a speech-language pathologist.  It is always better to begin treatment while the child is young, before he has had time to build up incorrect speech habits.   Phonological Disorder – this is when the child has many errors and is very hard to understand. The child is unable to understand the rules of sounds (phonology).  Here is an example of how a child with a phonological disorder would speak.  If the teacher says, “Tell me what you did last summer,” the child might respond, “We went to Talifonnia an wen to Ditneywan, an we wen to da beats an went surpin. Den we wen to Wedo Wan an Sea Wood an I saw sarts an pendins.  Den we tame home adin an dat's all.” The child exhibited many substitution errors, as well as deletion and distortion of other sounds.  Rare condition -- Childhood Apraxia of Speech (CAS) -- this is when the child cannot coordinate signals between his brain and his speech articulators in order to form words correctly.  His errors will be inconsistent, and he may exhibit groping behaviors.  The cause of CAS is usually unknown, and it is different than apraxia in adults.   Because a child with CAS or a phonological disorder will probably have many errors that make the child hard to understand, he should be evaluated by a speech-language pathologist.   LANGUAGE DISORDERS:  There are many facets of a language disorder.  A child may have difficulties in one area or several.   Syntax/Grammar – this is when the child struggles with the rules of language and can't put together a complete sentence correctly. He may struggle to use the right verb form or pronoun when he speaks or writes. Using the same vacation story above, a child with a grammar problem might say it this way:  “I go California, go see Disneyland, go at beach and do surfing. Then us see Lego Land and Sea World, I see sharks and penguins.  Then us go home, go home again and that's all.” Notice how the child is pronouncing his sounds correctly, but is using the wrong verb tenses and pronouns, among other things.   Language Processing – this is when children are slower to interpret and respond to the language signals they receive.  It can take them longer to answer questions, follow directions, write a paper, or do anything involving language. It's not that they don't want to listen, or respond, or follow directions, it's just that they can't keep up with the rest of the class.  This is different than an attention disorder like ADD/ADDHD, although they can occur together.   An example would be a child who struggles to follow multi-step directions at home or at school.  Imagine if a first grade teachers is telling the class, “Take out your math book and turn to chapter 2, exercise 1.  That should be on page 54.”  Already the child will be struggling to follow the directions but the teacher will continue, “Now get out a piece of paper and write your name on the top right corner and number the paper from 1-10 down the left-hand side.”  By now the child will probably be asking the teacher, “What?  What do we do again?”  or turning to his neighbor and saying, “What page?  What do I put on the paper?”    Language Comprehension – this is where the child just doesn't understand the language input. Even if they understand the meaning of words, they may not understand the subtleties of how changing the order of words in a sentence can change the meaning.  Or they may hear the words of a story but not understand the underlying message or theme of the story. For example, you may read your child the story of The 3 Little Pigs, and ask her, “What was the main idea of this story?”  She may answer, “Pigs!”  If you push her by saying, “Yes, there were pigs in the story, but what was the problem?” she may give up and say, “Umm… I don't know.”   Language – Vocabulary – this is when children do not know the amount of words that they should know by their age. It interferes with their ability to understand others and to communicate what they want to say.  It may take them longer than average to learn and store the meaning of words, and so they might need help catching up.  This can be a particular problem if they don't know ‘academic' language, or language that is used in the classroom frequently, such as: title, author, absent, conclusion, community, arrive, exit, and many more.   If you suspect your child has a language disorder, she might need to be evaluated by a speech-language pathologist, depending on your child's age and performance at school. As with speech-sound disorders, it is best to catch language disorders early and begin treatment when the child is young.  The child's problems with language can become more evident as they get older and try to keep up with the increased demands of the upper elementary grades and beyond.   FLUENCY DISORDERS – this is when the child stutters or clutters. It is not related to what your child's teacher might call fluency of reading, or how fast and accurately they can read.  Here we are talking about how smoothly your child can speak without multiple repetitions of sounds and words.   Stuttering – this is when the child is repeating sounds and words so frequently that it interferes with communication.  It may often cause stress and tension behaviors while the child is trying to get his words out – blinking, licking lips, fidgeting, groping mouth movements – anything to ease stress or postpone having to get the words out.   Most of us are familiar with what stuttering sounds like.  And most of us repeat our words or sounds on occasion.  When the amount of stuttering reaches a certain point, it becomes an issue.   For example, using the vacation story from earlier, the child who stutters might respond this way, “I–I-I - I went to Ca-Ca-Ca-Ca- California………….. We-We-, you know, we- went to D- d- d- Disneyland.  To Disneyland. ……And and and we went to Sssssss Sea World.”   Cluttering – this is when the child speaks unusually fast and in a somewhat disorganized way. It may sound as though they are speaking in rapid spurts, and the syllables in a word may blend together. We see cluttering less commonly, but it is worth mentioning here.  It can co-occur with stuttering.   It is not uncommon for children 3-4 years old to exhibit some  stuttering behaviors.  Often, they will grow out of it, but it's hard to know who will and who won't.  If your child has fluency symptoms that make it hard for family, friends and teachers to understand him, it may be time to have him evaluated by a speech-language pathologist.     OTHER DISORDERS – You may not be aware that there are other disorders that speech-language pathologists work with that may first occur in children or adults.   Voice Disorders – this is when there is an issue with the vocal cords.  Symptoms may include a very hoarse voice for an extended period with no known illness, or a voice having an unusual pitch or sound. Swallowing Disorders (dysphagia) – this may be a problem for newborns, or older patients who may have suffered a stroke. The patient is unable to use their tongue and other swallowing mechanisms correctly. TBI-related (traumatic brain injury) cognitive or speech disorders: A stroke, injury or illness might cause memory, executive functioning, or speech/language disorders in children or adults.  Aphasia, Apraxia, and Dysarthria are some speech conditions that might result.   I hope this mini-course was helpful to you.  Please check out our other courses at clarityspeechandlanguage.com.  Thanks and have a great day!

