Oropharyngeal Dysphagia Assessment and Treatment Efficacy: Setting the Record Straight (Response to Campbell-Taylor)

Coyle, James L.; Davis, Lori A.; Easterling, Caryn; Graner, Darlene E.; Langmore, Susan; Leder, Steven B.; Lefton-Greif, Maureen A.; Leslie, Paula; Logemann, Jeri A.; Mackay, Linda; Martin-Harris, Bonnie; Murray, Joseph T.; Sonies, Barbara; Steele, Catriona M.

doi:10.1016/j.jamda.2008.10.003

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Volume 10, Issue 1 , Pages 62-66, January 2009

Oropharyngeal Dysphagia Assessment and Treatment Efficacy: Setting the Record Straight (Response to Campbell-Taylor)

James L. Coyle, PhD, CCC-SLP, BRS-S
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
Lori A. Davis, EdD, CCC-SLP
- Department of Communication Disorders, University of Tulsa, Tulsa, OK
Caryn Easterling, PhD, CCC-SLP, BRS-S
- Department of Communication Sciences and Disorders, University of Wisconsin-Milwaukee, Milwaukee, WI
- Veterans Admin istration Medical Center, Milwaukee, WI
Darlene E. Graner, MA, CCC-SLP, BRS-S
- Mayo Clinic, Rochester, MN
Susan Langmore, PhD, CCC-SLP, BRS-S, ASHA Fellow
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, MA
- Department of Speech and Hearing Sciences, Boston University, Boston, MA
Steven B. Leder, PhD, ASHA Fellow
- Yale University School of Medicine, New Haven, CT
Maureen A. Lefton-Greif, PhD, CCC-SLP, BRS-S, ASHA Fellow
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD
Paula Leslie, PhD, CertMRCSLT(UK), CCC-SLP
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
Jeri A. Logemann, PhD, CCC-SLP, BRS-S, ASHA Fellow
- Departments of Otolaryngology-Head & Neck Surgery, Neurology, and Communication Sciences and Disorders, Northwestern University. Evanston, IL
Linda Mackay, MA, CCC-SLP, BRS-S
- Saint Francis Hospital and Medical Center, and Specialty Board on Swallowing and Swallowing Disorders, Hartford, CT
Bonnie Martin-Harris, PhD, CCC-SLP, BRS-S, ASHA Fellow
- Departments of Otolaryngology-Head and Neck Surgery and Communication Sciences and Disorders, Evelyn Trammell Institute for Voice & Swallowing, Medical University of South Carolina, Charleston, SC
Joseph T. Murray, PhD, CCC-SLP, BRS-S
- Audiology/Speech Pathology Service, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI
Barbara Sonies, PhD, CCC-SLP, BRS-S, ASHA Fellow
- National Institutes of Health, Clinical Center, and Department of Hearing and Speech Sciences, University of Maryland, College Park, MD
Catriona M. Steele, PhD, S-LP(C), CCC-SLP
- Department of Speech-Language Pathology, University of Toronto, and Toronto Rehabilitation Institute, Toronto, Canada
- Address correspondence to Catriona M. Steele, PhD, S-LP(C), CCC-SLP, Toronto Rehabilitation Institute, 550 University Avenue, #12030, Toronto, ON, Canada M5G 2A2

published online 11 December 2008.

In September 2008, an article was published in the Journal of the American Medical Directors Association criticizing current dysphagia assessment and management practices performed by speech-language pathologists in Long-Term Care (LTC) settings. In the same issue, an editorial invited dialogue on the points raised by Campbell-Taylor. We are responding to this call for dialogue. We find Campbell-Taylor's interpretation of the literature to be incomplete and one-sided, leading to misleading and pessimistic conclusions. We offer a complementary perspective to balance this discussion on the 4 specific questions raised: (1) Is the use of videofluoroscopy warranted for evaluating dysphagia in the LTC population? (2) How effective are thickened liquids and other interventions for preventing aspiration and do they contribute to reduction of morbidity? (3) Can aspiration be prevented and is its prevention important? and (4) Is there sufficient evidence to justify dysphagia intervention by speech language pathologists?

Keywords: Dysphagia, swallowing, videofluoroscopy, evidence-based medicine