Understanding Dysphagia – Details, episodes & analysis

Guests: Jessica Conn and Hilary Cooper - One of our favorite topics is the SLP’s role in advocacy, and today we are joined by some of the fiercest advocates around. Jessica Conn is a Visiting Clinical Instructor at Stephen F. Austin State University, where she teaches undergraduate and graduate coursework, including dysphagia and neurogenic communication disorders. She also owns East Texas Swallow Diagnostics, a mobile FEES company serving the broader East Texas area. She is currently the Director of University Relations for the Dysphagia Outreach Project as well. Hilary Cooper, our second guest, is a self-proclaimed dysphagia nerd who has extensive experience with pediatrics and adults in a variety of settings. She owns North Louisiana Swallow Solutions, a mobile FEES company, and is the President and CEO of the Dysphagia Outreach Project. In today's episode, after hearing about how Jessica and Hilary became SLPs, we dive into advocacy. We talk about how it differs from education, the importance of getting involved at state and national levels, and why advocacy needs to be a part of curriculums. We also get into some specific ways that you, as an SLP, can advocate for your patients and their families, who are constantly faced with the injustice and systemic inequality in our healthcare system. To hear more from these inspiring women, tune in today!

Guest: Dr. Raquel Garcia - As SLPs, it is so important that we maintain a spirit of continual learning, and today's guest, Dr. Raquel Garcia, is an exemplary example of a life-long learner. She is a trained craniofacial speech-language pathologist and works at Joe DiMaggio Children's Hospital, where she is a core member of the craniofacial team. Raquel works in the acute care setting in the neonatal
intensive care unit and pediatric cardiac intensive care unit. In this episode, Raquel talks about
her journey to becoming an SLP and how she found her current niche. We dive into a range of
infant airway disorders, where Raquel thoroughly guides us through what we should be looking
out for. While it may appear overwhelming, Raquel is gifted at explaining complicated concepts
in a digestible, accessible manner. Our conversation also touches on the importance of
authentically connecting with other practitioners, the power of remembering our why, and
understanding the key role that the community SLP plays in helping patients and their families
overcome their difficulties. Raquel's passion for her craft is truly inspiring, so tune in to hear it
all!

Guest: Caitlin Saxtein MS, CCC-SLP, BCSS, CBIS: For this episode of the Understanding Dysphagia Podcast, we are joined by Caitlin Saxtein to talk about end-of-life care and palliative care. Caitlin Saxtein MS, CCC-SLP, BCSS, CBIS is a medical speech-language pathologist currently working in the acute care setting and has experience in subacute, rehabilitation, outpatient, and home health. She also has an extensive background with East End Hospice, having volunteered with them for nearly 15 years. In our conversation, we talk with Caitlin about how she became passionate about end-of-life care during her many years of volunteering and what she has learned working in the field of
palliative care. Palliative care is sometimes assumed to mean end-of-life care, even among
some health workers, but this is not necessarily the case. Caitlin unpacks the term and
explains how palliative care is distinct from hospice care, describing palliative care as
specialized medical care for people living with a serious illness to improve the quality of life for
patients and their families. We discuss alternate means of nourishment and why feeding a
loved one who is ill is so significant for a family. Later, we discuss advance directives, outlining
what they are and how they impact your medical choices when you can no longer make them
yourself. We wrap by hearing from Caitlin about how she practices self-care, especially during
the COVID-19 pandemic. For all this and much more, join us today for a wonderful
conversation about Caitlin's experiences with palliative care!

Guest: Sarah Breshears, MA, CCC-SLP: Today we continue our special series in collaboration with the Dysphagia Outreach Project in honor of Dysphagia Awareness Month, this time to speak about strokes with Sarah Breshears. This amazing woman is an SLP in her sixth year of practice working in an acute hospital setting, is the creative powerhouse behind Short and Sweet Speech, and on top of it all, she is the Instagram Manager for Dysphagia Outreach Project. She leads a team of five women who work to create content that is engaging, informative, and reaches those who would benefit from
DOP’s mission. We kick things with the moment of divine intervention that set Sarah off on her
track to becoming an SLP before chatting about how she got involved with DOP. From there, we
wind our way into the heavy topic of strokes, beginning with what happens to the brain when
somebody has one, the effects it can have on their life, and how to recognize early symptoms.
We also get into how strokes can result in dysphagia, and then move onto best practices for
intervention and recovery, where we highlight the necessity of PT and OT. Our conversation
covers the importance of instrumental assessment for dysphagia and the dangers of
recommending the chin tuck swallow wholesale as well. Before wrapping up, Sarah gives us all
her top tips for lowering the risk factors for strokes, so be sure to listen along with us today and
learn all that Sarah has to share.

