The effects of oral-motor exercises on swallowing in children: an evidence-based systematic review

AIM

The aim of this unregistered evidence-based systematic review was to determine the state and quality of evidence on the effects of oral motor exercises (OME) on swallowing physiology, pulmonary health, functional swallowing outcomes, and drooling management in children with swallowing disorders.

METHOD

A systematic search of 20 electronic databases was completed to identify relevant peer-reviewed literature published in English between 1960 and 2007. Experimental or quasi-experimental design studies examining OME as a treatment for children with swallowing disorders were appraised for methodological quality by two assessors and reviewed by a third.

RESULTS

Sixteen studies of varying methodological quality were included. No study examining the effects of OME on pulmonary health in children was identified. The included studies incorporated a wide variety of OME, and mixed findings were noted across all of the outcomes targeted in this review.

INTERPRETATION

Based on the results of this evidence-based systematic review, there is insufficient evidence to determine the effects of OME on children with oral sensorimotor deficits and swallowing problems. Well-designed studies are needed to provide clinicians with evidence that can be incorporated into the preferences of the client and the clinicians' knowledge of anatomy, physiology, and neurodevelopment in the management of this group of children.

School-Based Speech-Language Pathologists' Perspectives on Dysphagia Management in the Schools

Purpose

Although provision of dysphagia services is within the scope of practice of speech-language pathologists (SLPs), little is known about the perspectives of school-based SLPs in relation to these services. The purpose of this study was to examine SLPs' perspectives related to school-based management of students with dysphagia.

Method

Focus group interviews were conducted with 33 SLPs who were employed by a large school district in the Midwest before development of district-supported policies and protocols related to dysphagia management. The interviews were analyzed using qualitative analysis methods.

Results

A variety of common perspectives emerged from the data, including a primary perceived difficulty in adapting practice in dysphagia from medical to educational service delivery models and settings. Additionally, 3 thematic categories of concerns emerged that were related to child characteristics, training, and support.

Implications

Information gained in this investigation may be used to develop effective service delivery models, policies, and protocols, as well as to identify necessary supports related to the management of students with dysphagia in school settings.

Establishing a public school dysphagia program: a model for administration and service provision

PURPOSE

Many school-based speech-language pathologists (SLPs) are hampered in participating in managing children with dysphagia by their school systems' lack of supportive policies and procedures. A need exists to better define the dysphagia-trained SLP's role and clarify the district's responsibility. The purpose of this article is to address the critical administrative issues and administrative components surrounding dysphagia in the schools and to offer the SLP some solutions to these problems.

METHOD

A narrative review of the relevant literature addresses the following questions that are important for administrative planning and implementation of programs for students with dysphagia in the schools: (a) Should school systems assume responsibility for working with students with dysphagia? (b) Why is a system-supported procedure recommended? (c) What service delivery models can a system use to serve students with dysphagia? (d) What components should be included in a dysphagia procedure?

CONCLUSION

SLPs should be proactive in providing dysphagia services to students in the schools. A procedure that is adopted by a school system for all of its employees to follow will offer direction and guidance. This system-supported procedure may provide assurance that dysphagia services are being provided in a professionally acceptable manner. Ongoing staff development and training is essential. A system can implement dysphagia services using existing staff, when possible, and policies and procedures that have been approved by the system.