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As discussed in our first episode on feeding and swallowing (Feeding and Swallowing in Schools: Foundational Knowledge), treating feeding and swallowing disorders can be a very daunting task, and it’s not always clear where to begin. Is it an issue with feeding or swallowing? How do you know it’s a sensory based feeding issue and not just behavior? What if you don’t know how to thicken liquids? What if you make a mistake? Begin brain explosion. We had the pleasure of welcoming back Tracey Callahan for this second episode on feeding and swallowing to walk us through it. Thank you again for joining us Tracey!

There are a lot of resources for how to treat feeding and swallowing deficits, including the International Dysphagia Diet Standardisation Initiative, scouring the ASHA website, digging through the dusty graduate school books that you knew you would need some day, crowdsourcing on social media, amazing podcasts (looking at you Dysphagia Cafe, First Bite, Swallow your Pride, and Down the Hatch), and collaborating with a team. And like every other treatment intervention, what resources you use will depend on the presentation of your client. Will you use a compensation technique or a rehabilitative technique? Will you collaborate with your OT to brainstorm positioning? Or a BCBA to identify reinforcers or break a feeding task into discrete steps? Or maybe you will spend a few sessions building trust and rapport - one of the most important aspects of feeding and swallowing therapy. In this episode we review each of these treatment strategies and discuss how and when they may be effective with someone with experience. We hope that after listening that you feel better prepared and equipped to interpret reports and make decisions about therapy.

ASHA Professional Development hours are offered for this course (1 certification maintenance hour). Visit our ASHA Professional Development page for more information.

Learning Outcomes

1. Identify and define at least 2 modifications and compensation strategies commonly used in feeding and swallowing therapy

2. Identify and explain at least 2 exposure strategies to address sensory-based feeding issues

3. Define and explain food chaining techniques

References

Bahr, D. C., (2001). Oral motor assessment and treatment: Ages and stages, Boston: Allyn & Bacon.

Mccauley, Rebecca & Strand, Edythe & Lof, Gregory & Schooling, Tracy & Frymark, Tobi. (2009). Evidence-Based Systematic Review: Effects of Nonspeech Oral Motor Exercises on Speech. American journal of speech-language pathology / American Speech-Language-Hearing Association. 18. 343-60. 10.1044/1058-0360(2009/09-0006).

Online Resources

Food Chaining Adapted from Verna M. Baker, M.S., R.D., L.D. Cheri Fraker, CCC/SLP, CLC and Laura Walbert, CCC/SLP, CLC: https://www.sensorysolutions.org/application/files/2214/9815/7292/Food_School_Handout-1.pdf

The International Dysphagia Diet Standardisation Initiative: https://iddsi.org/

ASHA Information on ICF: study: https://www.asha.org/uploadedFiles/ICF-Pediatric-Feeding-Swallowing.pdf

ASHA Resources on pediatric dysphagia: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Treatment

Disclosures:

Financial: Tracey is currently employed in a private practice setting in Boston MA, owns her own practice and is launching a new online learning platform called guest monster games. Kate Grandbois is the owner / founder of Grandbois Therapy + Consulting, LLC and co-founder of SLP Nerdcast. Amy Wonkka is an employee of a public school system and co-founder of SLP Nerdcast.

Non-financial: Tracey is a member of ASHA and the corresponding special interest group for Dysphagia (SIG 13). Kate and Amy are both members of ASHA, SIG 12, and both serve on the AAC Advisory Group for Massachusetts Advocates for Children. Kate is a member of the Berkshire Association for Behavior Analysis and Therapy (BABAT), MassABA, the Association for Behavior Analysis International (ABAI) and the corresponding Speech Pathology and Applied Behavior Analysis SIG.

Time Ordered Agenda:

10 minutes: Introduction, Disclaimers and Disclosures

20 minutes: Descriptions of modifications and compensation strategies commonly used in feeding and swallowing therapy

15 minutes: Descriptions of exposure strategies to address sensory-based feeding issues

10 minutes: Descriptions of food chaining techniques

5 minutes: Summary and Closing

Disclaimer

The contents of this episode are not meant to replace clinical advice. SLP Nerdcast, its hosts and guests do not represent or endorse specific products or procedures mentioned during our episodes unless otherwise stated. We are NOT PhDs, but we do research our material. We do our best to provide a thorough review and fair representation of each topic that we tackle. That being said, it is always likely that there is an article we’ve missed, or another perspective that isn’t shared. If you have something to add to the conversation, please email us! Wed love to hear from you!__

SLP Nerdcast is a podcast for busy SLPs and teachers who need ASHA continuing education credits, CMHs, or professional development. We do the reading so you don’t have to! Leave us a review if you feel so inclined!

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