Many articles have addressed effective school-based dysphagia management practices. There is not a defined best practice plan available for speech-language pathologists, as the information is spread among various published articles. Four optimal outcomes and the most relevant management suggestions to help guarantee achievement of these outcomes are described. Sufficient information found from published articles describes the areas of referral, team responsibilities, assessment, Individualized Education Plan formulation, and treatment in school-based dysphagia management. This information, along with additional suggestions not frequently mentioned in the articles was added to a proposed school-based dysphagia management model. This model is intended for use as a guide for speech-language pathologists in the schools who do not have a management plan available for use. / text

Introduction: To date, few research studies have evaluated pediatric feeding and swallowing practices in school systems across the United States. This study aims to i) understand the factors that impact a speech-language pathologists (SLPs) level of comfort in providing these services, ii) to identify barriers to service provision, iii) develop a concrete understanding of a SLPs role in providing feeding and swallowing services in a school setting, and iv) to identify the types of service suggested by school-based SLPs in response to a fictional case study. Methods: School-based SLPs and clinical fellows were invited to participate in a 10-15 minute web-based survey. The survey questions focused on basic demographic information, vocational history, barriers to treatment, and clinician comfort level. In addition, survey respondents were asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were collected and analyzed. Results: Descriptive data, summarizing the demographic and vocational factors of the survey respondents, are provided. In addition, independent Pearson Chi-Square analyses were performed to determine the degree of association between the demographic/vocational factors and the SLPs self-reported comfort level. The results of these correlation analyses are reported and discussed. Barriers to dysphagia management and a summary of the services currently provided in the school setting are discussed from the perspective of professional practice issues. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications and the implementation of safe swallow strategies. Discussion: The survey results indicate a number of factors impact clinician comfort level including geographic region, previous medical experience and current service provision. A number of barriers to practice were identified which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Approximately 26.5% of survey respondents indicated that there were providing feeding and swallowing related services in a school setting with 98.1 % of these clinicians providing collaborative consultation. The case study results highlighted the variability in treatment approaches.

台灣高齡者之吞嚥困難解決方案的市場分析與商機 / It has been suggested that dysphagia affects approximately 8 % of the world’s population. People may be completely unable to swallow or may have trouble in safely swallowing liquids, foods, or saliva. When that happens, eating becomes a challenge. Recent studies have identified elderly people who require the long- term care as being at increased risk for dysphagia due to changes in the swallowing mechanism as aging occurs, it may affect 30% to 40% of the population at 65 years old or more. Taiwan is on course to go from being an “aging society” to an “aged society” and is experiencing a rapid increase in the number of older adults who require long-term care. Dysphagia is a prevalent difficulty among elderly people. Though increasing age facilitates subtle physiological changes in the swallow function, age-related diseases are significant factors in the presence and severity of dysphagia. Among elderly diseases and health complications, stroke and dementia reflect high rates of dysphagia. In both conditions, dysphagia is associated with nutritional deficits and increased risk of pneumonia. Recent efforts have suggested that long-term care organizations or nursing homes are also at risk for dysphagia and are associated deficits in nutritional status and increased pneumonia risk. Swallowing rehabilitation is an effective approach to increase safe oral intake in these populations and recent research has demonstrated extended benefits related to improved nutritional status and reduced pneumonia rates. Living with dysphagia is challenging, but it can be managed. For elderly people with dysphagia, it's important to continue the principle of maintaining hydration, calories and nutrients, especially protein and fluids. Texture-modified foods and thickened liquids can help achieve nutritional and hydration goals. This research provides the market analysis of dysphagia solution and its market opportunities in Taiwan. It concludes with a market plan to assess the viability of such a business opportunity. Well- structured management of dysphagia can not only provide elderly people’s physical, mental and social well-being but also brings the elderly people the pleasures of eating and the dignity during the last few years of their lives.