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[Dysphagia] Dysphagia Digest, Vol 46, Issue 7
I use the MCLA (Measures of Cognitive Linguistic Abilities) and like that!
Lisa Cole, SLP
Larkin Chase Nursing and Rehab Center
lisacoleslp at comcast.net
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com]On Behalf Of
dysphagia-request at dysphagia.com
Sent: Friday, September 07, 2007 1:57 PM
To: dysphagia at dysphagia.com
Subject: Dysphagia Digest, Vol 46, Issue 7
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When replying, please edit your Subject line so it is more specific
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Today's Topics:
1. off topic: cognitive evals (Laurie Baker)
2. Re: Anarthria (Irene Campbell-Taylor)
3. Re: off topic: cognitive evals (AnnaMaria Koo)
4. vital stim & mentallt retarded population
(Michele.Graziadei at dhs.state.nj.us)
5. FEES Workshop (Susan G. Butler/Otolaryngology)
6. off topic question (Suzanne Humes)
7. Re: Drooling (Suzanne Morris)
8. Re: Drooling (Dailey, Scott)
9. Re: vital stim & mentallt retarded population (Thompson, Elana)
10. Re: vital stim & mentally retarded population (Suzanne Morris)
----------------------------------------------------------------------
Message: 1
Date: Thu, 6 Sep 2007 14:28:16 -0700 (PDT)
From: Laurie Baker <lauriejeanb at yahoo.com>
Subject: [Dysphagia] off topic: cognitive evals
To: weebugga at charter.net, dysphagia at dysphagia.com
Message-ID: <67639.9392.qm at web51309.mail.re2.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
Just curious if those of you out there that do
cognitive therapy have any recommendations on
comprehensive cognitive assessment tools. I'm looking
for something with good norms in a large age range and
is fairly sensitive. I'm not a fan of the SCATBI,
Cognistat, or the RIPA b/c they either don't have good
norms or are not sensitive enough. The descriptions
for the DTLA-A, Wide Range Assessment of Memory and
Learning, and the Reynolds Intellectual Assessment
Scales sound good in the catalogues but I haven't used
them. Any comments on any of them or any other good
cognitive tools would be greatly appreciated.
Thanks so much!
Laurie Slovarp, M.S., CCC-SLP
Evergreen Healthcare
____________________________________________________________________________
________
Got a little couch potato?
Check out fun summer activities for kids.
http://search.yahoo.com/search?fr=oni_on_mail&p=summer+activities+for+kids&c
s=bz
------------------------------
Message: 2
Date: Fri, 7 Sep 2007 02:47:15 -0700 (PDT)
From: Irene Campbell-Taylor <eripley at yahoo.com>
Subject: Re: [Dysphagia] Anarthria
To: dysphagia at dysphagia.com
Message-ID: <739024.84965.qm at web30206.mail.mud.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1
Does anyone have experience with anarthria and swallowing? I have a patient
who has no volitional oral motor movement. Pt is s/p CVA.
*** I have had several patients who were anarthric and aphagic, usually
after a second stroke. Like the majority of stroke patients, they recovered
spontaneously within three months. Most remained dysarthric (pseudobulbar)
but able to eat/drink. How long is this patient post insult and where is/are
the lesions? Any comorbidities?
------------------------------
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End of Dysphagia Digest, Vol 46, Issue 6
****************************************
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
------------------------------
Message: 3
Date: Fri, 07 Sep 2007 09:26:19 -0400
From: "AnnaMaria Koo" <AnnaMaria.Koo at sjhc.london.on.ca>
Subject: Re: [Dysphagia] off topic: cognitive evals
To: <weebugga at charter.net>, <dysphagia at dysphagia.com>, "Laurie Baker"
<lauriejeanb at yahoo.com>
Message-ID: <46E1193B.00BC.008F.0 at sjhc.london.on.ca>
Content-Type: text/plain; charset=US-ASCII
Our S-LPs in the ABI program use the Woodcock Johnson, it has numerous
subtests to choose from.
