Muscle Tension Dysphagia: Contributing Factors and Treatment Efficacy

2020 ◽  
pp. 000348942096633 ◽  
Author(s):  
Christina H. Kang ◽  
Nan Zhang ◽  
David G. Lott
Keyword(s):  
Treatment Efficacy ◽  
Muscle Tension ◽  
Speech Language Pathology ◽  
Contributing Factors ◽  
Level Of Evidence ◽  
Swallowing Function ◽  
Disease Etiology ◽  
Laryngeal Muscle ◽  
Study Results ◽  
Language Pathology

Objective: To determine factors contributing to disease etiology and treatment efficacy. Study Design: Original Report. Setting: Tertiary academic center. Methods: IRB approved prospective study of 20 patients with reported dysphagia who exhibited normal oropharyngeal and esophageal swallowing function as evidenced by videofluoroscopic swallow study, esophagogastroduodenoscopy, high-resolution esophageal manometry with stationary impedance, and Bravo pH probe off proton pump inhibitor. Patients underwent speech-language pathology intervention. Results: Atypical laryngeal muscle tension was present in 100% of patients. Forty percent of patients had diagnosed positive gastroesophageal reflux disease. Sixty-five percent of patients showed signs of non-specific laryngeal inflammation and laryngeal hyperresponsiveness during strobolaryngoscopy. All patients reported a mean of 90% recovery by the completion of voice therapy directed toward unloading muscle tension. Conclusion: The study results suggest an association between laryngeal muscle tension and these patients’ dysphagia symptoms regardless of associated conditions. Speech-language pathology intervention showed high treatment efficacy. Level of Evidence: 2c- Outcomes research.

Telehealth applications in speech-language pathology: a modified narrative review

2009 ◽  
Vol 15 (6) ◽  
pp. 310-316 ◽  
Author(s):  
Andrea Leigh Reynolds ◽  
Jessica Lindsay Vick ◽  
Nancy Jeanne Haak
Keyword(s):  
Service Delivery ◽  
Social Services ◽  
Narrative Review ◽  
Scottish Intercollegiate Guideline Network ◽  
Speech Language Pathology ◽  
Level Of Evidence ◽  
Complete Replacement ◽  
Face To Face ◽  
Study Results ◽  
Language Pathology

We conducted a modified narrative review of the literature on telehealth applications used in speech-language pathology assessment and treatment. The following databases and information resources were used: MEDLINE, CINAHL, PSYCInfo, ERIC, Digital Dissertations, CSA Social Services Abstracts, CSA Sociological Abstracts, On-line ASHA publications and personal contacts. Sixty-two full-text documents were located. Twenty-eight provided sufficient detail to be reviewed using a checklist adapted from the Scottish Intercollegiate Guideline Network (SIGN) recommendations for level of evidence rankings and quality assessment ratings. Five of the 28 studies received a ranking indicating a high level of evidence (larger sample sizes, assessed outcomes with valid and reliable measures, performed statistical analysis of study results, measured reliability of study results, ensured internal and external validity, and ensured randomization of participants to groups). These five studies concluded that the service delivery results from telehealth were equivalent to traditional face-to-face results. However, telehealth was not a complete replacement for face-to-face service delivery and further research is required.

scholarly journals How COVID-19 Patients Were Moved to Speak: A Rehabilitation Interdisciplinary Case Series

2020 ◽  
Vol 16 (S1) ◽  
pp. 56-63
Author(s):  
Brianne Mooney ◽  
Cecelia Lawrence ◽  
Elizabeth Gerosa Johnson ◽  
Amanda Slaboden ◽  
Karen Ball
Keyword(s):  
Physical Therapy ◽  
Case Series ◽  
Interdisciplinary Cooperation ◽  
Patient Specific ◽  
Multidisciplinary Teams ◽  
Speech Language Pathology ◽  
Retrospective Case ◽  
Swallowing Function ◽  
Prolonged Intubation ◽  
Language Pathology

