A DYSPHAGIA

SURVEY
What are we doing???
THE MAILED RESPONSES
 75 surveys were mailed to area SLP’s in
Indiana.
 Of the 75 surveys, 13 were returned.
 The following slides details each question
and the average response regarding
dysphagia assessment and therapy within the
various settings.
NUMBER OF YEARS YOU HAVE
BEEN PRACTICING….
 Mean number of years was 10.
 The longest time being 30 years.
 The shortest time being 2 years.
SETTING WHERE YOU
CURRENTLY WORK
 SNF 10/13
 Hospital 4/13
 Home Health 4/13
 ENT 1/13
 Assisted Living 0
 Inpatient rehab 0
IS YOUR CASELOAD MOSTLY…..
 Adults 12/13
 Infants/peds 2/13
APPROXIMATE NUMBER OF DYSPHAGIA PATIENTS
ON CASELOAD
 On Average, 49% of caseload is dysphagic
patients
 Average number 6
NUMBER OF PATIENTS ON
ALTERED DIET
 Average 43% of dysphagic patients on
caseload are on an altered diet.
EVALUATION PROCEDURES YOU
PERFORM
 Bedside evaluation 12/13
 MBSS 6/13
 FEES 1/13
 Nobody that completed this survey uses
ultrasonography, manometry, sEMG or
scintiscanning
FOR BEDSIDE EVALUATIONS DO YOU
USE A STANDARDIZED ASSESSMENT?
 Yes=2
 No=10
 15% of respondants use a standardized
bedside assessment.
 Mann Assessment of Swallowing Ability
(MASA) was the only standardized test listed
as being used.
DOES YOUR FACILITY CURRENTLY
USE A SCREENING FORM?
 Yes=3
 No=7
 54% do NOT use facility screening forms.
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 Participants were provided a list which they
could mark.
 Most popular at 85%
 Diet alterations
 Oral exercises
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 77%
 Chin tuck
 Multiple swallows
 Alternate consistencies
 Limit bolus size
 No straws
 Pharyngeal exercises
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 54%
 Cough/throat clear after bolus
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 46%
 Effortful swallows
 Masako
 Exerciseswith resistance
 Shaker exercise
 Lemon ice after bolus presentation
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 38%
 Mendelsohn maneuver
 Alternate temperature
 Head turn to left or right
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 31%
 Supra-glotticswallow
 Super-supra glottic swallow
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 23%
 Oral manipulation exercises
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 15%
 NMES
 Thermal/tactilestimulation
 DPNS (deep pharyngeal neuromuscular
stimulation
WHAT TREATMENT STRATEGIES DO YOU
CURRENTLY USE IN YOUR PRACTICE?
 At 7%
 Pressure feedback (IOPI)

 Noparticipant in this survey reported using

Biofeedback (sEMG).
WHICH TREATMENT TECHNIQUES
DID YOU FIND MOST EFFECTIVE?
 This was left blank for participants to write in
their reponses.
 1. diet alterations
 2. chin tuck/limit bolus size/no
straws/multiple swallows/Masako/effortful
swallow/compensatory
strategies/oropharyngeal exercises
 3. strengthening/thermal stim/Vitalstim
 4. pt./family
education/positioning/supraglottic
swallow/super supraglottic swallow/lemon ice
ARE YOU VITALSTIM CERTIFIED?
 Yes 31%
 4 respondants stated that they are Vitalstim
Certified.
 Nobody is certified in use of any other NMES
machine.
ARE YOU DPNS CERTIFIED?
 Yes=15% (2 respondants)
WHAT IS THE APPROXIMATE PERCENTAGE OF PATIENTS
THAT YOU TREAT THAT HAVE RETURNED TO A REGULAR
DIET?
 Average return to a regular diet is 50%
 Keepin mind also that most respondants work in
a SNF unit and have dementia patients that
sometimes require management services.
DO YOU USE THE FRAZIER WATER
PROTOCOL WITH PATIENTS
 Yes=77% (10 participants)
 No-2 participants
DO YOU USE COMMERCIALLY
AVAILABLE DYSPHAGIA PRODUCTS?
 Provale cups-8
 Laryngeal mirrors-5
 Chewy tubes-3
 Ice finger-2
 Thermostim-2
 Nuk brush-2
 Wedge cup-2
 Safestraw-2
 Oralight-1
 TheraSip-1
 The Breather-1
 One Way Valve Straw-1
 Other cups-1
 VHI Oral Sensory and Motor Treatment Prescription Cards-0
 IOPI (Iowa Oral Performance Instrument)-0
PLEASE FEEL FREE TO LIST ANY BOOKS OR ARTICLES
RELATED TO DYSPHAGIA THAT YOU FIND HELPFUL OR
INTERESTING.
 Clinical Anatomy and Physiology of the
Swallow Mechanism by Corbin-Lewis, Liss and
Sciortino.