Anna Maria Koo
Speech-Language Pathologist
Specialized Geriatric Services & NRC
SJHC, Parkwood Site
ext.42205
>>> Laurie Baker <lauriejeanb at yahoo.com> 9/6/2007 5:28 PM >>>
Just curious if those of you out there that do
cognitive therapy have any recommendations on
comprehensive cognitive assessment tools. I'm looking
for something with good norms in a large age range and
is fairly sensitive. I'm not a fan of the SCATBI,
Cognistat, or the RIPA b/c they either don't have good
norms or are not sensitive enough. The descriptions
for the DTLA-A, Wide Range Assessment of Memory and
Learning, and the Reynolds Intellectual Assessment
Scales sound good in the catalogues but I haven't used
them. Any comments on any of them or any other good
cognitive tools would be greatly appreciated.
Thanks so much!
Laurie Slovarp, M.S., CCC-SLP
Evergreen Healthcare
____________________________________________________________________________
________
Got a little couch potato?
Check out fun summer activities for kids.
http://search.yahoo.com/search?fr=oni_on_mail&p=summer+activities+for+kids&c
s=bz
_______________________________________________
Dysphagia mail list: Normal and disordered swallowing information
Dysphagia at dysphagia.com
Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
---------------------------------------------------------------------------
-----
The information transmitted is intended only for the person or entity to
which it is addressed and may contain confidential and/or privileged
material. Any review, retransmission, dissemination or other use of, or
taking of any action in reliance upon, this information by persons or
entities other than the intended recipient is prohibited. If you received
this in error, please contact the sender and delete the material from any
computer.
------------------------------
Message: 4
Date: Fri, 07 Sep 2007 11:36:39 -0400
From: Michele.Graziadei at dhs.state.nj.us
Subject: [Dysphagia] vital stim & mentallt retarded population
To: dysphagia at dysphagia.com
Message-ID: <a4d4e68759d3.46e137c7 at dhs.state.nj.us>
Content-Type: text/plain; charset=us-ascii
Does anyone have any information regarding Vital Stimulation Therapy with
the severe and profound developmentally disabled
population (MR)? I presently am employed at a residental facility for the
MR population -mainly severe & profound whom are not able to follow
directions. Thanks!!!!!
This E-mail, including any attachments, may be intended solely for the
personal
and confidential use of the sender and recipient(s) named above. This
message
may include advisory, consultative and/or deliberative material and, as
such,
would be privileged and confidential and not a public document. Any
Information
in this e-mail identifying a client of the Department of Human Services is
confidential. If you have received this e-mail in error, you must not
review,
transmit, convert to hard copy, copy, use or disseminate this e-mail or any
attachments to it and you must delete this message. You are requested to
notify
the sender by return e-mail.
------------------------------
Message: 5
Date: Fri, 7 Sep 2007 11:47:11 -0400
From: "Susan G. Butler/Otolaryngology" <sbutler at wfubmc.edu>
Subject: [Dysphagia] FEES Workshop
To: <dysphagia at b9.com>
Message-ID:
<9AEEF1FB6254224AA355ED285F849165250A52F4 at EXCHVS2.medctr.ad.wfubmc.e
du>
Content-Type: text/plain; charset="us-ascii"
October 26-27, 2007 Winston-Salem, NC
FEES Workshop
Two-day hands-on FEES Workshop where participants will:
learn how to perform FEES, learn how to interpret FEES,
understand when FEES is indicated, and learn how to
start and maintain a FEES program. In addition,
participants will obtain a minimum of 6-7 scope passes
under direct supervision. The FEES Workshop will be
held at the Center for Voice and Swallowing Disorders
at Wake Forest University School of Medicine housing
state-of-the art instrumentation and facilities.
Susan Butler, PhD, CCC-SLP has taught FEES Workshops
for over nine years and serves as the course instructor.
Earn 1.5ASHA CEUs. Cost: $515. Contact: 336-716-7157.