Abstract Background Up to 36% of patients admitted to the ICU for COVID-19 require tracheostomy. While the literature recommends the use of multidisciplinary teams in the management of patients with tracheostomy for other diseases, little is known on the collaborative administration of physical therapy and speech language pathology services in the COVID-19 population. Purpose We sought to determine the outcomes of a collaboration between physical therapy (PT) and speech language pathology (SLP) in the treatment of patients who underwent tracheostomy placement as part of their treatment for COVID-19 at our facility. Methods We conducted a retrospective case series on patients with COVID-19 who had a tracheostomy. We included patients who had undergone mechanical ventilation for 14 days or longer, had a surgical tracheostomy, been discharged from intensive care to a medical unit, and received PT and SLP referrals. We compiled retrospective data from electronic medical records, analyzing days from tracheostomy to achievement of PT and SLP functional milestones, including mobility, communication, and swallowing. Of six critically ill patients with COVID-19 who had tracheostomy placement at our facility, three met inclusion criteria: patient 1, a 33-year-old woman; patient 2, an 84-year-old man; and patient 3, an 81-year-old man. For all patients, PT interventions focused on breathing mechanics, secretion clearance, posture, sitting balance, and upper and lower extremity strengthening. SLP interventions focused on cognitive reorganization, verbal and nonverbal communication, secretion management, and swallowing function. Intensity and duration of the sessions were adapted according to patient response and level of fatigue. Results We found that time to tracheostomy from intubation for the three patients was 23 days, 20 days, and 24 days, respectively. Time from tracheostomy insertion to weaning from ventilator was 9 days for patient 1, and 5 days for patient 2 and patient 3. Regarding time to achieve functional PT and SLP milestones, all patients achieved upright sitting with PT prior to achieving initial SLP milestone of voicing with finger occlusion. Variations in progression to swallowing trials were patient specific and due to respiratory instability, cognitive deficits, and limitations in production of an effortful swallow. Patient participation in therapy sessions improved following establishment of oral verbal communication. Conclusion Interdisciplinary cooperation and synchronized implementation of PT and SLP interventions in three COVID-19 patients following prolonged intubation facilitated participation in treatment and achievement of functional milestones. Further study is warranted.

Food for Thought

2013 ◽  
Vol 22 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Laurie Sterling ◽  
Rebecca Axline ◽  
Patrice Ragland
Keyword(s):  
Graduate School ◽  
Tube Placement ◽  
Formal Training ◽  
Speech Language Pathology ◽  
Swallowing Function ◽  
Endoscopic Gastrostomy ◽  
Language Pathology ◽  
Peg Tube ◽  
Delivering Bad News ◽  
Lateral Sclerosis

Speech-language pathologists have little, if any, formal training in counseling during graduate school. Working with neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS) requires more listening than talking and direct therapy. Knowing what to say and how to address patient emotions about loss of speech and swallowing function can be difficult. We share an patient with ALS's perspective of her experiences in life as she lost her ability to go out to lunch with her coworkers and fought to maintain her weight. We introduce the SPIKES protocol (Baile et al., 2000) for delivering “bad news” as a format for speech-language pathology sessions when broaching difficult topics such as percutaneous endoscopic gastrostomy (PEG) tube placement.

Data-Based Supervision Methods for Speech-Language Pathology

1989 ◽  
Vol 20 (3) ◽  
pp. 296-304 ◽  
Author(s):  
Ann Johnson Glaser ◽  
Carole Donnelly
Keyword(s):  
Public Schools ◽  
Student Teachers ◽  
Clinical Supervision ◽  
Speech Language Pathology ◽  
The Public ◽  
Language Pathology ◽  
Supervision Model ◽  
Supervisory Process

The clinical dimensions of the supervisory process have at times been neglected. In this article, we explain the various stages of Goldhammer's clinical supervision model and then describe specific procedures for supervisors in the public schools to use with student teachers. This easily applied methodology lends clarity to the task and helps the student assimilate concrete data which may have previously been relegated to subjective impressions of the supervisor.

Developing an Early Intervention Preservice Specialization in Speech-Language Pathology

1995 ◽  
Vol 4 (2) ◽  
pp. 31-36 ◽  
Author(s):  
Joanne E. Roberts ◽  
Elizabeth Crais ◽  
Thomas Layton ◽  
Linda Watson ◽  
Debbie Reinhartsen
Keyword(s):  
Early Childhood ◽  
Early Intervention ◽  
Intervention Program ◽  
Graduate Program ◽  
Master's Level ◽  
Clinical Experiences ◽  
Speech Language Pathology ◽  
Early Intervention Program ◽  
Language Pathology ◽  
Family Centered

This article describes an early intervention program designed for speech-language pathologists enrolled in a master's-level program. The program provided students with courses and clinical experiences that prepared them to work with birth to 5-year-old children and their families in a family-centered, interdisciplinary, and ecologically valid manner. The effectiveness of the program was documented by pre- and post-training measures and supported the feasibility of instituting an early childhood specialization within a traditional graduate program in speech-language pathology.