We’re joined by the host of “The Swallow Your Pride Podcast.” A specialist in swallowing disorders, Theresa Richard shares what she’s learned while hosting the show aimed at SLPs managing dysphagia. We discuss Theresa’s path to the health care field, the origins of her podcast, and what it’s been like to speak to SLPs working on the front lines against COVID-19. Plus, Theresa shares a few of the episodes that changed how she practices.

We’re talking about swallowing disorders in the time of COVID with two expert SLPs. Johns Hopkins’ Martin Brodsky joins us to trace the challenges facing clinicians tasked with managing dysphagia during the pandemic. He tells us what’s changed since the pandemic began, what he’s heard while serving on the Dysphagia Research Society (DRS) COVID-19 Task Force, and the important role of clinicians in research. Then, we talk telepractice. With concerns over infection control and closed facilities, some clinicians turn to the internet as an alternate way to serve clients. Purdue University’s Georgia Malandraki, who specializes in telepractice and is also on the DRS task force, shares questions researchers are asking about telepractice and dysphagia, and what she’s heard from other clinicians.

This episode Is dedicated to all things BCS-S , or Board Certified Specialist in Swallowing and Swallowing Disorders. BUT, Before Selena and Theresa get Into the designation of BCS-S, they discuss the recent controversy In the dysphagia world. The post 162 – So You Want to be Board Certified – Selena Reece appeared first on Swallow Your Pride Podcast.

This episode Is dedicated to all things BCS-S , or Board Certified Specialist in Swallowing and Swallowing Disorders. BUT, Before Selena and Theresa get Into the designation of BCS-S, they discuss the recent controversy In the dysphagia world. The post 162 – So You Want to be Board Certified – Selena Reece appeared first on Swallow Your Pride Podcast.

Guest: Alyson Smith, MS, CCC-SLP - This episode combines the great minds of Alyson Smith, MS CCC-SLP from @ei.teletherapy on Instagram, Erin Forward, MSP CCC_SLP, and Michelle L.W. Dawson, MS CCC-SLP, CLC, where they deep dive into evidence based intervention for Pediatric Feeding and Swallowing Disorders. Join this electrifying trio as they tackle what the true definition of evidenced-based practice is for PFDs, move into explaining exercise principles, and discuss how to implement EBP strategies in your Early Intervention Clinic or Home-Based Services. These three women are on a mission to bring fabulously functional tips to your practice via an hour packed with laughter and #SLPNerdCrushes.

This week I'm back with Melissa Farrow, Founder & CEO of GlobalFlow, LLC, to learn more about her journey to Board Certification and how it has impacted herself, business and clients. ---> Download this episode's “study guide” (https://bit.ly/MLE16FarrowO) or the full audio transcript (https://bit.ly/MLE16Farrow)

Co-Host: Erin Forward, MSP, CCC-SLP - In this episode Michelle is joined again by her regular First Bite Co-Host, Erin Forward, MSP CCC-SLP, and they share some recent research in the world of Pediatric Feeding and Swallowing Disorders! Today, Michelle and Erin address 5 different research articles covering everything from laryngomalacia and a supraglottaplasty repair to a systematic weaning protocol of thickened for little ones with a past medical history that includes aspiration. The ladies of First Bite are hitting up some of their favorite journals including “JAMA-Otolaryngology Head & Neck Surgery”, “The Journal of Pediatrics”, and “The Laryngoscope” to name a few! Enjoy the research review and how they build a bridge to real world applications of clinical case studies!

