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[DYSPHAGIA] Swallowing Policy and Training Documents-Graduate and Professional Training

  • Subject: [DYSPHAGIA] Swallowing Policy and Training Documents-Graduate and Professional Training
  • From: janrc@pacbell.net (Jan Corwin)
  • Date: Sat, 21 Jul 2001 14:55:22 -0700
  • In-reply-to: <sb582e3d.065@asha.org>

In light of the current discussion on training, I reviewed the ASHA document
that Janet Brown brought to our attention. (Thanks, Janet.) I was very
impressed with the increased specificity of the information that we are
asked to acquire to evaluate and treat dysphagic patients.  I think the
training issues that remain involve standardizing the acquisition of the
knowledge base that this document advocates. Ideally, it should start at the
Graduate School level. As several list members have commented, there is
still a wide variety of training (or lack of) that graduate students
receive. The next step that I hope ASHA, or Division 13 can tackle is a
recommendation for graduate training in swallowing disorders-a
recommendation of certain amount and type of classes that students need to
take to aid in achieving the above policy recommendations.  It may mean
deciding early in graduate training if students want to specialize certain
treatment areas.
Is fluency a required class in most graduate programs?  It was in my
training.  It seems sad that Dysphagia class training may be optional, if it
is even offered.

I can see the problem with standardizing graduate training. It may add time
and expense and I wouldn't want to see that happen.  (I spent 10 years
paying off my graduate training student loans).  Dr. Jeff pointed out that
perhaps if enrollment in Dysphagia classes are low, this could be because of
lack of awareness of the central role of Dysphagia management in the
medical/neuro. caseload.  Maybe more voices need to be heard from the
working speech pathology community in our local graduate programs re: the
NEED to include dysphagia curriculum.

Training can only be begun at the graduate level.  Much of it will continue
as part of our professional careers.  It would be wonderful if optional
supervised Clinical Hours in the Area of Swallowing Disorders could be added
in the CFY year.  We are asked to dutifully record speech, language, voice,
fluency etc. eval and treatment hours in graduate training, but are not
required to have any in the area of swallowing.  When I graduated 20 years
ago, my second patient at the acute hospital where I did my CFY was a
swallowing patient.  I had had one lecture in graduate school from a
visiting professor-J. Logemann.  You can bet I went home and looked for
those notes!  Her book came out at the end of my CFY year.  I used to carry
it around with me for reference. I looked for classes.  It took me 2 years
to find one-J. Logemann came to Palo Alto, CA in 1984 and answered about 500
questions I had amassed in 2 years of professional work. (Dysphagia has
always been 80% of my caseload.) I basically had to self-train.  That is why
I have taken so many courses over the last 20 years in Dysphagia, because I
had to work so hard to acquire the knowledge-it has become so important to

Thank goodness now there is much more available out there for graduate
students and professionals.  Yet, there is still a need for standardized
professional training.  The problem with hiring a therapist with limited
experience in Dysphagia is the expense of training them. I believe it is an
investment in the quality of services provided, but I am not sure our
hospital administrators would see it my way.  (We found out yesterday, my
hospital is laying off 300 people by Aug 1.) If we're going to be committed
to post-graduate training, I wish we could develop a standardized, time
efficient aka cost effective training regimen.  We have a training program
at our hospital that I would be happy to share, if I can get permission from
my superiors.

Are we all doing on the job training?  What constitutes "experienced" or
"competent" in terms of mentored eval and treatment hours?  How many MBS's?
How many FEES? In the literature, there are more and more articles looking
at interrater reliability with bedside evals, MBS.  It would be interesting
to look back and see what their definitions of "experienced therapists"
involved re: eval and treatment hours.  Is anyone at ASHA or division 13
looking at this aspect of training?  Are there any papers coming that we can
look forward to?  (I must be getting hooked on peer review!)

I am interested to hear others who have thought about this area of training.
Thanks for bearing with my ruminations.


-----Original Message-----
From: owner-dysphagia@medonline.com
[mailto:owner-dysphagia@medonline.com]On Behalf Of Janet Brown
Sent: Friday, July 20, 2001 10:12 AM
To: dysphagia@medonline.com
Cc: jcarved@aol.com; Nswigert@aol.com; dlundy@med.miami.edu;
claz@northwestern.edu; sullivan@surgery.wisc.edu;
McculloughGaryH@uams.edu; lnewman@utmem.edu
Subject: [DYSPHAGIA] Peer Review for Updated ASHA-Special Interest
Division Swallowing Policy Documents

I hope all of you will take the opportunity to read and provide feedback for
updated swallowing policy documents that were developed by an ASHA-Special
Interest Division Working Group consisting of Joan Arvedson, Cathy Lazarus,
Donna Lundy, Gary McCullough, Lisa Newman, Paula Sullivan (Chair), and Nancy

The documents are: Roles of the Speech-Language Pathologist in Swallowing
and Feeding Disorders: Position Statement and Technical Report; and
Knowledge and Skills Needed by Speech-Language Patholgists Providing
Services to Individuals with Swallowing and/or Feeding Disorders.

You can access the draft reports at:
http://professional.asha.org/peer_review/dysphagia/index.htm and submit your
comments on line at that link by August 20.

Thanks for taking the time to provide your input, and thanks to the Working
Group for their months of effort in developing these drafts!


Janet Brown, MA CCC-SLP
Health Care Services in Speech-Language Pathology
American Speech-Language-Hearing Association
10801 Rockville Pike
Rockville, MD  20852
800-498-2071 x 4136

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