Compensatory strategies have an immediate, but temporary effect on swallow safety; rehabilitative strategies may promote a long-term effect and change the physiology of the swallow. Oral motor control exercises b. 32. In the supraglottic swallow a person inhales, holds their breath, swallows, and then coughs to clear food residue from the larynx. Compensatory strategies may include postural adjustments, like a head turn or chin tuck, swallowing maneuvers, such as a Mendelsohn maneuver or supraglottic swallow and/or diet modifications. (Frymark et al 2009), Texture-give a variety of textures. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Posterior 1. C and D depict a deterioration in swallowing function and safety due to a diagnosis or health condition known to affect swallowing . DYSPHAGIA PROGRAM FOR PATIENTS ... • Attempt compensatory strategies. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. It doesn’t mean you have to give the person an unmanageable amount. How to avoid aspiration and choking . When deciding which behavioral techniques are most appropriate for our pediatric clients, … Compensatory techniques are used to alter the swallow, however compensations may not create a lasting effect to the swallow. ---Compensatory changes usually do not increase muscular effort or the duration of airflow closure, which tends to be a problem with patients who have a respiratory disease. stream History of the Use and Impact of Compensatory Strategies in Management of Swallowing Disorders Dysphagia. %PDF-1.3 Part V–Applications for clinicians and researchers. Compensatory Swallowing Strategies. PLAY. Types of Treatment: Compensatory Strategies a. Postural changes b. I use this often. Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. Use with oral containment issues (posterior loss of bolus resulting in aspiration). Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. Compensatory Strategies (use during meal) SpeechRamblings.weebly.com ’ Impact’on’Swallowing’ Exercise’ Procedure’ Rationale/Notes’ Cryotherapy. Treatment for Dysphagia: Matching Treatment to the Disorder . The Dysphagia by Rationale is a quick two sided cheat sheet organized by Dysphagia Diagnosis and presents recommended therapeutic strategies to attempt along with the rationales of why these treatments strategies are appropriate. Part IV–impact of dysphagia treatment on individuals’ postcancer treatments. Have the patient point exactly where. Trialing compensatory strategies does require the evaluating clinician to think critically and quickly, but wouldn’t you rather try this first than significantly … Part III–impact of dysphagia treatments on populations with neurological disorders. 3/1/2015 9 Identification/Screening If the patient is fed by staff, observe during mealtime to assess: • Rate of feeding • Patient’s response to different foods and liquids (textures, temperatures, flavors) • Patient’s behaviors during mealtime 33 Identification/Screening zThe accuracy of your bedside screening can be improved … 8 Overview: Components of a Comprehensive Dysphagia Program •Emphasis in both assessment and treatment is influenced by the characteristics of the client, his home environment, and his caregivers. This is usually at 90 degrees; however, therapists may find a different, more suitable position. Safe Swallowing Tips . The efficacy of postural compensatory strategies is a topic of debate throughout the literature and, clinically, should be used only after being tested using instrumental evaluation. Below is a list of common compensatory swallowing strategies. Dear Tffany, I´d like to ask you about the term: “posterior loss of bolus resulting in aspiration”. used for: - delayed onset of pharyngeal swallow - reduced BOT retraction to posterior pharyngeal wall - decreased airway protection - aspiration DURING swallow. McCoy, Y., & Wallace, T. (2018). Your speech pathologist will check the tips that will be most helpful for you. