[Dysphagia] Cross training

[mbuckie at dmc.org (Buckie,Marcia)]

I haven't read the ASHA document in it's entirity, but it sounds like you have a well defined set of expectations. I am just venturing a guess here, but I think the document in question came about because of situations that I have heard about related to the 1500 therapy cap where SLPs were asked to train OTs to do dysphagia because they could be reimbursed. I don't think there were standards in place that were nearly as high as those established by your state board.
 
I have only worked in one geographic region, and  my experience with OTs working in dysphagia is quite different. I do believe that with proper training, most allied health professionals  PT (have an even more rigorous medical background) OT, RD, maybe respiratory even? could have a role in dysphagia. But having worked with maybe 50 different OTs and SLPs, coming out of the starting gate (college) the SLPs had far more ground work in anatomy and physiology.
 
Before someone even launches into the shortcomings of SLPs in dysphagia...they have been well documented..I am not saying that our profession does not have a long ways to go in this area. We do, indeed. Based on MY experiences, the OTs I work with are not able to divide their clinical and cont. ed time among ADLS, splinting, transfers, vision, etc, etc. and also include the complexity of dysphagia. Please note I said: the OTs I personally worked with. 
 
MBuckie

	-----Original Message----- 
	From: dysphagia-bounces@b9.com on behalf of v.cooper 
	Sent: Thu 10/7/2004 8:32 PM 
	To: Irene Campbell-Taylor; Dysphagia@b9.com 
	Cc: 
	Subject: Re: [Dysphagia] Cross training
	
	

	With regards to this: In California, the board of OT specifically states
	that OTs can practice dysphagia under the supervision of an SLP while
	obtaining their hours (240 direct tx and 45 ed hours). Interesting that this
	was written in conjunction w/the ST licensing board. Clearly the STs on our
	state board did not feel that it was a violation of the code of ethics. I am
	currently supervising a highly competant OT who quite frankly has more
	education and knowledge of dysphagia than almost any of my 16 CFYs ever had
	when starting. I do not feel that I am violating any code of ethics. What do
	others think?
	----- Original Message -----
	From: "Irene Campbell-Taylor" <eripley@yahoo.com>
	To: <Dysphagia@b9.com>
	Sent: Thursday, October 07, 2004 8:09 AM
	Subject: [Dysphagia] Cross training
	
	
	>
	> Something has come to my attention that is really
	> unacceptable and it is this:
	> With respect to presentations for continuing education
	> etc. :
	>
	> "ASHA would like the instructors to be aware that
	> training individuals other than SLPs may be in
	> violation of the ASHA Code of Ethics."
	> Can someone explain to me, please, which ethical code
	> this would be violating?
	> It goes on:
	> "Please note that ASHA has approved a position
	> statement regarding speech-language pathologists
	> training and supervising other professionals in the
	> delivery of services to individuals with  swallowing
	> and feeding disorders.  Instructors who are ASHA
	> members and/or hold ASHA's Certificate of Clinical
	> Competence may be in violation of ASHA's Code of
	> Ethics if they train professionals other than
	> speech-language pathologists in this area ......do not
	> support cross-training of clinical skills at a
	> professional level because the welfare of individuals
	> served may be compromised when SLPs cross-train other
	> professionals to provide these services."
	>
	> Were I an ASHA member involved in such activities or
	> teaching at a university that allows any and all
	> academically qualified individuals to attend any class
	> of their choosing, I would be deeply insulted at the
	> implication that my teaching say, a dietitian,  or an
	> OT who wanted to take my class would "compromise"
	> their patients.
	>
	> "Speech-language pathologists (SLPs) are primary
	> providers of evaluation and treatment for swallowing
	> and feeding disorders"
	> According to whom? ASHA? When there is not yet any
	> type of specialization, certificate or clear
	> qualification in the field? Just because someone
	> claims something doesn't make it so. And the American
	> Gastroenterological Association has a position
	> statement saying that they are the primary providers
	> of care and management. I would say the same thing to
	> them - just because you claim it.. The thought of
	> having gastroenterologists doing clinical evals plus
	> VFSS plus therapeutic intervention would be laughable
	> if they weren't serious about it.
	> "The unique foundation acquired by SLPs in their
	> professional education and training provides the basis
	> for the integration of the highly specialized
	> knowledge and skills necessary for this role;"
	>
	> Following on the heels of public statements by ASHA
	> officials about the numbers of SLPs who receive no
	> formal training, are given false or outdated
	> information in courses etc. etc. this statement is
	> verging on the ludicrous as well as being arrogant
	> almost beyond belief.
	>
	> "this foundation is not transferable to members of
	> other professions."
	>
	> Why not, if it exists? And, as a member of another
	> profession, who has taught SLPs, dietitians, OTs,
	> physicians, nurses and others for many years,
	> published in leading medical journals, produced
	> teaching materials, and performed research, I am
	> stupefied and offended.
	>
	> And then: "This position statement does not apply to
	> sharing information with other professionals for
	> purposes such as teaching another professional how to
	> screen for potential dysphagia so that a referral can
	> be made to the speechlanguage pathologist; advancing
	> the scientific knowledge base across
	> professions;......
	>
	> How is advancing this knowledge base any different
	> from training?
	> Can anyone defend this document and, if not, why does
	> it exist?
	>
	>
	>
	> =====
	> Dr I Campbell-Taylor
	> Clinical Neuroscientist
	> Exclusive Distributor:
	> www.interactivetherapy.com
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