A Family With Autosomal-Dominant Progressive Sensorineural Hearing Loss

1996 ◽  
Vol 5 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Chris Halpin ◽  
Barbara Herrmann ◽  
Margaret Whearty
Keyword(s):  
Speech Production ◽  
Hearing Aids ◽  
Role Models ◽  
Speech Intelligibility ◽  
Large Scale ◽  
Speech Language Pathology ◽  
The Family ◽  
Patient Will ◽  
Language Pathology

The family described in this article provides an unusual opportunity to relate findings from genetic, histological, electrophysiological, psychophysical, and rehabilitative investigation. Although the total number evaluated is large (49), the known, living affected population is smaller (14), and these are spread from age 20 to age 59. As a result, the findings described above are those of a large-scale case study. Clearly, more data will be available through longitudinal study of the individuals documented in the course of this investigation but, given the slow nature of the progression in this disease, such studies will be undertaken after an interval of several years. The general picture presented to the audiologist who must rehabilitate these cases is that of a progressive cochlear degeneration that affects only thresholds at first, and then rapidly diminishes speech intelligibility. The expected result is that, after normal language development, the patient may accept hearing aids well, encouraged by the support of the family. Performance and satisfaction with the hearing aids is good, until the onset of the speech intelligibility loss, at which time the patient will encounter serious difficulties and may reject hearing aids as unhelpful. As the histological and electrophysiological results indicate, however, the eighth nerve remains viable, especially in the younger affected members, and success with cochlear implantation may be expected. Audiologic counseling efforts are aided by the presence of role models and support from the other affected members of the family. Speech-language pathology services were not considered important by the members of this family since their speech production developed normally and has remained very good. Self-correction of speech was supported by hearing aids and cochlear implants (Case 5’s speech production was documented in Perkell, Lane, Svirsky, & Webster, 1992). These patients received genetic counseling and, due to the high penetrance of the disease, exhibited serious concerns regarding future generations and the hope of a cure.

Student Experience Applying to Graduate School for Speech-Language Pathology

2020 ◽  
Vol 5 (1) ◽  
pp. 192-205
Author(s):  
Lesley Sylvan ◽  
Andrea Perkins ◽  
Carly Truglio
Keyword(s):  
Graduate School ◽  
Master's Degree ◽  
Graduate Programs ◽  
Student Experience ◽  
Degree Programs ◽  
Speech Language Pathology ◽  
Application Process ◽  
Master's Degree Programs ◽  
Language Pathology ◽  
Master’S Degree

Purpose The purpose of this study is to better understand the experiences faced by students during the application process for master's degree programs in speech-language pathology. Method Data were collected through administering an online survey to 365 volunteers who had applied to master's degree programs in speech-language pathology. Survey questions were designed to gain the student perspective of the application process through exploration of students' deciding factors for top choices of graduate programs, emotional involvement in the application process, biases/rumors heard, student challenges, advice to future applicants, and what students would change about the application process. Results Factors that influenced participants' reasoning for selecting their “top choice” programs were largely consistent with previous studies. Issues that shaped the student experience applying to graduate school for speech-language pathology included financial constraints, concern regarding the prominence of metrics such as Graduate Record Examinations scores in the admissions process, a perceived lack of guidance and advising from faculty, and confusion regarding variation among graduate program requirements. Conclusion Gaining insight into the student experience with the application process for graduate programs in speech-language pathology yields useful information from a perspective not frequently explored in prior literature. While the data presented in this study suggest the process is confusing and challenging to many applicants, the discussion highlights practical solutions and sheds light on key issues that should be considered carefully by individual graduate programs as well as the field as a whole.

Considering the Language Disorder Label Debate From a School Speech-Language Pathology Lens

2020 ◽  
Vol 5 (1) ◽  
pp. 47-54
Author(s):  
Kimberly A. Murza ◽  
Barbara J. Ehren
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Language Disorder ◽  
Public Awareness ◽  
Developmental Language Disorder ◽  
Speech Language Pathology ◽  
Speech Language Pathologist ◽  
School Based ◽  
Language Pathology ◽  
Education Act

Purpose The purpose of this article is to situate the recent language disorder label debate within a school's perspective. As described in two recent The ASHA Leader articles, there is international momentum to change specific language impairment to developmental language disorder . Proponents of this change cite increased public awareness and research funding as part of the rationale. However, it is unclear whether this label debate is worthwhile or even practical for the school-based speech-language pathologist (SLP). A discussion of the benefits and challenges to a shift in language disorder labels is provided. Conclusions Although there are important arguments for consistency in labeling childhood language disorder, the reality of a label change in U.S. schools is hard to imagine. School-based services are driven by eligibility through the Individuals with Disabilities Education Act, which has its own set of labels. There are myriad reasons why advocating for the developmental language disorder label may not be the best use of SLPs' time, perhaps the most important of which is that school SLPs have other urgent priorities.

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