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. postural - chin up. Use when you see aspiration prior to or during the swallow. Oral vs. nonoral feeding. Dr. Jeri Logemann (1993) has suggested using compensatory strategies/maneuvers in the following order: Postural techniques; Sensory techniques; Maneuvers; Diet changes; Remember we can often change the swallow through sensory techniques. Fiberoptic endoscopic examination of swallowing safety: a new procedure. (Don’t try one texture only!! A. Frymark, T., Schooling, T., Mullen, R., Wheeler-Hegland, K., Ashford, J., McCabe, D., … & Hammond, C. S. (2009). intake … - often used with cancer pts. This handout gives tips to help lower your risk of aspiration and choking. Truth: The “chin tuck” is a popular compensatory strategy for swallowing impairments. Your speech pathologist will check the tips that will be most helpful for you. Subjects: Anatomy, Life Skills, Speech Therapy. Many times compensatory and rehabilitative techniques are used con-currently when treating children with dysphagia. DYSPHAGIA GOALS LONG TERM GOALS - SWALLOWING • Client will maintain adequate hydration/nutrition with optimum safety and efficiency of swallowing function on P.O. Closes the weak side of the swallow directing the bolus to the stronger side. Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. Journal of Rehabilitation Research & Development, 46(2). used for: - oral transit dysfunction. Dysphagia - Compensatory strategies. Model each, then have the patient demonstrate it back to you. McCabe, D., Ashford, J., Wheeler-Hegland, K., Frymark, T., Mullen, R., Musson, N., … & Schooling, T. (2009). Evidence-based systematic review: Oropharyngeal dysphagia behavioral treatments. McCabe, D., Ashford, J., Wheeler-Hegland, K., Frymark, T., Mullen, R., Musson, N., … & Schooling, T. (2009). While most compensatory strategies do not cause long-term effects to the swallowing system, some can be used as exercise to create a lasting effect to swallowing. May assist patients with poor oral control or difficulty propelling the bolus. * Educate patients and caregivers about the signs and symptoms of … Compensatory strategies provide a scaffold to a safer swallow by reducing the complexity of the swallowing task (Huckabee and Hughes 2013). The … Facilitates timing and extent of laryngeal closure at specific levels of the larynx. Dysphagia is difficulty in swallowing. Swallowing compensatory strategies may be spontaneously adopted, such as dose metering ... such as by performing swallowing compensatory behaviours (B). Sour has been known to stimulate a faster swallow. Oral vs. nonoral feeding. "���t��z/lD4��*�b�Bd F����A� {D��]*@�� ���"�0��������t@�d��Iԙ��cLV���d��vrΝ��Ɨ��N�U� [�5��e���B�SkJ_��|g�����4Mu�[S/8d����X�-�22ڜ��͂C�^H��)��C�X��6)�r;>�2�W�L�2f������B}�«5?�rmk]4Q*ʒ�7�5�d}�v������eT��S�;Z��ϽB5�&mnk��T׆M�2O-3��,��RWoyX�Jw͌���� ��ܿ?�����+Kr�ŷ��P�,����g2�x&�9M¹.3C�bS That is what the MBSS or FEES is for. postural - head turn. x�XKs�6��W�(�4�H=(�������L�v��n��l��yH�d�g�[|��,�j&!�>����z���*m�6��-�F�ty�kj{���o�sn�a�Ӓ�*�T�YjX�uZ�j��3b�'Fs"�9Y�P��w�q�����)Y�Xi�y�l�t��8�6��;%��ʔ���]������Ł�. Postural - chin tuck. When have we gotten away from trialing compensatory strategies FIRST instead of going right to the thickened? Wheeler-Hegland, K., Frymark, T., Schooling, T., McCabe, D., Ashford, J., Mullen, R., … & Musson, N. (2009). A … compensatory swallowing strategies and swallowing exer-cises may be used in combination to manage dysphagia sec-ondary to stroke. Compensatory Strategies Diet Characteristics. https://www.asha.org/PRPSpecificTOpic.aspx?folderid=8589942550§ion=Treatment. Part II–impact of dysphagia treatment on normal swallow function. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as … (May help you determine if thick liquids could be used therapeutically during sessions, not necessarily for diet changes.). STUDY. Some patients require a larger bolus to trigger the swallow. When deciding which behavioral techniques are most appropriate for our pediatric clients, … The Adult Dysphagia Pocket Guide: Neuroanatomy to Clinical Practice. Post was not sent - check your email addresses! Swallowing disorders, also called dysphagia (dis-FAY-juh), can occur at different stages in the swallowing process: ... (SLP) will utilize a combination of Compensatory Techniques and Direct Treatment strategies to improve the safety of oral intake by reducing your risk for aspiration and maintaining quality of life. Swallowing Strategies 11) Myth: People with dysphagia shouldn’t use straws. Just like compensatory strategies should be used for specific pathophysiological deficits, the same goes for diet changes. Thank you! postural - head tilt. Measuring Outcomes for Success…..What are You Using? 58 Broadly speaking, therapy can be differentiated into compensatory and rehabilitative strategies. Jul … Compensatory Strategies Part 3 To Thicken or Not To Thicken? When have we gotten away from trialing compensatory strategies FIRST instead of going right to the thickened? McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., & Frymark, T. (2009). 