Susan G. Butler, PhD, CCC-SLP
Associate Professor
Center for Voice and Swallowing Disorders
Department of Otolaryngology
Wake Forest University Health Sciences
Medical Center Boulevard
Winston-Salem, NC 27157
Academic Office: (336) 716-7272
Academic Fax (336) 716-3857
Clinic: (336) 716-7157
Clinic Fax: (336) 716-8878
email: sbutler at wfubmc.edu
------------------------------
Message: 6
Date: Fri, 7 Sep 2007 12:36:08 -0400
From: Suzanne Humes <shumes at PINNACLEHEALTH.org>
Subject: [Dysphagia] off topic question
To: "'dysphagia at dysphagia.com'" <dysphagia at dysphagia.com>
Message-ID:
<7375E17267B3DB4583032BDEFDA2D76E01A8216A at mailphs.pinnaclehealth.org
>
Content-Type: text/plain
Does anyone know of or belong to a list serve for cognitive communication
disorders?
Thank you.
The information transmitted is intended only for the person or
entity to which it is addressed and may contain confidential
and/or privileged material. Any review, retransmission,
dissemination or other use of, or taking of any action in
reliance upon, this information by persons or entities other
than the intended recipient is prohibited. If you received this
in error, please contact the sender and delete the material
from any computer.
------------------------------
Message: 7
Date: Fri, 7 Sep 2007 13:16:09 -0400
From: Suzanne Morris <sem at new-vis.com>
Subject: Re: [Dysphagia] Drooling
To: dysphagia at b9.com
Message-ID: <87BB29D0-DD8D-409F-8CC1-9E865D67FE62 at new-vis.com>
Content-Type: text/plain; charset=US-ASCII; delsp=yes;
format=flowed
Equipment does not change oral motor patterns such as drooling. You
have to know, for example, why the individual is drooling (There are
a ton of different reasons). Then you have to know what treatment
strategies specifically address the problem and the changes you want
to make. Then you must have an idea of what type of equipment (if it
exists) could help you and your client reach your goals more
effectively or efficiently. Finally, you search to find the
equipment that meets your needs. Asking whether something like a
tongue scraper (or any other piece of equipment) would help drooling
is putting it all backwards. Somehow we've gotten the idea that our
treatment is the equipment. I can't tell you how many families I
have worked with who have the most complete collection of spoons,
cups, nipples etc. available and nothing "works". This simply
reflects the belief that the equipment will resolve the problem. A
piece of equipment is only valuable when it is appropriately targeted
as a partner in a treatment program that makes sense in addressing
the underlying components of the problem.
Suzanne
__________________________________
Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com
On Sep 4, 2007, at 8:57 PM, melissa zilberstein wrote:
I looke dover the Ark products. Is it the tongue scraper that you are
referring to?
------------------------------
Message: 8
Date: Fri, 7 Sep 2007 12:31:51 -0500
From: "Dailey, Scott" <scott-dailey at uiowa.edu>
Subject: Re: [Dysphagia] Drooling
To: "Suzanne Morris" <sem at new-vis.com>, <dysphagia at b9.com>
Message-ID:
<825A13A34899AB40A5039B9E1B71939F830125 at HC-MAIL12.healthcare.uiowa.e
du>
Content-Type: text/plain; charset="US-ASCII"
I agree with Suzanne. You only have to look at the baby section of any
store to find the marketing/labeling that would lead parents to think
that a particular nipple, bottle, cup etc is the best for their babies
or going to fix particular problems (gas is a big one). We must be
careful, ourselves, when looking not only at regular infant/toddler
utensils and equipment but also at "therapy" or "adaptive" equipment.
The adaptive equipment and therapy items are many times made by the same
companies who have the same MARKETING departments and strategies.
As a parent, I understand the desire to have an "easy" fix for a
difficulty, "the right nipple, the right bottle etc." The Marketing
plays into that. We need to be careful consumers and encourage parents
to be careful consumers also.
A careful assessment is with attempts to find out why (sometimes not
possible) is the basis for treatment and choice of equipment. Sometimes
it is not possible for us to do anything until the medical issues are
resolved. For example, large tonsils and adenoids leading to nasal
obstruction, therefore, the child mouth breaths and is drooling. The
airway issues need to be resolved before any treatment we offer will be
helpful.
Scott
Scott Dailey, MA, CCC-SLP
Department of Otolaryngology
University of Iowa Hospitals and Clinics.
