dysphagia compensatory strategies asha

Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Deficit-Based Dysphagia Management ISHA Nov 2019 Page 4 (Dietsch & Westemeyer) • Altered liquid consistencies – multiple RCTs (Logemann et al., 2008; Robbins et al., 2008) and a systematic review and meta-analysis (Kaneoka et al., 2017) conclude that thickened liquids are relatively successful at immediately eliminating aspiration on VFSS (without regard to nature of dysphagia), but rates of dysphagia? intake … Model each, then have the patient demonstrate it back to you. Swallowing compensatory and exercise therapy are regarded as the moderate risk of nonprocedural encounters. oUse of compensatory strategies begins to break down oDisplays deficits in concentration and word/name finding at work oDrop in performance and poor retention of material/information may be evident oMay display mild to moderate anxiety, denial of deficits, and increased self-centeredness Pharyngeal Tests Initiation of swallow: [ ] Prompt Diet modification and compensatory strategy training to manage symptoms, with ongoing adjustment as swallowing status changes. After the results were obtained from the database, the 2020 publications that contained relevant information to the objectives of this work in title and abstract were selected for further review. Inform the client and/or health care team of the time that the client may lie down. Policy documents (e.g., Preferred Practice Patterns, position statements, technical reports, guidelines, knowledge and skills) on swallowing and feeding disorders, videofluoroscopic swallowing studies, endoscopic evaluation of swallowing, and swallowing disorders in schools) Treatment for Dysphagia •Compensatory methods •Postural adjustments •Maneuvers •Diet modifications •Eating strategies •Optimize environment for eating •Alternating liquids and solids •Rehabilitative •Change swallowing physiology to restore function •Exercise regimens Supervises new FEES clinicians into competency in instrumental testing. Here’s a little something more to try. Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. Questions/Aims Addressed "This study aimed to establish the safety and the effectiveness of interventions for feeding and swallowing disorders in adults with ID, to critically appraise the evidence to inform clinical practice, and to identify key areas for future research" (p. 208). as a compensatory strategy, could not improve dysphagia in hemiplegic stroke patients. I enjoyed the rehab and compensatory strategies." The patient’s speech language pathologist (SLP) helps manage dysphagia. Evidence suggested that compensatory strategies, such as diet modification, head postures, swallowing maneuvers, seemed to be applicable and efficacious; however, no well-proven rehabilitative strategies were reported to improve swallowing function in … SLPs educate patients on specific oral compensatory and facilitatory strategies that can help the patient safely consume their meal. Take your time to eat a meal. Slow your rate. Purpose This study was designed to determine whether spaced retrieval (SR), when paired with an external memory aid, is an effective technique to teach persons with dementia to use compensatory swallowing strategies. Ageusia/dysgeusia and/or anosmia (complete or partial loss of taste and smell) Reduced oral intake of foods, changes in appetite, weight loss and insufficient nutrition and/or hydration. This course is a recorded session from the 2019 online conference “Cancer Care: Enhancing Communication, Swallowing, and Quality of Life.” Level 4 Swallowing is safe but usually requires moderate cues to use compensatory strategies, and/or individual has moderate diet restriction and/or still requires tube feeding and/or oral supplements. © 2002, 2013, American Speech-Language-Hearing Association. A swallowing disorder, known as dysphagia, may occur as a result of various medical conditions. It’s not like weight-bearing status, where one patient is generally consistent with another patient when the doctor says, … She is a Past-President of the Dysphagia Research Society, past Chair of the Specialty Board for Board Certification in Swallowing and Swallowing Disorders (BCS-S), and Associate Editor for the Dysphagia Journal. A combination of oral and enteral feeding may be necessary for some patients. These scales do not attempt to relate severity Swallowing Take small mouthfuls / sips Alternate mouthfuls of food and drink Allow ____ swallows per mouthful Use teaspoon / dessertspoon Use a cup with a spout / straw for drinking Listen to the voice – if it sounds “wet”, cough and clear the throat then swallow again Other Compensatory Strategies: Application to Specific Problems a. swallowing function on P.O. This 7-point scale also rates severity based on the patient’s ability to meet nutritional needs and independence with compensatory strategies. Swallowing rehabilitation can include: diet modifications, feeding strategies, compensatory techniques, and exercises. (Mar. The purpose of this course, with Stephanie Daniels, is to detail compensatory and rehabilitative treatment strategies for post-stroke dysphagia. Diagnostic accuracy; levels of agreement in clinical decision-making, swallowing feature ratings: Cassel (2016) 3: 59–74: Dysphagia (I) Provision of cueing for compensatory strategies during mealtime: Outcome: Swallowing strategy use Measure: Percent accuracy: Morrell et al. Movement of the hyoid bone and the epiglottis during swallowing in patients with dysphagia from different