In this episode, please welcome my guest Melissa Farrow, a medical SLP focused on disordered swallowing ---> Download this episode's “study guide” (https://bit.ly/MLE14FarrowO ) or the full audio transcript (https://bit.ly/MLE14Farrow )

In this episode Michelle is joined by Lisa Young Milliken, MA, CCC, FNAP, CDP, who received her BA from Louisiana Tech University and her MA from The University of Memphis in Audiology and Speech Language Pathology. Have you had questions regarding that laundry list of medications that your pediatric patient is taking? No fear and no shame from us here at First Bite…. because we have had the same questions too! Did you know that certain common medications for GERD and seizure management could trigger an oroprharyngeal dysphagia, trigger constipation, or result in bone density issues? As Clinicians we need to understand how the medications that our patients are taking can impact their hunger cues and desire for PO trials, or contribute to safety issues for PO intake… and Lisa is here to clarify the muddy waters that is pediatric medications.

Today on the Grief & Healing Corner, Episode 19, we speak with Lisa Ingrassia, from A Daughter’s Love and The Albert J. Ingrassia fund. Lisa is a Huffpost blogger, a Beliefnet monthly contributor and has written guest articles for the National Foundation of Swallowing Disorders, The Mighty and Her View From Home. Most recently Lisa has been nominated as a MVP Champion for CancerAid, the go-to resource for anyone affected by cancer and the #1 Cancer app currently on the Apple Store in the US, AU and the UK. Lisa enjoys spending time with her family and is obsessed with her Boston Terrier Diesel.

In this episode Michelle is joined by Donna Edwards, an Associate Professor, author, inventor, national/international speaker and Board Certified Specialist in Swallowing and Swallowing Disorders at Baldwin Wallace University. Now we have all felt isolated in the world of Pediatric Feeding and Swallowing Disorders, especially when it comes to evidenced based strategies for evaluations and interventions…overlooked by the massive amount of data for our adult peers and the apparent scant for pediatrics…but that changes today! Donna is here to provide her inside first hand experience, knowledge, and expertise about the amazing endeavors that are being undertaken by various organizations, (BCS-S, The Dysphagia Research Society, and ASHA SIG 13), to not only fill the void, but to propel us forward!! Three cheers and “Hooah” are in order for this uplifting hour!

In this episode Michelle is joined by Megan Richmond, DHA, M.S., CCC-SLP, CLC, a pediatric speech-language pathologist with over eighteen years of clinical and research experience, who is also trained in yoga for the special child through Kripalu. Dr. Megan’s unique background of research on best practices for Interprofessional Practice when treating Pediatric Feeding and Swallowing Disorders is a special treat for this episode. She too was frustrated by traditional “silo” approaches to therapy, so she dove into the field with a desire to learn “How do we fix this?” and long story short it became her life’s work for 4 years of intense study. The end result, one amazing journey towards a Doctorate in Health Administration, and a new zeal to share that information with colleagues around the globe! Be inspired with laughter and light when these two nerdy SLP gals take on Interprofessional Practice!

In this episode Michelle is once again joined by the passionate Erin Forward, MSP CCC-SLP. Together they spend an hour dedicated to dissecting common airway, cardiac, and GI issues prevalent with Infants, Toddlers, and Children who have Down syndrome, and how these can result in a Pediatric Feeding and Swallowing Disorders. Special attention is placed on how airway, cardiac, and GI issues can occur in isolation, but often for our patients with Down syndrome, they occur concomitantly. Appropriate Interprofessional Practice referrals, Functional Feeding strategies, and shout outs for the amazing work that the National Down syndrome Society is doing… are all on the menu too!

The Feeding and Swallowing Program at Boston Medical Center specializes in helping infants and children who have difficulty eating and drinking. Kerry Pearl, CCC-SLP shares symptoms of feeding or swallowing difficulty, pediatric dysphagia, and treatment options available.

