Dysphagia Assessment and Treatment Planning: A Team Approach

This textbook, now in its third edition, is ideal for graduate dysphagia courses in speech-language pathology programs. The unique value of this book is the multidisciplinary approach it presents. Too often, speech-language pathologists function clinically with insufficient interaction with, or understanding of, the roles of other professionals involved with their patients. This text incorporates information pertinent to the roles, tools, and views of a multidisciplinary dysphagia team, including physicians, speech pathologists, nurse specialists, and dieticians, that works together on a daily basis.

For the third edition, the authors have added a companion workbook that includes practical exercises accompanying each chapterfor example, a step-by-step tutorial for making objective measures of timing and displacement from fluoroscopic swallow studies. The exercises are designed to clarify and expand on information presented in the text and should be of interest not only to students but to practicing clinicians hoping to add new skills to their repertoires.

Previous chapters have also been thoroughly revised and updated, including new information on the following topics:

Effects of head and neck cancer, chemotherapy, and radiation therapies on swallowing
*Clinical and bedside assessments
*Survey instruments used by patients and clinicians
*How surgeries/treatments affecting the head and neck (e.g., cervical spine, thyroid) affect swallowing
*Greatly expanded information pertinent to unique features of dysphagia associated with CVA, neurogenic and neuromuscular disorders
*New information regarding reflexive interactions between esophagus and larynx that potentially influence swallowing
*Assessment in infants and children
*New tools for nonoral feeding
*Recommendations for dysphagia diets, and practical ways to implement these
*Rheologic characteristics of foods and how this information is incorporated in assessment and treatment planning
*The utility of endoscopy in assessment and treatment; how and why critical endoscopic observations (i.e., aspiration, penetration) may differ from fluoroscopy
*Greater discussion of radiation and need/recommendations for exposing patients to radiation
*The value and validation of the anterior-posterior esophageal screen
*New technologies and improvements in existing technologies for oral-pharyngeal and esophageal dysphagia assessment
*New information regarding swallowing in the normal elderly, with particular attention to utility of information in differentiating normal from disease
*Contribution of objective measurement data in treatment planning (in particular, the use of objective data to predict aspiration even when not observed on fluoroscopy)
*New tools for making measures in dynamic swallow studies that streamline the measurement process
*A comprehensive overview of behavioral, medical, and surgical approaches to dysphagia

The book comes with a DVD that includes an animated tutorial demonstrating techniques for objective measures from fluoroscopy studies. In addition, it includes both normal and patient fluoroscopy studies for review and measurement. The patient studies selected are representative of impairments typically observed in clinical practice (inpatient and outpatient). Other media clips illustrate each instrumental assessment technique introduced in the book (e.g., endoscopic, transnasal esophagoscopy, high resolution manometry), performed on a variety of dysphagic patients.

As noted, a separate workbook is also available to reinforce student learning of the concepts presented in the textbook and DVD.

With its updated and expanded content, Dysphagia Assessment and Treatment Planning, Third Edition highlights the most current evidence-based research as it applies to a team-based approach to clinical practice.