etiologies. Exercise guidelines rules considerations, timing, coordination with medications. (ASHA) 30 31. SLPs employ many strategies when working with adults to address feeding and swallowing disorders. - Measurable. Thirteen out of 703 articles identified met the eligibility criteria and were included. Swallowing Take small mouthfuls / sips Alternate mouthfuls of food and drink Allow ____ swallows per mouthful Use teaspoon / dessertspoon Use a cup with a spout / straw for drinking Listen to the voice – if it sounds “wet”, cough and clear the throat then swallow again Can I bill for a treatment session immediately following a swallowing evaluation for the time I spend reviewing compensatory strategies and educating the patient? • Swallowing/Dysphagia • Locate Tools & Resources . Patients should receive clinical dysphagia evaluations along with videofluoroscopy. With each bite or sip, swallow 2 to 3 times before taking the next bite or sip. 4 Description of Seven-Level FCM scoring Each level of the FCMs contain references to the intensity and frequency of the cueing method and use of compensatory strategies that are required to assist the patient in intake without overt signs and symptoms of aspiration for the highest appropriate diet level • Client will utilize compensatory strategies with optimum safety and efficiency of swallowing function on P.O. 2020) "Good explanations. Oropharyngeal dysphagia is a frequent occurrence following stroke. Taking longer to finish meals or snacks (longer than 30 minutes). Compensatory strategies/ Swallowing therapy. Licensed in Florida . intake without overt signs and symptoms of aspiration for the highest appropriate diet level • Client will utilize compensatory strategies with optimum safety and efficiency of swallowing function on P.O. May 13, 2020 - How to do a strategy review for swallowing disorders, dysphagia, and more for the medical SLP. It is imperative that the swallowing therapist have a thorough understanding of evidence-based compensatory and … [Medline] . Dr. Fisher holds ASHA Certificate of Clinical Competence, endorsement for endoscopy practice, and is a … Compensatory strategies include postural changes and modification of bolus volume and consistency as well as rate of food presentation. intake without overt signs and symptoms of aspiration for the highest appropriate diet level • Client will utilize compensatory strategies with optimum safety and efficiency of swallowing function on P.O. Clinicians across multiple healthcare settings manage swallowing disorders. This 7-point scale also rates severity based on the patient’s ability to meet nutritional needs and independence with compensatory strategies. Swallow Study Dysphagia intervention may concentrate on swallowing exercises, compensatory swallowing strategies (including posture considerations), bolus consistency modification, and caregiver/patient education. Double or triple swallow. intake without overt signs and symptoms of aspiration for the highest appropriate diet level . ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). DYSPHAGIA GOALS LONG TERM GOALS - SWALLOWING • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. July 26, 2020. by dysphagiaramblings. Designed for clinicians who are new to the area of swallowing disorders – as well as experienced clinicians who want a refresher – this six-course set provides a comprehensive overview of dysphagia assessment and treatment. ... oUse of compensatory strategies begins to break down oDisplays deficits in concentration and word/name finding at work ... ASHA Compendium ASHA Mapping studies NIH DARE Evidence Based Practice. This strategy wid- July 15, 2019. ASHA is currently field test-ing the ASHA Functional Communication Measure swal-lowing subscale for reliability [12]. 2008 Apr. Taking only small amounts of food, overpacking the mouth, and/or pocketing foods. Reduced lip and tongue strength; Exercises exist for these symptoms, but not recommended due to energy expenditure; Reduced Pharyngeal contraction bilaterally; Turn head sideways: best strategy to allow throat to become narrower and compensate for lack of muscle constriction This helps to narrow the vallecular space and pharynx. Take a deep breath and hold tightly, swallow hard or with greater force than usual, after swllow, pt should cough prior to inhalation. Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. The following were compensatory strategies attempted during the videofluoroscopic evaluation: Chin tuck effectively eliminated predeglutitive aspiration of thin liquids. For example, a patient with a delayed swallow trigger or reduced epiglot-tic deflection may benefit from the use of a “chin tuck” or “chin-down” posture while swallowing. Do not talk and eat at the same time. Patient-focused evidence-based interventions will be discussed, including rehabilitative exercises, compensatory strategies, caregiver education, environmental modifications and end-of-life care. dysphagia compensatory strategies whilst eating the client should remain in sitting for a minimum of 20 minutes after the task. Compensatory treatments included postural techniques, diet modification, and maneuvers (e.g., Mendelsohn, effortful swallow, super supraglottic swallow). ASHA’s website has a great overview of dysphagia. There are some compensatory strategies that we can help patients with. DYSPHAGIA GOALS LONG TERM GOALS - SWALLOWING • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. Six studies focused on pharmacological interventions, three studies focused on dietary interventions and compensatory strategies, one study focused on oral care, two studies focused on multidisciplinary interventions, and one study assessed a screening method. Strength Training In Dysphagia Management ... ASHA CEUs are awarded to those that meet eligibility criteria by the ASHA CE Registry upon receipt of the ASHA CEU Participant Form from the ASHA Approved CE Provider. When unrecognized or poorly managed, dysphagia can result in malnutrition, volume depletion, and reduced quality of life, as well as aspiration, pneumonia, and death. Their goal is to ensure that the patient is safely tolerating a diet without any overt signs or symptoms of aspiration. ASHA has a well developed program of support for SLPs involved in dysphagia. Provide a list of the exercises you recommend. 