Topics in the Delivery of Swallowing Services

Course Number

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Presenters: Dr. John Tracy and Athena Nofziger, RDN, LD, CHC
The presenters are a clinical dietitian and a speech-language pathologist. This course will include issues related to the clinical swallowing evaluation, a demonstration of a clinical swallowing evaluation, criteria for recommending an instrumental evaluation, the role of the speech pathologist in identifying and evaluating esophageal disorders, life saving and end of life issues related to swallowing, artificial means of nutrition and achieving oral intake and hydration in those with dementia, and integration  of the swallowing program into a context of nutrition services in an acute care hospital setting. Discussion of the use of rigid vs. dynamic evaluation protocols in light of the cognitive functioning of the patient will be included.


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

  • Describe a clinical swallowing evaluation along with the pros and cons of this diagnostic procedure.
  • Discuss effective diagnostic and intervention strategies in the following clinical topic areas:

         - esophageal disorders,
         - alternative means of nutrition and hydration in people with dementia and dysphagia,,
         - comfort care vs. life saving intervention strategies for those with dysphagia,
         - clinical screening vs. clinical diagnostic evaluation, and
         - criteria for requesting an instrumental evaluation.

  • Apply a model of collaboration between the speech-language pathologist and clinical dietitian to achieve the best nutritional outcomes.
  • Describe a method of performance improvement to ensure accuracy in the preparation of dysphagia diets.
About John: John Tracy, is a speech-language pathologist with 40 years of experience in the profession. He is employed by Samaritan Lebanon Community Hospital in Lebanon, Oregon where he sees inpatients, outpatients, and patients in home health with swallowing difficulties. He has also taught in higher education, been a rehabilitation program manager and worked in hospitals in the Mid-Willamette Valley and Southern Oregon. He has worked on legislative and policy issues for the Oregon Speech-Language and Hearing Association for the last 20 years.

About Athena: Athena is a Registered Dietitian Nutritionist through the Academy of Nutrition and Dietetics and a Certified Health Coach through the National Society for Health Coaches. Athena graduated from Oregon State University with a degree in Nutrition and Food Management and completed a 1200 hour dietetic internship at the University of South Dakota. Athena is licensed to practice in the state of Oregon. Athena is employed at the Samaritan Lebanon Hospital with 10 years of experience and specializes in wellness and digestive nutrition. Athena works in the acute care setting as well as providing outpatient services for cardiac rehabilitation, pulmonary rehabilitation and oncology. 

Additional Information

This course is offered for 0.2 ASHA CEUs (Intermediate level, Professional area)

Course Timeline:
10 minutes: Introduction of the presenter and a description of the acute care setting in which they practice and an overview of the course organization.
20 minutes: Pros and cons of the clinical swallowing evaluation.
20 minutesDemonstration of a clinical swallowing evaluation. 
10 minutesScreening for dysphagia  vs. the clinical swallow evaluation.
10 minutes: Identifying esophageal disorders.
10 minutesComfort care vs. lifesaving strategies in dysphagia.
10 minutesOral and non-oral feeding for those with dementia and dysphagia.
15 minutesCollaborating with the dietitian for the best nutritional outcomes.
15 minutesA model of performance improvement of the reliability and validity  of therapeutic dysphagia diets.

Disclosure Statements:
Financial: John Tracy is a speaker for and receives royalties. Nonfinancial: No relevant nonfinancial relationships exist
Financial: Athena Nofziger is a speaker for Video Continuing Education and receives royalties.
Nonfinancial: No relevant nonfinancial relationships exist

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