Professional issues in paediatric dysphagia: what are the implications for research and clinical practice?

Abstract

Speech and Language Therapists (SLTs) have a unique and distinctive professional role in the assessment and management of oro-pharyngeal dysphagia with special care babies, infants with cleft palate and other cranio-facial abnormalities, children who have physical disabilities (including Cerebral Palsy) and other developmental learning disabilities including autism. Working with these populations, SLTs play a key role in multi-disciplinary teams with a wide range of other professionals in healthcare as well as with colleagues in education and social care. We also provide essential support for the families, so it is vital that we are able to confidently keep ourselves updated with the most current research evidence for best practice in assessment and management for these cases.
The lecture will present an overview of the most recently published research evidence base, including sign-posting delegates to the most relevant pre-appraised sources such as systematic reviews. Awareness of the key research groups in this field is also important for us to be able to more efficiently keep ourselves updated within our own specialist areas of practice. This synthesis will map out what is known, and where are the key gaps in our current research evidence base: especially the current (im)balance of evidence between diagnosis approaches and intervention approaches. The recent international work for a consensus classification system for describing dysphagia in children with Cerebral Palsy is also highly relevant.
Professional guidance for SLTs, including regulatory standards for additional post-graduate competences and specialist clinical skills training in dysphagia will be discussed; in particular, the new UK Royal College of Speech and Language Therapists (RCSLT) competences framework approach for SLTs to demonstrate their theoretical knowledge and their clinical skills for working in dysphagia. Values-based practice and ethically-based practice will be defined, reinforcing a deeper understanding of evidence-based practice, with illustrative case examples of working with families of children who have dysphagia. The range of challenges and opportunities for implementation of published research findings into real – world practice settings will be considered.
In the year ahead there will be a number of international campaigns to raise public awareness of our distinctive SLT role working in the field of dysphagia. These include the UK “Swallow Awareness” initiative, and of course CPLOL’s European Day on March 6th 2017. These campaigns will offer clinical SLTs a range of resources for updating their own knowledge base, as well as generating opportunities for promoting messages about quality of life and social inclusion for the whole family of children with dysphagia.