Speech–Language Pathologist-led Fiberoptic Endoscopic Evaluation of Swallowing: Functional Outcomes for Patients after Stroke

Background: The application of fiberoptic endoscopic evaluation of swallowing (FEES) in the pediatric dysphagia protocol requires specialized knowledge of pediatric conditions that result in dysphagia, recognition of normal and abnormal laryngopharyngeal anatomy and function across ages, and the ability to identify maturational changes in anatomy and function of the aerodigestive tract that pertain to airway protection and swallowing function. Methods: Over the past 25 years, we have performed over 7,000 collaborative Otolaryngology and Speech-Language Pathology FEES examinations in patients ranging from 2 days of age to young adults. During this time period, we have monitored the safety of the procedure, explored the feasibility and utility of FEES across conditions, compared and contrasted FEES to the videofluoroscopic evaluation of swallowing (VFSS), and developed specific pediatric FEES protocols with operational definitions for identification and interpretation of swallowing parameters. Results: FEES has proved to be a safe procedure in patients across ages. There have been no significant adverse events. FEES is comparable to the VFSS in the assessment of events before and after the swallow. It provides unique information regarding laryngopharyngeal anatomy and function, airway protection integrity, sensory threshold, and secretion management ability, as well as pharyngeal swallowing dynamics and the efficacy of compensatory swallowing strategies. Conclusions: There are specific indications and contraindications for pediatric FEES, and unique components that characterize the pediatric FEES protocols across ages and conditions. FEES procedures performed jointly by an Otolaryngologist and Speech-Language pathologist offer a team approach to interpretation and management recommendations.

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Impact of a Multidisciplinary Round Visit for the Management of Dysphagia Utilizing a Wi-Fi–Based Wireless Flexible Endoscopic Evaluation of Swallowing

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489416674223 ◽

2016 ◽

Vol 126 (1) ◽

pp. 47-53 ◽

Cited By ~ 3

Author(s):

Koichi Sakakura ◽

Masayuki Tazawa ◽

Natsuko Otani ◽

Masato Takagi ◽

Mariko Morita ◽

...

Keyword(s):

Multidisciplinary Team ◽

Functional Outcomes ◽

Large Scale ◽

Multidisciplinary Approach ◽

Oral Intake ◽

Conventional System ◽

Endoscopic Evaluation ◽

Wireless System ◽

Short Period ◽

Management Of Dysphagia

Objectives: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi–based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. Method: We conducted novel Wi-Fi–based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively. Results: Using the wireless system, we could visit more patients in a short period of time. Furthermore, a large multidisciplinary team was able to be present at the bedside, which made it easy to hold discussions and rapidly devise appropriate rehabilitation strategies. Aspiration pneumonia recurred in a few cases following our intervention with wireless FEES. Functional oral intake score was significantly increased following the intervention. Moreover, the number of deaths during hospitalization using wireless FEES evaluation was lower than those observed using the conventional system. Conclusion: Wi-Fi–based wireless FEES system, the first of its kind, allowed our multidisciplinary team to easily and effectively assess inpatients with dysphagia by facilitating simple examinations and intensive transprofessional discussions for patient rehabilitation.

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Effective Clinical Interviewing

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.0904.265 ◽

1978 ◽

Vol 9 (4) ◽

pp. 265-271 ◽

Cited By ~ 1

Author(s):

Pauline T. Flynn

Keyword(s):

Family Members ◽

Essential Elements ◽

Speech Language Pathologist ◽

Lay Persons ◽

Clinical Interviewing ◽

Client Management

Speech, language, and hearing professionals rely on many individuals to provide information about a client. Management programs, in part, are devised, modified, and evaluated according to responses obtained from the client, family members, educators, and other professional and lay persons who have contact with the client. The speech-language pathologist has the responsibility of obtaining pertinent, complete, unbiased information about clients. This article provides an overview of the essential elements of an interview.

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Writing Funding Proposals for Speech-Language Staff Development Projects

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1303.163 ◽

1982 ◽

Vol 13 (3) ◽

pp. 163-171

Author(s):

Carol A. Esterreicher ◽

Ralph J. Haws

Keyword(s):

Staff Development ◽

Development Project ◽

Project Manager ◽

State Funding ◽

Service Needs ◽

School Environments ◽

Speech Language Pathologists ◽

Service Programs ◽

Speech Language Pathologist ◽

Special Programs

Speech-language pathologists providing services to handicapped children have pointed out that special education in-service programs in their public school environments frequently do not satisfy the need for updating specific diagnostic and therapy skills. It is the purpose of this article to alert speech-language pathologists to PL 94-142 regulations providing for personnel development, and to inform them of ways to seek state funding for projects to meet their specialized in-service needs. Although a brief project summary is included, primarily the article outlines a procedure whereby the project manager (a speech-language pathologist) and the project director (an administrator in charge of special programs in a Utah school district) collaborated successfully to propose a staff development project which was funded.

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Improving Speech and Language Services through Effective Time Management

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1402.86 ◽

1983 ◽

Vol 14 (2) ◽

pp. 86-91 ◽

Cited By ~ 1

Author(s):

Barbara W. Travers

Keyword(s):

Time Management ◽

Management Strategies ◽

Federal State ◽

Speech Language Pathologist ◽

School Based ◽

Work Area ◽

Paper Work ◽

Areas Of Concern ◽

State And Local ◽

Therapeutic Services

This paper presents strategies for increasing the effectiveness and efficiency of the school-based speech-language pathologist. Various time management strategies are adapted and outlined for three major areas of concern: using time, organizing the work area, and managing paper work. It is suggested that the use of such methods will aid the speech-language pathologist in coping with federal, state, and local regulations while continuing to provide quality therapeutic services.

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A Classroom Sign Communication Program for the Severely Handicapped

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1204.233 ◽

1981 ◽

Vol 12 (4) ◽

pp. 233-239

Author(s):

Linda Goodman ◽

Robin Kroc

Keyword(s):

Service Delivery ◽

Speech Language Pathologist ◽

Communication Program ◽

Severely Handicapped

This article describes a strategy used to teach sign communication to severely handicapped students in the classroom. It recommends that the speech-language pathologist adopt a consultant role in service delivery.

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Communication/Interaction Development at Mealtimes for the Multiply Handicapped Child

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1204.216 ◽

1981 ◽

Vol 12 (4) ◽

pp. 216-232 ◽

Cited By ~ 7

Author(s):

Suzanne Evans Morris

Keyword(s):

Handicapped Child ◽

Positive Interactions ◽

Speech Language Pathologist ◽

Specific Program ◽

Communication Interaction

The mealtime setting can be creatively used by the speech-language pathologist to increase the positive interactions between the child and caregiver and to establish the basic prerequisites for the development of communication. Specific program suggestions are provided to enable the speech-language pathologist to utilize the mealtime setting to integrate both vocal and nonvocal communicative objectives. The roots of interaction and communication which underly both vocal and nonvocal systems are described.

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