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com] On Behalf Of Suzanne Morris
Sent: Friday, September 07, 2007 12:16
To: dysphagia at b9.com
Subject: Re: [Dysphagia] Drooling
Equipment does not change oral motor patterns such as drooling. You
have to know, for example, why the individual is drooling (There are
a ton of different reasons). Then you have to know what treatment
strategies specifically address the problem and the changes you want
to make. Then you must have an idea of what type of equipment (if it
exists) could help you and your client reach your goals more
effectively or efficiently. Finally, you search to find the
equipment that meets your needs. Asking whether something like a
tongue scraper (or any other piece of equipment) would help drooling
is putting it all backwards. Somehow we've gotten the idea that our
treatment is the equipment. I can't tell you how many families I
have worked with who have the most complete collection of spoons,
cups, nipples etc. available and nothing "works". This simply
reflects the belief that the equipment will resolve the problem. A
piece of equipment is only valuable when it is appropriately targeted
as a partner in a treatment program that makes sense in addressing
the underlying components of the problem.
Suzanne
__________________________________
Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com
On Sep 4, 2007, at 8:57 PM, melissa zilberstein wrote:
I looke dover the Ark products. Is it the tongue scraper that you are
referring to?
_______________________________________________
Dysphagia mail list: Normal and disordered swallowing information
Dysphagia at dysphagia.com
Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
------------------------------
Message: 9
Date: Fri, 7 Sep 2007 13:32:56 -0400
From: "Thompson, Elana" <EThompson at mountnittany.org>
Subject: Re: [Dysphagia] vital stim & mentallt retarded population
To: <Michele.Graziadei at dhs.state.nj.us>, <dysphagia at dysphagia.com>
Message-ID:
<5F6D273DE35E8044900B92C3BC005F66034E965C at mailapps.cch1.org>
Content-Type: text/plain; charset="iso-8859-1"
Michele,
While I have no particularly strong beliefs about whether or not VitalStim
is a good choice in dysphagia management (I have been certified in its use
since 2004), I can say that VitalStim is not supposed to be considered a
passive treatment approach. According to my training, in order for it to be
used ethically and efficaciously, it should be used in conjunction with
therapy techniques and/or compensatory strategy education. If a patient
cannot participate with that then it is questionable whether VitalStim
should be used.
Best of luck ...
-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com]On Behalf Of
Michele.Graziadei at dhs.state.nj.us
Sent: Friday, September 07, 2007 11:37 AM
To: dysphagia at dysphagia.com
Subject: [Dysphagia] vital stim & mentallt retarded population
Does anyone have any information regarding Vital Stimulation Therapy with
the severe and profound developmentally disabled
population (MR)? I presently am employed at a residental facility for the
MR population -mainly severe & profound whom are not able to follow
directions. Thanks!!!!!
This E-mail, including any attachments, may be intended solely for the
personal
and confidential use of the sender and recipient(s) named above. This
message
may include advisory, consultative and/or deliberative material and, as
such,
would be privileged and confidential and not a public document. Any
Information
in this e-mail identifying a client of the Department of Human Services is
confidential. If you have received this e-mail in error, you must not
review,
transmit, convert to hard copy, copy, use or disseminate this e-mail or any
attachments to it and you must delete this message. You are requested to
notify
the sender by return e-mail.
_______________________________________________
Dysphagia mail list: Normal and disordered swallowing information
Dysphagia at dysphagia.com
Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
------------------------------
Message: 10
Date: Fri, 7 Sep 2007 13:56:34 -0400
From: Suzanne Morris <sem at new-vis.com>
Subject: Re: [Dysphagia] vital stim & mentally retarded population
To: Michele.Graziadei at dhs.state.nj.us, dysphagia at b9.com
Message-ID: <4D51FF42-F558-48B0-B654-66BE01A85D91 at new-vis.com>
Content-Type: text/plain; charset=US-ASCII; delsp=yes;
format=flowed
I am not trained in VitalStim and thus, do not consider using it in
my practice. I have had extensive experience with individuals who
have severe and profound developmental disabilities. Many of these
individuals who have severe swallowing problems also have substantial
problems with muscle tone and movement coordination throughout their
body. The swallowing issues, in my experience, are rarely an issue
of the oral-pharyngeal mechanism independent of what is going on in
the rest of the body. The mouth and pharynx are very much
influenced by head and trunk position, postural tone and reflexive
movements. You may be able to stimulate specific muscles in the neck
that influence the physiological swallow, but this is going to be in
strong competition with the shifts in tone and movement that occur on
a daily basis with reflexes that respond to the vestibular input of
gravity and the proprioceptive stimulation of muscles in the neck.