Guest: Kristen West, MS, CCC-SLP - Everything is connected within the realm of SLP; nutrition, education, family dynamics, environmental factors, to name but a few. Our guest today works at the intersection of all of these. Her name is Kristen West, and she is an expert on all things related to Pediatric Feeding Disorder (PFD). One in 37 children under five in the United States struggle with PFDs, and we are thrilled that there is soon to be an ICD 10 code that accurately captures PFDs for the first time. Alongside numerous other roles, Kristen is the Director of Education for the Dysphagia Outreach Project (DOP), and the work she is doing through this organization is what forms the basis of our conversation today. Kristen is passionate about equipping communities with the skills and resources they need in order to ensure the best possible outcomes for children with feeding and swallowing issues. The lack of continuity of care, overarching feeding programs, and funding, make this a difficult task, but Kristen is well prepared for the challenge. Kristen shares with us today what she has learned over many years about bridging the gap between knowledge and action, sharing resources, transition meetings, and the importance of getting everyone on board with the mission to help children who are struggling with PFD’s. Feeding is a paramount life skill, and the interventions that DOP is implementing, are changing lives!

Guest: Brooke Beilman, MS, CCC-SLP - Today’s episode is dedicated to the SLP’s role in head and neck cancer and we invite Brooke Beilman, MS, CCC-SLP, to speak about this important subject. Brooke is an SLP with experience in acute care, inpatient rehab, outpatient rehab, and skilled nursing settings. With certifications in manual interventions like myofascial release, neuromuscular electrical stimulation, NMES, and the Mcneill Dysphasia Therapy Program, Brooke is as brilliant as she is kind. We kick things off by hearing about how Brooke got the idea to become a speech pathologist and then bring this proactive intervention to patients with head and neck cancer, thereafter helping to develop a rehabilitative program for these patients during her CF. From there, we discuss the rise of the role of HPV in the development of head and neck cancer in younger patients and the implications of this. We get into the signs and symptoms of head and neck cancer, common treatment forms used by oncologists, and how this differs from those used by an SLP. Next up, we take a deep dive into the role of lymphatic impairment in head and neck cancer. Brooke helps us understand the lymphatic system and the role it plays in the body, and also weighs in on the condition of lymphedema and the role of myofascial release in treating it. We wrap things up with a conversation about functional aspiration as well as scope of practice and the role of the SLP in treating head and neck cancer patients. Tune in today!

Guest: Jessica Lasky, MS, CCC-SLP - For this episode of the Understanding Dysphagia Podcast, we are joined by Jessica Lasky to talk about trauma and ARF (not to be confused with adult ARFID)! Jessica is a medical SLP that specializes in dysphagia in the adult geriatric population. She is the founder of Mobile Scope and Evolutionary Education Solutions, and also co-founded the Dysphagia Outreach Project. We talk about the issue of patients having no access to resources after discharge and how this led to the founding of the Dysphagia Outreach Project. Our conversation then takes a deep dive into the many misconceptions and outlying cases that Jessica has experienced in her time working in outpatient neuro-rehabilitation, stroke, and trauma one hospitals, acute rehab facilities, and more. We hear about the discovery of foreign objects as well as atypical presentations from stab wounds and withdrawal, hardware in the cervical spine, and more. Jessica talks about a few of the times she has been in public and noticed that a person was presenting with symptoms and how she took action. In the last part of our conversation we get into the important issue of the utilization of interprofessional practice in our patients’ care, hearing Jessica weigh in on the other clinicians who help her bolster her practice and understanding of the respiratory system every day. Tune in for a brilliant conversation about the wide scope of Jessica’s experiences with dysphagia patients today!

Guests: Maggie Donaker, MS CCC-SLP & Katie Gollin, MS CCC-SLP - To honor Dysphagia Awareness Month, we have linked up with the Dysphagia Outreach Project to speak to some of their amazing leaders and spread their expertise and knowledge as far as possible! We are bringing you this ten-part podcast series and today's focus is neurodegenerative dysphagia. To help us understand these important subjects we are joined by Maggie Donaker and Katie Gollin, who give us some great insight, focusing on three of the main conditions under this umbrella: ALS, Parkinson's disease, and Guillain-Barre syndrome. Maggie is a medical speech-language pathologist, who has been awarded seven ASHA ACE awards! As a young medical speech-language pathologist, Katie currently works full-time in the acute care setting, with experience in inpatient rehab and skilled nursing too. In today's exploration we get some great high level, as well as specific information on these three topics, with our guests introducing each and also sharing some personal experiences and advice on diagnoses, treatments, and education. It is particularly illuminating to hear about how these conditions affect adults, with so much of what we usually do focusing on younger ones! So for a great show, packed with useful information and helpful tips and thoughts, be sure to join us!

