Dysphagia for Children and Adults

Study Course Description

Course Description Statuss:Approved

Course Description Version:12.00

Study Course Accepted:16.08.2023 08:59:53

Study Course Information
Course Code:		REK_044		LQF level:		Level 6
Credit Points:		2.00		ECTS:		3.00
Branch of Science:		Clinical Medicine; Health Care		Target Audience:		Rehabilitation
Study Course Supervisor
Course Supervisor:		Santa Katrīna Salaka
Study Course Implementer
Structural Unit:		Department of Rehabilitation
The Head of Structural Unit:
Contacts:		Riga, 26a Anninmuizas boulevard, rkrsu[pnkts]lv, +371 20271291
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		2	Lecture Length (academic hours)		4	Total Contact Hours of Lectures		8
Classes (count)		6	Class Length (academic hours)		4	Total Contact Hours of Classes		24
Total Contact Hours								32
Study course description
Preliminary Knowledge:
Anatomy, normal physiology.
Objective:
To acquire qualitative basic knowledge about the physiology of normal swallowing, physiology, etiology and clinical manifestations of swallowing disorders. Gain evidence-based theoretical knowledge and practical skills in diagnosing swallowing disorders (dysphagia), setting goals and tactics for treatment (based on comprehensive assessment of dysphagia and using ICF principles) for children and adults.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Lecture topic: Dysphagia in adults. Normal swallowing process. Definition of swallowing disorders (according to WHO), physiology, etiology, manifestations and complications. Examination of swallowing disorders, diagnostics. Test on lecture topics.			Lectures		1.00	auditorium
2	Lecture topic: Dysphagia in pediatrics. Anatomy and physiology of the normal sucking and swallowing process in childhood, intrauterine development. Factors affecting normal sucking and swallowing, clinical manifestations, complications. Development of drinking and eating skills in the first years of life. Work with analysis of evidence-based literature. Test on lecture topics.			Lectures		1.00	auditorium
3	Topic: Assessment and diagnosis of swallowing disorders within the competence of an speech and language therapist. Cervical auscultation. Instrumental methods for diagnosis of swallowing disorders. Video recording analysis. Test - instrumental diagnostics.			Classes		1.00	auditorium
4	Topic : Assessment of swallowing disorders within the competence of an speech and language therapist. Patient history data / anamnesis collection and analysis. Structural and motor performance evaluation of the oral cavity. Water Swallowing Test. Assessment of sensation in the oral cavity. Assessment of swallowing reflexes. Working with evidence-based literature analysis: measurements of dysphagia assessment and their content. Demonstration of practical skills.			Classes		1.00	auditorium
5	Topic: Planning for the treatment of swallowing disorders. Setting long-term and short-term goals for therapy based on patient assessment, using ICF principles. Development of therapy tactics. Analysis of clinical cases, setting therapeutic goals.			Classes		1.00	auditorium
6	Topic: Direct and indirect therapy methods. Direct therapy / indirect therapy. Diet modification. Use of compensatory strategies and postures in case of swallowing disorders. Use of oromotor exercises in therapy. Use of swallowing maneuvers in therapy. Demonstration of practical therapy tactics. Work with analysis of evidence-based literature. Discussion.			Classes		1.00	auditorium
7	Topic: Possibilities of evaluation of sucking and swallowing disorders and treatment tactics in case of dysphagia in children. Clinical case analysis.			Classes		1.00	auditorium
8	Topic: presentations of students' independent group work. Literature source analysis presentations. Clinical case analyzes.			Classes		1.00	auditorium
Assessment
Unaided Work:
Clinical case analysis: Dysphagia in an adult. Clinical case analysis: Dysphagia in a child. Evidence-based therapy for dysphagia. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
1. An active and successful participation in practical classes; 2. Passed tests during the course (3); 3. Clinical case analyse (2); 4. Group work presentations – evidence-based treatment. 5. Cumulative exam: Class attendance 10%, clinical case analyse 15%, test 10%, group work 10%, practical skill demonstration 15%, exam written test 40%.
Final Examination (Full-Time):		Exam (Written)
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		As a result of successful acquisition of the study course, students: • strongly describe the course of normal swallowing physiology in adults / sucking and swallowing physiology in children; • will be able to explain the etiology and pathogenesis of swallowing disorders in adults and children; • will be able to name the types of classification of dysphagia; • will be able to present and orientate in the possibilities of cognition of swallowing disorders in adults and children; • will be able to describe the clinical manifestations, complications and functional limitations of dysphagia (using the ICF framework) in adults and children; • will be able to explain, analyze and apply appropriate treatment tactics.
Skills:		As a result of successful acquisition of the study course, students: • will be able to evaluate the clinical signs of dysphagia in adults and children; • will be able to assess swallowing disorders using different assessment methods for adults; • will be able to assess sucking and swallowing disorders using different assessment methods for children; • will be able to evaluate the structures of the oral cavity and perform motor performance evaluation. To perform sensory evaluation in the oral cavity, evaluation of swallowing reflexes; • will be able to set evaluation and ICF-based treatment goals for adults and children; • will be able to plan treatment for dysphagia in adults and children.
Competencies:		As a result of successful completion of the study course, students will be able to theoretically explain and practically use the acquired knowledge about the normal swallowing process, dysphagia and, applying skills, evaluate, plan and perform swallowing disorders for adults and children within the audiologist's competence.
Clinical Skills:
No.	Skill					Level
1	Gugging Swallowing Screen (GUSS)					A - Beginner level
2	Gugging Swallowing Screen (GUSS)					B1 - Basic level
Bibliography
No.	Reference
Required Reading
1	Dysphagia: Complications, Management and Clinical Aspects. 2016.
2	Maria H. Provencio-Arambula, Dora Provencio, and M. N. Hegde. Assessment of Dysphagia in Adults: Resources and Protocols in English and Spanish, 2006. (akceptējams izdevums)
3	Miller, Claire Kane, Maybee, Jennifer, Prager, Jeremy, Pentiuk, Scott. Feeding and Swallowing Disorders. Kendig’s Disorders of the Respiratory Tract in Children, 2019-01-01, p.1106-1113.e1, 2019
4	Lauren E. Fulks, and Benjamin N. Nguyen MD. Dysphagia and aspiration, [Brain Injury Medicine, 31, 219-226.e2], 2021
5	Messing, Barbara P, Burns, Clare, Wishart, Laurelie, Brown, Bena. Swallowing Function and Implications in Head and Neck Cancer. Cummings Otolaryngology, 2021, p.1466-1473.e3, 2021
Additional Reading
1	Apinis P. Cilvēks. Anatomija, fizioloģija, patoloģijas pamati. Cēsis: SIA apgāds Jāņa sēta
2	Chapter 47 - Oromotor Dysfunction in Neuromuscular Disorders: Evaluation and Treatment. 2015. In: Neuromuscular Disorders of Infancy, Childhood, and Adolescence. 2nd Edition
Other Information Sources
1	http://dysphagia.com/
2	http://www.dysphagiaonline.com/Pages/home.aspx
3	http://www.dysphagiaresearch.org/
4	World Health Organization / International Classification of Functioning, Disability and Health (ICF)