Comprehensive Dysphagia

Course Number

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Presenter: Tom Francischini, MS, CCC-SLP
Comprehensive Dysphagia Interventions: The Esophagus, Acid Reflux Disease, Prevention of Aspiration Pneumonia, Free Water Protocols, Oral Hygiene, Xerostomia and Meds & Dysphagia

Swallowing doesn't end at the pharynx. As such, comprehensive dysphagia interventions cannot consist solely of muscle exercises, maneuvers, compensatory postures, and diet modifications. To ensure the highest quality of care is achieved, dysphagia clinicians must consider other factors that contribute to swallowing difficulties, such as esophageal abnormalities, acid reflux disease, and pharmacology.

Upon completion of this course, participants will be able to:

  • Describe the anatomy and physiology of the esophagus and understand how swallowing and voice disorders occur from disorders of the esophagus.
  • Explain Laryngeal-Pharyngeal Reflux and its role in voice disorders.
  • State diagnostic and treatment options for patients with LPR and Acid Reflux Disease.
  • State the differences in the various symptoms of LPR and Acid Reflux Disease as seen in infants, children, teenagers and adults.
  • Explain the theoretical basis behind the free water protocol.
  • Identify and discuss patients who can benefit from the protocol.
  • State the risks and costs of dehydration in the elderly population.
  • List the rules of the free water protocol.
  • Explain how the colonization of oral pathogens contributes to aspiration pneumonia.
  • List components of a comprehensive oral care program.
  • List two medications that can adversely affect swallow behavior
About Tom: Tom Franceschini, MS CCC-SLP,  is a highly sought after speaker on the topic of Dysphagia Management, having educated thousands of Speech-Language Pathologists, Nurses and other health care professionals throughout North America and Europe. With 30 years in the field, Tom has accumulated a high level of experience in all areas of medical speech pathology and continues to pursue a special interest in the esophageal stage of the swallow, and how this impacts swallowing disabilities and voice disorders.

Tom is nationally known for the role he has played in the development of the Free Water Protocol, and he routinely provides consultation to hospitals and other institutions on establishing heartburn and swallowing disorders centers, developing free water protocols and on implementing oral hygiene programs. 
Additional Information

This course is offered for 1.3 ASHA CEUs (Introductory Level, Professional Area)
Course Timeline:

1:00-2:00: PART I: Conflicts in Dysphagia

  • Where have we been and where are we going?

2:00-3:30: PART II: Esophageal Considerations

  • Anatomy and Physiology of the Esophagus
  • Role of the SLP in Esophageal Screening and Referral Guidelines
  • Esophageal Disorders and Management Considerations

3:30-8:00: PART III: Acid Reflux Disease and Laryngeal-Pharyngeal Reflux (LPR) in Adults

  • Etiology and Pathophysiology of Acid Reflux Disease
  • Oral, Laryngeal, Otological and Pulmonary Symptoms of Acid Reflux Disease and LPR
  • Screening and Assessment
  • Radiographic Evaluation and Interpretation
  • Developing a Plan of Care
  • Management Options
    • Counseling 
    • Medications
    • Surgical Interventions

8:00-9:00: PART IV: Acid Reflux Disease and LPR in Infants & Children

  • Symptoms
  • Asthma and Acid Reflux Disease in the Pediatric Population
  • Referral Guidelines for Acid Reflux Disease in the Pediatric Population
  • Management Options

9:00-10:00: PART V: Predictors of Aspiration Pneumonia

  • The Langmore et al Study of 1998
  • A Model for Pneumonia Risk and Prevention
  • Study Implications and Treatment and Management

10:00-11:15: PART VI: The History and Development of the Free Water Protocol

  • Human Physiology and Water
  • The Development of the Protocol
  • Criteria for Use of the Free Water Protocol
  • The Supporting Research for the Protocol

11:15-12:15: PART VII: Oral Hygiene Programs

  • Colonization of Oral Pathogens
  • Oral Care Interventions
  • Comprehensive Oral Care Protocol

12:15-13:00: PART VIII: Xerostomia

  • Anatomy and Saliva Production
  • Common Signs and Symptoms of Xerostomia
  • Management Options
Disclosure Statement: 
Financial: Tom Francischini is a speaker for and receive royalty payments.
Non Financial: No relevant non financial relationship exists 
Course Hours
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