We did a Facebook live with Walt Fritz talking about Myofascial Release and his educational workshop. Walt has been a physical therapist since 1985 and has been practicing MFR since 1992. He has taught MFR workshops to PTs, OTs, and MTs since 2006, with his work being taught in comprehensive Upper Body and Lower Body workshops. In 2013 he introduced The Foundations in Myofascial Release Seminar for Neck, Voice, and Swallowing Disorders, directed toward the unique patient population of the speech-language pathologists and other voice professionals. Visit waltfritzseminars.com to get in touch. Excuse the quality as this is a Facebook live, but check it out and get to know what Walt Fritz is all about!! ConEdInstitute.com 2massagetherapists.com

After a webchat on Achalasia and Swallowing Disorders, thoracic surgeon Dr. Siva Raja and gastroenterologist Dr. Scott Gabbard review common concerns about treatment options and diagnostic testing to obtain the best outcomes; pain management; as well as what patients should know who have had prior treatments.

This course provides participants with an overview of all the currently available dysphagia apps to help guide clinicians in decision-making, assessment, and treatment of swallowing disorders. This episode is an excerpt of an XED course which was originally offered as a free live webinar during the Special Apps Update Conference, April 2018.

How many times do you get patients with a voice or swallowing disorder and no obvious neuro diagnosis? What the heck might have possibly happened to them?Did you know that according to this paper, 49% of patients with laryngeal injury post extubation present with dysphagia?Are you aware of the significant association between laryngeal injury and penetration/aspiration scores?What about the costs associated with readmission due to a repair of tracheal injury?Apparently, Dr. Brodsky was on to something when he decided to write this systematic review... and he's here to spill the beans on what this paper CAN and can NOT tell us!Show notes can be downloaded below. To share your thoughts:- Join the MedSLP Newbies Facebook group-Share this episode on Instagram and tag me @TheresaRichardSLPTo help out the show:- Leave a review on iTunes. Your comments help me immensely and I just might read it on the show!- Contribute at patreon.com/swallowyourpride  Download Ep. 058 Show Notes! Download Ep. 058 Transcript This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next

As we age, swallowing foods and liquids can become harder to do. When someone has trouble swallowing, it is defined as dysphagia. Dr. Nicole Pulia discusses dysphagia and its signs, effects, treatments, and relation to Alzheimer’s disease. Guest: Nicole Pulia, PhD, CCC-SLP, Assistant Professor of Geriatrics, University of Wisconsin School of Medicine and Public Health

Do you know the impact that COPD can have on swallowing? Do you know the impact that laryngopharyngeal reflux disease (LPRD) can have on swallowing? Do you know the impact that COPD can have on LPRD? Do you even know what LPRD is?In episode 023 of the Swallow Your Pride podcast, Dr. Eric Blicker discusses some really interesting research on the SLPs role in assessing and treating LPRD and its link to the COPD population.Eric Blicker CCC-SLP.D BCS-S has been a Board Certified Specialist in Swallowing and Swallowing Disorders since 2008. That same year, Dr. Blicker received his Clinical Doctoral degree from Nova Southeastern University. In 2000-2001, he was trained at Columbia University in Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) by Dr. Jonathan Aviv, the otolaryngologist who developed FEESST. Eric has started multiple Flexible Endoscopic Evaluation of Swallowing (FEES) programs in the United States while training speech-language pathologists and physicians in the process. For the past five years, his company, Community Care Partners Inc, has been an ASHA Approved CE Provider. Dr. Blicker has lectured at several universities and has provided FEES training courses in several states. His clinical FEES experience includes working in a variety of settings. Dr. Blicker is the FEES Committee Chairperson and Project Coordinator in the Mercy Health East Market in Cincinnati Ohio.Dr. Blicker can be found on Facebook (Eric Blicker), on Twitter (@ericblicker), his website is http://ceualliedhealth.com or you can email him at ceucustomercare@gmail.com to inquire about any FEES training courses or online CEU courses.To learn more about the Medical SLP Collective, an exclusive community for Medical SLPs with new peer-reviewed resources, handouts, and videos distributed weekly, monthly ASHA CEU webinars, and a private forum on Facebook, or on the website to get answers to all of your burning clinical questions, check out MedSLPCollective.com Download Ep. 023 Show Notes! Download Ep. 023 Transcript This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next