Guest: Casey Lewis, MS CCC-SLP, CNT, NTMTC - June is Dysphagia Awareness month, and to honor this time, we have decided to do a ten-part mini-series with the Dysphagia Outreach Project. They have brought together some incredible leaders to share their knowledge in hopes of raising awareness about dysphagia across the life continuum. Casey Lewis, MS, CCC-SLP, CNT, CLC, NTMTC, works in the NICU, in the world of swallowing and swallowing breakdown, which is right where it all starts. In today’s episode, Casey sheds light on the development process of suck, swallow, and breathe, and the work that she does. Importantly, Casey understands that her role is to educate and empower parents, staff, and families so that they can all help the babies in the best way possible. We talk about the steps Casey takes in her interventions, some of the tools she uses, like bottles and pacifiers, and the outcomes she hopes to see. Another vital part of working in a NICU is collaborating with other practitioners, and Casey talks about the hard work she has put in to ensure that her voice is heard and respected. Sometimes, we get caught up in our own bubbles, and we forget that we all simply want the best for our patients. Casey reminds us of just how important it is to reconnect with our why.

Expert Panel: Amy Hobek, PhD, CCC-SLP, Fé González Murray, EdD, CCC-SLP, Vishnu KK Nair, Archie Soelaeman, Betty Yu and Reem Khamis

Take ACTION HERE: Changes to 2020 certification standards feedback. Survey. (n.d.). https://www.surveymonkey.com/r/2020_Cert_Changes

This episode will be available for 0.1 ASHA CEU on July 2

Correction Note from Dr. Betty: “During the recording I referred to the executive order targeting associations with assets of $500 million or more. I thought ASHA met that criteria but actually ASHA’s net assets are around $174 million.”

In this episode, Michelle and Erin host an all start line up of colleagues from across the globe to discuss ASHA’s Proposed Changes to the “2020 Certification Standards” and the long-term ramifications that these changes could have for our profession. This conversation is timely in that there are only a matter of days, roughly 3 weeks or less, for audiologists and speech-language pathologists (including students) to write in and advocate to ASHA on whether the proposed changes to the 2020 Certification Standards should be accepted… changes that remove key words and language that were hard fought to obtain. Be informed that this conversation does address political rationale behind the changes and offer a plethora of resources for individuals to grow their knowledge regarding the long-term ramifications of these proposed changes… but it ends with resources on how to make your voice heard! So, come join the ladies of “First Bite” and ADVOCATE!

About the Panel:

Amy Hobek, PhD, CCC-SLP is an Associate Professor of Communication Sciences and Disorders at the University of Cincinnati. Her teaching and scholarship focus on equity and inclusion, with an emphasis on valuing and legitimizing cultural and linguistic variations in these areas within individuals, families, and communities. She is also a licensed speech language pathologist providing clinic supervision of graduate students in a culturally and linguistically diverse preschool setting on UC’s campus. She is a co-chair of the Cultural Humility Task Force of the National Black Association of Speech Language and Hearing. She is a topic co-chair of Equity, Inclusion, and Cultural-Linguistic Diversity for the ASHA 2025 Convention.

Professor Reem Khamis (also known as Reem Khamis-Dakwar) is Professor Emerita at Adelphi University and Chair of the Department of Communication Sciences and Disorders at Long Island University (LIU) Brooklyn. Her expertise centers on language development, processing, and clinical services within the sociolinguistic context of diglossia and diverse populations. Dr. Khamis is co-founder of the Journal of the Critical Study of Communication and Disability (JCSCD) and a co-founding member of the Speech, Language, and Hearing Scientists Equity Action Collective. She currently serves as Language Section Editor for the Journal of Speech, Language, and Hearing Research (JSLHR). She received the Excellence in Diversity Award in 2020 from the Council of Academic Programs in Communication Sciences and Disorders (CAPCSD).

Fé González Murray, EdD, CCC-SLP is an Associate Clinical Professor in the Department of Communication Sciences and Disorders at Northern Arizona University. Prior to joining the NAU faculty, she worked for 25 years as an English/Spanish bilingual speech-language pathologist in various settings, most notably in public schools serving Indigenous American, migrant, and immigrant populations. In addition to teaching and supervising clinical rotations, she facilitates workshops nationally and internationally on topics related to responsive practice with culturally and linguistically diverse individuals and their families, including multilingualism and collaboration with interpreters.

Vishnu KK Nair is a lecturer in the School of...