2). Oral and Pharyngeal ROM Exercises c. Sensory … Manual for the videofluorographic study of swallowing (Vol. •Compensatory Strategies •Exercise •Education . Logemann recommends 10x/day x5 min with 5-6 swallows each time as exercise. The handout lays out the basics of these types of thickeners, including main ingredients, shelf life, how they're thickened, and pros/cons. Austin, TX: Pro-ed. Other swallowing strategies involve sequential behavior modifications to alter the method for swallowing. 2017 Feb;32(1):3-10. doi: 10.1007/s00455-016-9779-6. See more ideas about Dysphagia, Swallowing disorder, Speech language pathologists. Patient may be more successful with a bolus they have to chew. %��������� Size-Patient may have difficulty with a small bolus vs. a large bolus or vice versa. postural - head turn . 11 Treatment: Compensatory, Postural, and Rehabilitation Strategies. used for: - delayed onset of pharyngeal swallow - reduced BOT retraction to posterior pharyngeal wall - decreased airway protection - aspiration DURING swallow. Compensatory strategies may be short term or used more long-term, such as with patients with head and neck cancer. Here’s a few things to ponder. Swallowing Strategies 1) POSTURAL CHANGES: a) Chin Tuck: i) Used For: (1) Delayed onset pharyngeal swallow (2) Reduced base of tongue retraction to posterior pharyngeal wall approximation (3) Decreased airway protection (4) Aspiration DURING the swallow ii) Instructions: (1) Bring chin to chest iii) Rationale: (1) Pushes base of tongue towards pharyngeal wall (2) Expands vallecular recesses (3) Narrows the … I really don’t want you going all Oprah and handing out thickened liquids to the masses. (Hyper).. (1993). Use with penetration/aspiration prior to or during the swallow. The explanation I’ve heard is that it provides increased oral/pharyngeal sensation for improved timing of the swallow. I really don’t want you going all Oprah and handing out thickened liquids to the masses. Compensatory Strategies Postural Adjustments- head tilt 1. Nelson Education. Wheeler-Hegland, K., Frymark, T., Schooling, T., McCabe, D., Ashford, J., Mullen, R., … & Musson, N. (2009). The time devoted to inpatient rehabilitation is also constrained by shortened LOS. The incredible Jeri Logemann (1993) suggested that we should trial a postural technique FIRST, and changes to the diet LAST. To help clear pharyngeal residue by altering gravity. requiring compensatory strategies for dysphagia. Usually, they do not involve the strengthening of the musculature. How to avoid aspiration and choking . Rehabilitation: Connecting exercises to specific deficits; Collaboration with registered dietitian; Sarcopenia, failure to thrive, frailty; Collaboration with the entire team (e.g., RN, OT, PT, physicians/NPs/PAs) and making appropriate referrals (e.g., GI, ORL, … According to Dysphagia Following Stroke (Daniels & Huckabee, 2014), a few key points to consider when deciding to recommend thickened liquids include: 1. Speech therapists instruct individuals in use of compensatory swallowing strategies, strengthening exercises, positioning and diet texture recommendations to increase overall safety when swallowing to promote a safe, healthy, and satisfying lifestyle. To close vocal cords prior to the swallow. Use for reduced PharyngoEsophageal (PES) opening. A Compensatory Strategy Review for Swallowing Disorders; Blog; Books; MBSimp Physiological Impairment Review; Podcast; The Step-by-Step Guide to Advocating for Access to Instrumentation; … For many, they’re temporary issues that can be managed with over-the-counter medicines and lifestyle changes. A very succinct and useful resource . Steele and Miller … Patients may respond to differing tastes. (A Compensatory Strategy Review for Swallowing Disorders Part 3) Are you absolutely certain that you should be thickening your patient’s liquids? Part I–background and methodology. Thank you in advance! Journal of Rehabilitation Research & Development, 46(2). 8 Overview: Components of a Comprehensive Dysphagia Program •Emphasis in both assessment and treatment is influenced by the characteristics of the client, his home environment, and his caregivers. When diagnosing and creating a treatment protocol it is always necessary to … compensatory swallowing strategies and swallowing exer-cises may be used in combination to manage dysphagia sec-ondary to stroke.