Dysphagia Sample Syllabi

Course Description

This course provides a thorough understanding of normal swallow physiology and its related disorders across the lifespan. Etiological factors are reviewed, noting the high risk categories for varied cultural groups. Instrumental diagnostic techniques are introduced. Emphasis is given to multiple management issues in general, as well as by varied cultural groups. Interdisciplinary approaches to the assessment and treatment of swallowing disorders are discussed.

Course Objectives

To describe the normal human deglutition process throughout the lifespan.
To understand the cause and effects of disorders on the swallowing mechanism.
To understand and experience the changing role of the speech-language pathologist in dysphagia practice.
To describe and integrate current research on normal and disordered swallowing.
To develop report writing skills for bedside and videofluoroscopic assessment approaches.
To develop a clear understanding of current assessment and treatment approaches for dysphagia management.
To demonstrate understanding of treatment approaches via completion of a treatment plan.
To demonstrate knowledge of theoretical and practical content via successful completion of a midterm and final examination.

Learning Objectives/KASA Expected Outcomes

1 Define language as a behavioral system comprising content (semantics), form (phonology, morphology, syntax), and use (pragmatics).

8 Recognize the medical model for SLP services in acute care, rehabilitation, and long-term care settings.

8a/IIIa, IIIb, 17-24 Describe the anatomic and neuromuscular systems involved in respiration, phonation, resonation, articulation, hearing, and swallowing.

12a 10. Possess skills in oral and written communication sufficient for entry into professional practice.

12b Demonstrate the speaking and listening ability necessary for effective clinical and professional interaction with clients/patients and their relevant others.

12c Be able to write and comprehend technical reports, diagnostic and treatment reports, treatment plans, and professional correspondence.

13 Demonstrate understanding and skill at use of instrumentation for the assessment and treatment of speech/language/hearing/swallowing functions.

15 Demonstrate the ability to analyze, synthesize, and evaluate information in the areas of basic human communication processes.

16/III-c Demonstrate knowledge of the nature of the following speech, language, hearing, and communication disorders and differences and swallowing disorders including their etiologies, characteristics, and anatomical/physiological, acoustic, psychological, developmental, linguistic and cultural correlates and principles and methods of prevention and assessment, and intervention.

16c, III-c, 55-64 - voice and resonance, including respiration and phonation.

16g, IIIc-85-94 - swallowing (oral, pharyngeal, esophageal, and related functions, including oral function for feeding; orofacial myofunction).

17 Demonstrate knowledge of standards of ethical conduct.

18 Demonstrate knowledge of processes used in research and the integration of research principles into evidence-based clinical practice.

19 Identify and use appropriate methods of qualitative and quantitative analysis.

19a Identify relevant variables in research design.

20 Know sources of research information and how to gain access to this information.

21 Have had experience critically evaluating and incorporating research relevant to professional practice.

22 Demonstrate knowledge of contemporary issues, including current professional clinical standards, accreditation requirements, and ASHA practice policies and guidelines; relevant legislation and regulations pertaining to students and adults with communication disorders; knowledge of policy and procedures at the federal, state, and local level; current models of evaluation and intervention; business practices; and reimbursement issue.

23/III-B, 26-33 Describe current surgical techniques related to communicative and swallowing functions, prosthetics.

24 Demonstrate knowledge about certification, specialty certification, licensure, and other relevant professional credentials.

25 Planning of goals and procedures.

27 Identify principles of collaboration among allied professionals, client, families in clinical practice.

30 Write recommendations for service (including long and short term goals).

41 Develop intervention goals and procedures with reference to the child's/adult's cultural and linguistic background, explicit theories defining language and its components, utilizing developmental taxonomies in the development of intervention plans.

46 Develop individual education/intervention plans with reference to baseline data (linguistic, maintaining factors) from evaluation of speech, language, hearing, and communication disorders.

47 Write appropriate long-term, short-term, and session goals.

50 Adhere to the ASHA Code of Ethics and behave professionally.

Required Text

Perlman, A.L., & Schulze-Delrieu, K. (1997). Deglutition and its disorders: Anatomy, physiology, clinical diagnosis, and management. San Diego: Singular Publishing Group.

Grading

Your grade will be based on the following:

Results from the two examinations (50%)
Videofluoroscopy reports (20%)
Class and lab participation/attendance (10%)
Observation/reaction paper (10%)
Treatment plan report (10%)

Class Outline

Week 1: Introduction

Course requirements
Overview and history of swallowing disorders management
Role of the SLP in dysphagia assessment, treatment and management
Overview of the anatomy & physiology of the normal swallow

Weeks 2 & 3: Anatomy & Physiology of the Normal Swallow (continued)

Neuromuscular controls
Respiratory functions related to deglutition

Weeks 4 & 5: Assessment Procedures

Medical chart review
Pharmacology
Direct clinical examination
Instrumentation-Videofluoroscopy
Fiberoptic nasoendoscopy (FEES)
Ultrasound
EMG
Manometry
Auscultation
Scintigraphy
Others

Weeks 5 & 6: Disorders of Swallowing

Etiological factors: neurogenic, structural, psychogenic
Signs and symptoms
Reaching a diagnosis
Introduction to esophageal disorders-symptoms, tests

Weeks 7 & 8: Treatment/Intervention

Examination #1
Treatment/intervention
Treatment planning: nutrition/hydration status
Management strategies
Treatment candidacy
Other referrals
Patient/caregiver/team education
Discharge planning
Clinical management: swallowing maneuvers
Compensatory postures/positioning
Bolus modification
Adaptive equipment
Physiotherapeutic exercises
Sensory stimulation
Biofeedback
Prosthetic/surgical management
Non-oral feeding

Week 9: Ethical Considerations

Patient rights/quality of life
Advanced directives
ASHA Code of Ethics
Insurance/reimbursement
Treatment/no treatment
PO versus NPO

Week 10: Pediatric Dysphagia

Review of the anatomy
Team issues
Assessment
Recommendations/treatment

Weeks11 & 12: Special Populations

Approaches to working with multicultural populations
Geriatrics-normal aging processes
Tracheotomized/ventilator dependent populations

Week 13: Final Examination

Assignments

Videofluoroscopy Reports (2)

Each student will be expected to hand in 2 written reports upon viewing the assigned videotaped examinations. Tapes and Sample Reports will be provided to each student in class.

Observation/Reaction Paper

Each student will be required to conduct an onsite observation of a Clinical Dysphagia Evaluation or a Videofluoroscopy. Paper is to include pertinent clinical information, as well as a personal reaction to the process. More information provided in class.

Treatment Plan Report

Each student will be expected to generate a Dysphagia Treatment Plan, based on diagnostic data provided by the Instructor.