18(2):329-35. The SLP serves as the “coach” for both partners (Hopper, Holland, & … Pharyngeal Exercises Effortful swallow: Swallow your saliva HARD, pretend that you’re swallowing a whole grape, and repeat 10 times. Mendelsohn maneuver: Swallow your saliva and feel your Adam’s apple move up and down. Swallow your saliva again, but halfway through the swallow, hold your Adam’s apple up using the muscles under your chin. - Functional. Speech dysarthria and swallow or dysphagia therapy treatment considerations, guidelines precautions, ideas for myasthenia gravis MG patients. Compensatory strategies designed to improve oral phase functioning and patient’s responses to those strategies (e.g., change in modality, positioning, external pacing, etc.) General overview of medication, causes, symptoms of myasthenia gravis that affect speech and swallow Assesses anatomy and pathophysiology of swallow function in the oral and pharyngeal phases. Treatment for Dysphagia •Compensatory methods •Postural adjustments •Maneuvers •Diet modifications •Eating strategies •Optimize environment for eating •Alternating liquids and solids •Rehabilitative •Change swallowing physiology to restore function •Exercise regimens The goals of dysphagia treatment are to maintain adequate nutritional intake for the patient and to maximize airway protection. Oral transit times were _____ (within functional limits/prolonged) (list oral transit times, if available). This course is a recorded session from the 2019 online conference “Cancer Care: Enhancing Communication, Swallowing, and Quality of Life.” Carbonated liquids can sometimes be a good compensatory strategy to make pill swallowing easier. Compensatory swallowing strategies are often used by clinicians where the goal is not to change swallowing physiology but instead the goal is to prevent symptoms of dysphagia in order to maintain safety and ensure adequate nutrition and hydration. J Electromyogr Kinesiol . This widens the valleculae to accommodate the bolus prior to the initiation of the swallow. “The review of presbyphagia vs. dysphagia with the clinical application was helpful.” J.D. A review in PubMed database was performed on May 23, 2020, using the following strategies with the terms COVID-19 OR SARS-COV-2 AND Dysphagia OR Deglutition Disorders. Level 5 Swallow is safe with minimal diet restriction and/or occasionally requires minimal cueing to use compensatory strategies. The swallow can improve by changing the swallow from an automatic behavior to a more volitionally controlled action Strategy: Breath holding - Supraglottic and Super-supraglottic ***Contraindicated for cardiac issues How do I do it? The review identified a number of compensatory and restorative options for treating dysphagia secondary to head and neck cancer. This course illustrates how SLPs can develop appropriate, evidence-based, and practical treatment plans for patients with dysphagia based on the results of instrumental swallow assessments. The speaker discusses case studies involving the use of various assessments, including videofluoroscopy, endoscopy, and high-resolution manometry. Compensatory strategies – Food/liquid texture modifications – Behavioral/environmental manipulation – Positioning Strengthening exercises – Shaker Exercise - LSVT?? Disorders of oral and pharyngeal swallowing are usually amenable to rehabilitation, including dietary modification and training in swallowing techniques and maneuvers. phagia (CED) manual [11]. – I.W. Read a compensatory strategy review for swallowing disorders, including how mobile FEES dysphagia & endoscopic swallow studies can work closely with speech language pathologists. Provides recommendations for diet modifications, compensatory strategies and treatment . This treatment-focused course presents perspectives on the evolution of dysphagia practice. This requires an understanding of the anatomy and physiology of swallowing, principles of motor learning, and the role of neuroplasticity. sustain.for.1.minute,.rest.1.minute,.repeat(3. cyclestotal);also.30.reps.of.brief.headAlifts(likea. 10 3 So what is Dementia? She is a speech-language pathologist (SLP) and clinical instructor with SA Swallowing Services and works at various hospitals, sub-acute care facilities, and rehab facilities. This document focuses specifically on oropharyngeal dysphagia. 