[Dysphagia] RE: Response to Jonathan Bennett

[scott-dailey at uiowa.edu (Dailey, Scott)]

In my impression section of my report, I discuss all the factors that may be impacting eating and swallowing (medical condition, medications, environment, etc)  Then in my recommendations section, I usually phrase it as "consider further evaluation of GERD"  "consider medication effects on swallowing"  etc rather than telling the doctor what to do.  My evaluation is a consult, and the doctor can take the information from my assessment and other consults and hopefully consider the entire patient to make changes in the medical care.  The patient/family also has to consider factors also.
 
Scott Dailey, MA, CCC-SLP
Speech-Language Pathologist
University of Iowa Hospitals and Clinics

	-----Original Message----- 
	From: dysphagia-bounces@b9.com on behalf of Jonathan Bennett 
	Sent: Tue 1/3/2006 6:53 PM 
	To: dysphagia@b9.com 
	Cc: 
	Subject: [Dysphagia] RE: Response to Jonathan Bennett
	
	

	  Dr. Campbell-Taylor I greatly appreciate your response to my  questions.  A question I would love to be answered is for those speech  therapists currently working in the field, since we are basing our  practice on the information we were taught in school, is there a good  reference book or books that we can turn to help guide us in more  evidence-based dysphagia therapy.  I am so often finding myself wanting  to get away from "traditional" dysphagia therapy but have no new references to guide me in how to diagnose AND treat dysphagia.
	 
	  Question #2, however ignorant this may sound, is what should one say a  SLP's "role" in dysphagain therapy is?  If we went by our basic  teaching in school, we are to, basically, thicken liquids, change diet  consistencies, suggest NPO status, and engage in therapy such as oral  thermal stim, muscles strengthening, etc (which I am also quite  hesitant on using, considering the lack of evidence to back it  up).  These are also what the doctors look at us to do and see as  our role.  Are we to say, "I'm finding deficits suggesting damage  to cranial nerve ___ which I believe is affecting his swallowing.   This is something you may need to look into," or "I believe 'this'  medicine is the patients problem...maybe you should consider changing  it."  Will the doctors not think of this as stepping on their  territory?  Or, do SLP's really have a position in dysphagian  treatment at all?  Should this just be left to the MD's?  In  reality, what IS our "role"and how do we defend i!
	 t if it
	 is not the  "traditional" way of approaching it?
	 
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