From time to time I view videotapes of children who are receiving
VitalStim. Their parents will be participating in an intensive
workshop that I teach or I will be seeing the kids themselves for
assessment and treatment at a later time. I just reviewed one of
these recordings yesterday which shows a VitalStim session. It was
very similar to others I have viewed in the past. In this instance
the client was a young pre-teen boy who had been in a near-drowning
accident as a toddler. He shows stiff extension throughout his body
and strong hyperextension of his head/neck in all positions. While
sitting in his wheelchair his trunk is pulling down toward the left
side and there is increased tension and shoulder girdle elevation on
the right side. His ribcage is stiff and shows slight movement
predominantly in the upper thoracic and clavicular areas. His jaw is
open widely in a thrust position and there is limited jaw movement.
There is minimal movement of the facial muscles at rest or with
emotion. The electrodes for the VItalStim are on his neck and I
assume that stimulation is occurring throughout the session. In the
filmed treatment session the therapist stimulates his mouth with a
cotton swab with taste and then with small spoonfuls of pudding.
The stimulation of the mouth itself elicits greater lip/cheek
movement and some purse-string closure of the lips; slight downward
pressure of the spoon on the tongue stimulates a very weak and
inconsistent backward-forward suckle motion of the tongue. There is
intermittent coughing up of mucus and food, usually occurring after
the 3rd or 4th spoonful of pudding. This suggests to me that a
swallow is not being triggered (despite the therapists comments that
he has swallowed). I think that food i simply falling over the back
of the tongue and disappearing into the valleculae and pyriform
sinuses until they fill up and trigger the cough. What concerned
me the most about this session is that his head was in severe
hyperextension the whole time and at times went into greater
extension with the oral stimulation. The therapist was working on
lip closure and swallowing but with a wide-open jaw. We know that
neck hyperextension can increase extensor tone in the jaw and reduce
oral coordination. Mechanically it is extremely difficult to get a
good and efficient swallow with the head pushing back into extension.
So my question is a common-sense one. Why do we choose to use a
specialized piece of equipment (VitalStim) to stimulate specific
muscles in the neck for swallowing (even assuming that this does
work) when the underlying foundation for the swallow really isn't
there? This therapist and family have continued with VitalStim
because the child's MBS has shown some "improvement over time" (I
haven't seen copies of the MBS reports so I don't know the
specifics). But even if there is some improvement in this artificial
setting, how does this relate to his life and to how we choose to
spend our time and money to improve swallowing function?
I have worked with numerous children whose physical involvement and
cognitive impairment was similar to that seen in this boy. The focus
of treatment has been on working in an integrated way with postural
tone and movement to reduce tone and the constant stimulation of
reflexive movements. A major focus has been to reduce the extension
patterns in the body and neck and help the child learn how to get a
"soft body" or "soft neck" just with a verbal or touch reminder. This
is combined with oral stimulation of the suckle to elicit a stronger
and more sustained suckle-swallow movement pattern. I have found
that this has been highly effective, and children have learned more
functional swallowing skills (especially for handling their own
secretions and reducing the amount of drooling or need for constant
suctioning to clear the airway) without any electrical stimulation of
the swallowing muscles.
Suzanne
__________________________________
Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com
On Sep 7, 2007, at 11:36 AM, Michele.Graziadei at dhs.state.nj.us wrote:
> Does anyone have any information regarding Vital Stimulation
> Therapy with the severe and profound developmentally disabled
> population (MR)? I presently am employed at a residental facility
> for the MR population -mainly severe & profound whom are not able
> to follow directions. Thanks!!!!!
------------------------------
_______________________________________________
Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
End of Dysphagia Digest, Vol 46, Issue 7
****************************************
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