Dysphagia Management in the Schools: Past, Present, and Future

Abstract

As the number of speech-language pathologists (SLPs) responsible for swallowing and feeding services in the educational setting increases, guidance informing this specialized practice continues to emerge. Although SLPs have provided dysphagia management for children in medical settings for many years, the extension of dysphagia services to the schools is comparatively new. This shift in care delivery for what was previously a hospital-based practice is now occurring more frequently, and in an environment void of extensive medical supports (i.e., the schools). With this transition, evidence-based approaches tailored to children with dysphagia receiving intervention in the school setting are paramount. Components that appear critical to this evolving specialty area include research, best practice guidelines, knowledge and skills training, and collaboration across professionals. This article addresses these pertinent issues by reflecting upon the past, reviewing the present, and planning for the future.

Keywords

Pediatric - schools - dysphagia - swallowing - feeding

• References

• 1 Finnie NR. Handling the Young Cerebral Palsied Child at Home. 2nd ed. New York, NY: E.P. Dutton; 1975
• 2 American Speech-Language Hearing Association. Report of the ad hoc committee on dysphagia. ASHA 1987; 29 (4) 57-58
• 3 American Speech-Language-Hearing Association. Roles of speech-language pathologists in swallowing and feeding disorders: technical report. 2001. Available at: http://www.asha.org/policy/TR2001-00150.htm . Accessed September 9, 2016
• 4 American Speech-Language-Hearing Association. Schools Survey report: Caseload Characteristics trends, 1995–2014. Rockville, MD: American Speech-Language-Hearing Association; 2014
• 5 American Speech-Language-Hearing Association. Guidelines for Speech-Language Pathologists Providing Swallowing and Feeding Services in Schools. Rockville, MD: American Speech-Language-Hearing Association; 2007. . Association 2007 DOI: 10.1044/policy.GL2007-00276
• 6 Arvedson J, Lefton-Greif M. Preface. Semin Speech Lang 1996; 17 (4) 259 Available at: https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-2008-1064378.pdf . Accessed September 16, 2016.
• 7 Owre DW. Dysphagia management in schools: survey results—issues and barriers. Perspect Sch Based Issues. 2006; 2016: 27-28
• 8 Homer EM, Bickerton C, Hill S, Parham L, Taylor D. Development of an interdisciplinary dysphagia team in the public schools. Lang Speech Hear Serv Sch 2000; 31 (1) 62-75
• 9 Homer EM. An interdisciplinary team approach to providing dysphagia treatment in the schools. Semin Speech Lang 2003; 24 (3) 215-234
• 10 Homer EM. Establishing a public school dysphagia program: a model for administration and service provision. Lang Speech Hear Serv Sch 2008; 39 (2) 177-191
• 11 Homer EM. Management of Swallowing and Feeding Disorders in Schools. San Diego, CA: Plural; 2016
• 12 Virginia Department of Education. Speech-Language Pathology Services in Schools: Guidelines for Best Practice. Richmond, VA: Virginia Department of Education; 2011
• 13 Virginia Department of Education. TTAC Online. Training and Technical Assistance Center. 2016. Available at: https://ttaconline.org/online-training-webshops . Accessed September 16, 2016.
• 14 Connecticut State Department of Education. Guidelines for Feeding and Swallowing Programs in Schools. Hartford, CT: Connecticut State Department of Education; 2008: 1-108
• 15 Arvedson J, Rogers B, Buck G, Smart P, Msall M. Silent aspiration prominent in children with dysphagia. Int J Pediatr Otorhinolaryngol 1994; 28 (2–3): 173-181
• 16 Lefton-Greif MA, Carroll JL, Loughlin GM. Long-term follow-up of oropharyngeal dysphagia in children without apparent risk factors. Pediatr Pulmonol 2006; 41 (11) 1040-1048
• 17 Arvedson J, Clark H, Lazarus C, Schooling T, Frymark T. The effects of oral-motor exercises on swallowing in children: an evidence-based systematic review. Dev Med Child Neurol 2010; 52 (11) 1000-1013
• 18 Morgan AT, Dodrill P, Ward EC. Interventions for oropharyngeal dysphagia in children with neurological impairment. Cochrane Database Syst Rev 2012; 10 (11) CD009456
• 19 Barlow SM, Poore MA, Zimmerman EA, Finan DS. Feeding skills in the preterm infant. ASHA Lead 2010; 15: 22-23
• 20 Szynkiewicz SH, Mulheren RW, Palmore KW, O'Donoghue CR, Ludlow CL. Using devices to upregulate nonnutritive swallowing in typically developing infants. J Appl Physiol 2016; 121: 831-837
• 21 Dodrill P, Gosa MM. Pediatric dysphagia: physiology, assessment, and management. Ann Nutr Metab 2015; 66 (Suppl. 05) 24-31
• 22 Gosa M, Schooling T, Coleman J. Thickened Liquids as a Treatment for Children with Dysphagia and Associated Adverse Effects, A Systematic Review. ICAN: Infant, Child, Adolescet Nutr 2011; 1-7
• 23 Arvedson JC, Brodsky L. Pediatric Swallowing and Feeding: Assessment and Management. 2nd ed. Delmar, Cenage Learning, Clifton Park, NY; 2001
• 24 Huffman NP, Owre DW. Ethical issues in providing services in schools to children with swallowing and feeding disorders. Lang Speech Hear Serv Sch 2008; 39 (2) 167-176
• 25 O'Donoghue CR, Dean-Claytor A. Training and self-reported confidence for dysphagia management among speech-language pathologists in the schools. Lang Speech Hear Serv Sch 2008; 39 (2) 192-198
• 26 Malandraki GA, Roth M, Sheppard JJ. Telepractice for pediatric Dysphagia: a case study. Int J Telerehabil 2014; 6 (1) 3-16
• 27 Ward EC, Burns CL. Dysphagia management via telerehabilitation: a review of the current evidence. J Gastroenterol Hepatol Res 2014; 3 (5) 1088-1094
• 28 Kantarcigil C, Sheppard JJ, Gordon AM, Friel KM, Malandraki GA. A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy. Res Dev Disabil 2016; 55: 207-217