Are you palpating your patients? Do you know what you're feeling for? What is the inter- and intra-rater reliability of palpation? What if it has alternate uses? Manual therapy has been a longstanding practice in the PT world, and benefits are just now being discovered as it relates to globus sensation and dysphagia. Today's guest is Walt Fritz, a physical therapist who breaks down the history of manual therapy, the use of myofascial release, and using a patient directed approach in treating dysphagia. Walt Fritz has been a physical therapist since 1985 and has been using manual therapy as his chosen intervention since 1992. After training and working with some of the well-known pioneers of the MFR field, he began to move the traditional myofascial release narrative from its historical past into more modern and accepted narratives of neurological explanation. He teaches his workshops to PTs, OTs, and MTs. Since 2013 he has added a class directed toward speech-language pathologists, The Foundations in Myofascial Release Seminar for Neck, Voice, and Swallowing Disorders, which focuses evaluation of voice, swallowing and other disorders seen by the SLP and Voice Professional. He takes a decidedly different approach to myofascial release and manual therapy, working toward an explanatory narrative that represents current thinking and pain science, as well as adding a feedback-based, patient-directed model of explanation. Walt sees patients at his physical therapy practice in Rochester, NY and can be found at http://www.waltfritzseminars.com To learn more about the Medical SLP Collective, an exclusive community for Medical SLPs with new peer-reviewed resources, handouts, and videos distributed weekly, monthly ASHA CEU webinars, and a private forum on Facebook, or on the website to get answers to all of your burning clinical questions, check out MedSLPCollective.com Download Ep. 022 Show Notes! Download Ep. 022 Transcript This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next

  Keri Danziger is Supervisor of inpatient adult speech and swallowing services at North Campus. She joined NYU Langone Medical Center and the Rusk Team in 2011. She is responsible for supervision of daily clinical and administrative operations for both acute care and inpatient rehabilitation services.  She has been a medical speech-language pathologist for the past 18 years with a background in assessment and treatment of communication and swallowing in patients with critical illness and following trauma. Special interests include management of patients with tracheostomy, head and neck cancer, ethical issues in managing communication and feeding/swallowing in end-of-life, and swallowing impairments with medically complex infants. She is a Board Certified Specialist in Swallowing and Swallowing Disorders. Her undergraduate degree is from Miami University of Ohio and her graduate degree is from NYU. She completed a Clinical Fellowship at Stonybrook University Medical Center.   In this interview, she discusses the kinds of patients she treats who have had a tracheostomy, the potential for hospital-acquired tracheostomy-related pressure ulcers to arise, swallowing and communication problems experienced by patients, speech-language pathology's role in treating such problems, available diagnostic tools to identify neuromuscular physiologic component of a swallow disorder, developing individualized approaches to patients who differ from one another, and the use of speaking valves.

010 - Catriona Steele Ph.D., CCC-SLP, F-ASHA - The International Dysphagia Diet Standardization Initiative Framework, IDDSI Flow Test, & Skill-Based Training For Rehabilitating the Swallow.The International Dysphagia Diet Standardization Initiative (IDDSI.org) Framework, The IDDSI Flow Test, and Skill-Based Training For Rehabilitating the Swallow.Dr. Catriona Steele is an incredible, internationally known, ASHA Fellow who is currently a researcher at the Toronto Rehab Institute. She had 10 years of experience as a medical SLP before pursuing her PhD, and she is still very much involved at the clinical level in our field. Dr. Steele has over 80 peer-reviewed publications, and has presented as an invited lecturer in Europe, Japan, China, Austrialia, and she actually just returned from the World Dysphagia Summit and European Society for Swallowing Disorders, so she does give us some scoop from that!Dr, Steele is one of the main key players in the International Dysphagia Diet Standardized Initiative also known as IDDSI. She also has received international recognition for her work on tongue functioning in the swallow. Dr. Steele has a 2-part series on Medbridge right now about tongue pressure resistance training, so feel free to check that out, and also one of my most favorite series on MedBridge is her 5-part series about best practices in VFSS, so if you're a Medbridge member check that out, if not, you can purchase that annual membership for unlimited CEUs for only 95$ with promo code SYP, so head over to medbridgeeducation.com and purchase that SLP education plan with promo code SYP to watch Dr.Steele’s awesome CEU videos on lingual resistance and videofluoroscopy.In this episode, we discuss the importance of IDDSI and standardizations amongst thickened liquids and texture modifications, we discuss skill based training, and the importance of rehabbing the swallow, as well as we get to hear about some of Dr. Steele’s mentors and who's work has really inspired her.To learn more about the Medical SLP Collective, an exclusive community for Medical SLPs with new peer-reviewed resources, handouts, and videos distributed weekly, monthly ASHA CEU webinars, and a private forum on Facebook, or on the website to get answers to all of your burning clinical questions, check out MedSLPCollective.com Download Ep. 010 Show Notes! This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next