5-15 Minutes Part I: Compensatory Strategies in Dysphagia Management; 15-45 Minutes Part II: Rehabilitative Strategies: Skill vs. Home care settings may lend themselves more to compensatory, but that’s not always the case. Carbonated liquids can sometimes be a good compensatory strategy to make pill swallowing easier. Recognizing that her current approach was not effective, Autumn searched for an appropriate treatment to improve independence in self-feeding and using compensatory swallowing strategies in the presence of STUDY. intake … Between January 1, 1998 and December 31, 2016 She is a speech-language pathologist (SLP) and clinical instructor with SA Swallowing Services and works at various hospitals, sub-acute care facilities, and rehab facilities. View Course Details. Exercise guidelines rules considerations, timing, coordination with medications. Significant gaps exist regarding the evidence for the evaluation and management of dysphagia … Add to Calendar 07/16/2021 08:00 AM 07/16/2021 11:30 AM America/New_York Dysphagia Dilemmas: Clinical and Instrumental Management of Pediatric Swallowing Hotel: Phone: 850-916-8886 CIAO Studios CIAO Seminars, Inc mail@ciaoseminars.com false MM/DD/YYYY. Refusing foods of certain textures or types. Such strategies are employed by speech-language pathologists and taught to patients following a clinical dysphagia assessment, the results of 3. Documentation Basics for Dysphagia. Twelve master clinicians in the field of dysphagia examine how speech-language pathologists were managing patients when dysphagia was added to ASHA's scope of practice, how challenges along the way developed into evidence-based interventions, and what best practice looks like today. ASHA. However, formal and informal training on normal and impaired swallowing is lacking and inconsistent across academic and clinical training domains. The new world of dysphagia therapy will have to yield greater results and shorter treatment times. Particular focus will be placed on implementing the correct rehabilitative strategy based on the underlying impairment. It provides clinically useful information on the influence of compensatory strategies and diet changes (Martin-Harris et al, 2000). Sensory enhancement procedures have been reported as effective compensatory strategies for dysphagia treatment (Bisch, Logemann, Rademaker, Kahrilas, & Lazarus, 1994; Lazarus et al., 1993; Lazzara, Lazarus, & Logemann, 1986; Siktberg & Bantz, 1999) and are often included as one component of a therapeutic program for students with dysphagia. Clinical Task Instruction – Delegated Task - 4 - and solid textures, along with compensatory strategies that may improve the patient’s swallowing safety. 6 Years Included. Below is a list of common compensatory swallowing strategies. These strategies are typically implemented during meal time ! Vomiting (more than typical “spit-up” for infants). 26. – Masako - EMST?? Keywords: Diet Modification, Diet Modification, Oral-Motor Treatments, Dysphagia, Postural Techniques/Maneuvers, Oral Motor Treatments (includes Shaker Exercises), Postural … Member of ASHA since 1991. An oropharyngeal swallowing rehabilitation program for patients with dysphagia should include restorative exercises, compensatory techniques, and diet modification (Grade B Evidence). The purpose of this retrospective study was to compare functional dysphagia outcomes following inpatient rehabilitation for patients with brain tumors with that of patients following a stroke. Results. ASHA Says: Short and long-term functional swallow goals and specific objectives are determined from assessment and represent the framework for treatment. Purpose Dysphagia occurs as a component of a wide variety of diseases and conditions. When you see: Vallecular residue You can try: Chin tuck and/or effortful swallow Why? Compensatory strategies have an immediate, but temporary effect on swallow safety; rehabilitative strategies may promote a long-term effect and change the physiology of the swallow. ASHA … Compensatory strategies can be used to alter posture, timing of the swallow, laryngeal closure. While most compensatory strategies do not cause long-term effects to the swallowing system, some can be used as exercise to create a lasting effect to swallowing. I also enjoyed the handouts for the exercises and the compensatory strategies and the rationale for each.” – … This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for … Dr. Fisher holds ASHA Certificate of Clinical Competence, endorsement for endoscopy practice, and is a … The modified barium swallow study (MBSS) is a fluoroscopic motion … [] Surgery is rarely indicated for patients with swallowing disorders, although in patients … Pick and choose for your patients based on the signs and symptoms they present. Critical thinking in dysphagia management is needed to significantly shift clinical practice patterns. For: pts with dysphagia secondary to oral-pharyngeal carcinoma for those with compromised airway protection and … Dysphagia: Guide to Establishing a Restorative Mealtime Program is a 2-hour online CEU course that will enable therapists in long-term care or post-acute rehabilitation facilities to present staff training that offers strategies and techniques for implementing a Restorative Mealtime Program (RMP). Treatment outcome studies have provided evidence that compensatory strategies designed to have an immediate effect on the swallow (i.e., postural changes or diet manipulation) can improve swallowing safety and efficiency. Postural techniques eliminated aspiration on thin liquids in 75 to 80% of dysphagic patients. Dysphagia (Adults) Of the seven articles included, four examined the use of compensatory postural maneuvers or techniques (e.g., head turn, supraglottic swallow, Mendelsohn maneuver) and three examined the use of rehabilitation treatments (e.g., oral motor strengthening exercises).

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