007 - Yvette McCoy, M.S. CCC-SLP, BCS-S - Advocating for the Tools You Need to Do Your Job, The Predictors of Aspiration, and the Evidence-Based TriadThis is episode 007 of the Swallow Your Pride podcast, and on today’s episode we have Yvette McCoy. She is Board Certified Specialist in Swallowing and Swallowing Disorders, and owns a private practice clinic in Maryland called Speak Well Solutions. Yvette is also an adjunct instructor at the University of Maryland in College Park.Yvette has over 25 years of experience in the field, and specializes in treating dysphagia in our aging population. Yvette is so stinking down to earth, very real, and one of the kindest people you will meet. She loves to help younger clinicians (and I’m secretly very jealous of her grad students), and she is passionate about teaching EBP in dysphagia.Yvette has training in the area of FEES (Fiberoptic Endoscopic Examination of Swallowing) and MBSImP (Modified Barium Swallow Impairment Profile), she is co-creator of the Dysphagia Therapy app through Tactus therapy, and she also has 2 CEU courses through Northern Speech Services called The Cranial Nerve Examination: Integrating Assessment And Treatment In Dysphagia Management and also Gauging The Aging Swallow: 3-Part Course For The Medical SLP.In this episode we discuss how to advocate to your boss for the tools you need to do your job, we discuss Dr. Langmore Predictors of Aspiration paper, and we discuss the importance of the evidence-based triad.To learn more about the Medical SLP Collective, an exclusive community for Medical SLPs with new peer-reviewed resources, handouts, and videos distributed weekly, monthly ASHA CEU webinars, and a private forum on Facebook, or on the website to get answers to all of your burning clinical questions, check out MedSLPCollective.com Download Ep. 007 Show Notes Download Ep. 007 Transcript This Month’s Featured Affiliates: If you like our work, support us on Patreon for as little as a dollar a month! Previous Next Previous Next

Introducing the newest podcast to join the Speech Science Network, Swallow Your Pride by Theresa Richard.  Theresa Richard is a Board Certified Specialist in Swallowing and Swallowing Disorders, and owner and founder of Mobile Dysphagia Diagnostics. She completed her Bachelors and Masters degrees in Speech-Language Pathology from the University at Buffalo. She has completed Advanced FEES training under Dr. Susan Langmore as well as SASS Swallowing Services.  She is a visiting guest lecturer at the University at Buffalo, Buffalo State College, Edinboro University, and Buffalo Hearing and Speech Center on the topic of FEES as well as a clinical instructor on the hands-on application and interpretation of the FEES as part of an ASHA approved CEU course with Dr. Eric Blicker. She is a member of ASHA Special Interest Group 13 (Swallowing and Swallowing Disorders), the Dysphagia Research Society, former President of the Nevada Speech-Language Hearing Association, and 3-time ASHA ACE Award recipient for continuing education.  Her website is https://www.mobiledysphagiadiagnostics.com/about-us/ .

Parkinson's Disease (PD) can lead to swallowing disorders (dysphagia). Swallowing disorders in PD can be serious because it can lead to aspiration pneumonia, which is one of the most common causes of death in PD. In response to a special request by the National Parkinson Foundation (www.parkinson.org), this installment of Down the Hatch (The Swallowing Podcast) focuses on swallowing impairments in PD. Special guest experts Karen Wheeler-Hegland, Ph.D., CCC-SLP and Emily Plowman, Ph.D., CCC-SLP discuss issues related to swallowing disorders in PD for patients, care-givers, speech-language pathologists, physicians, and the general public.

Our voice is central to how we communicate with the world, and a voice problem can be very limited and stressful. It can also impact our ability to complete daily activities. Symptoms of common voice disorders may range from hoarseness or a chronic dry, scratchy throat, a pitch/tone that is not pleasing or uncomfortable, limited ability to speak clearly, or periods of voice loss.Videostroboscopy is a simple, non-invasive procedure that helps to evaluate and diagnose voice-related disorders and concerns.The speech language pathologists at Hendricks Regional health can use this specialized test to better understand why you may be having vocal issues.David Cravotta, MS, is here to discuss Vdeostroboscopy and the treatment of voice disorders.

This podcast highlights original research in the April 2014 issue of Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief Richard Rosenfeld is joined by author Sunil Verma and associate editor Kenneth Altman in discussing the prevalence of swallowing disorders and opportunities to improve the quality of care for afflicted patients.   Click here to read the full article.