Alternative Treatment Procedures For Dysphagia Outline & Bibliography

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How the outline should look like:

General purpose: to persuade

Specific idea: to persuade that (this treatment) is better for dysphasia than (this treatment). *specify the treatments from the annotated bibs*


a. theisi

b.supporting claims

2- supporting claim 1

a- facts

b-other facts

3-supporting claim 2



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Shama, L., Connor, N. P., Ciucci, M. R., & Mcculloch, T. M. (2008). Surgical Treatment of Dysphagia. Physical Medicine and Rehabilitation Clinics of North America, 19(4), 817-835. doi:10.1016/j.pmr.2008.05.009 In this article, medical researchers explored the role that surgical treatment can play in the treatment of dysphagia. They examine the different surgical procedures that can be utilized to alleviate dysphagia, depending on its underlying cause. Along with a description and an evaluation of the condition and the surgical treatment, the researches also present data about alternate procedures which are also employed. The analysis presented by the authors does appear to be verifiable, as the explanation that they provide for their claim is both backed by evidence and logic. Likewise, they include data about alternate procedures so that the reader can draw their own comparisons. Over all, it is thorough and objective analysis on the utility that surgical engagement can have when treating dysphagia. Annotated Bibliography Hill, M., Hughes, T., & Milford, C. (2004). Treatment for swallowing difficulties (dysphagia) in chronic muscle disease. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd004303.pub2 In their review, Hill, et al., examine the existing literature regarding the treatment of dysphagia in patients with a chronic muscular disorder. Because the literature is scarce regarding this topic – and because there is a specific lack of a study that meets these two unique conditions, dysphagia and chronic muscular disease – the researchers unable to propose the preferred form of treatment. Evidence, though, does show that for individuals with dysphagia caused by one particular type of chronic muscular disease, OPMD, surgical treatment could provide some improvement. However, limitations in the study that yielded that conclusion makes it impossible to suggest surgical treatment as a better choice than other possible approaches to the matter. Because there is not a specific treatment that was presented on the review, it cannot be recommended based on this matter. However, the review does shed some important data about dysphagia, the treatment options that exist, and the recovery of the patients. It also provides a lot of data about the limitations found in the literature evaluated, as well as highlighting the needs for further, specific research. Guidelines for the use of parenteral and enteral nutrition in adult ... ASPEN Board of Directors and the Clinical Guidelines Task Force JPEN, Journal of Parenteral and Enteral Nutrition; Jan/Feb 2002; 26, 1; ProQuest Central pg. SA1 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Guidelines • Roles and Responsibilities of the School-Based Speech-Language Pathologist Guidelines 1999 / III - 249 Guidelines for the Roles and Responsibilities of the School-Based Speech-Language Pathologist American Speech-Language-Hearing Association These guidelines are an official statement of the American Speech-Language-Hearing Association (ASHA). They were approved by ASHA’s Legislative Council in March 1999. They provide guidance for school-based speechlanguage pathologists but are not official standards of the Association. The guidelines were prepared by the ASHA Ad Hoc Committee on the Roles and Responsibilities of the School-Based Speech-Language Pathologist: JoAn Cline, chair; Susan Karr, ex officio; Jacqueline Green; Ronald Laeder; Gina Nimmo; and Ronnie Watkins. Nancy Creaghead, 1997–1999 vice president for professional practices in speech-language pathology, served as monitoring vice president in 1997; Crystal Cooper, 1994–1996 vice president for professional practices in speechlanguage pathology, served as monitoring vice president in 1996 and consultant in 1997–1998. Committee members have extensive experience providing direct speech-language pathology services in school settings. The contributions of ASHA members, committee members, and staff peer reviewers are gratefully acknowledged and have been carefully considered. Additionally, the committee wishes to thank those who shared state handbooks and district procedure manuals from the following states: California, Connecticut, Florida, Georgia, Illinois, Iowa, Kentucky, Maryland, Michigan, Nevada, New York, North Carolina, Ohio. Table of Contents I. Introduction Purpose Guiding Principles Definitions History Reference this material as: American Speech-LanguageHearing Association. (2000). Guidelines for the roles and responsibilities of school-based speech-language pathologist. Rockville, MD: Author. Index terms: Caseload (service delivery), documentation activities, Individuals with Disabilities Education Act, practice scope and patterns, schools (practice issues), service delivery models, speech-language pathology Document type: Standards and guidelines Current Model II. Roles and Responsibilities Prevention Identification Assessment Evaluation Specific Evaluation Considerations Eligibility Determination IEP/IFSP Development Caseload Management Intervention for Communication Disorders Intervention for Communication Variations Counseling Re-evaluation Transition Dismissal Supervision Documentation and Accountability III. Additional Roles and Opportunities Community and Professional Partnerships Professional Leadership Opportunities Advocacy IV. Summary References Bibliography Appendices A. ASHA Code of Ethics B. ASHA School Related Resources C. Goals 2000 Educate America Act: National Education Goals D. School Reform Issues Related to Speech-Language Pathology E. Advantages and Disadvantages of Types of Assessments F. Developmental Milestones for Speech and Language G. Examples of a Severity/Intervention Matrix H. Signs and Effects of Communication Disorders I. Example of an Educational Relevance Chart J. Example of Entry/Exit Criteria for Caseload Selections K. Example of Dismissal Criteria Chart III - 250 / 1999 ASHA 2002 Desk Reference Volume 3 • Speech-Language Pathology Guidelines Quick Reference WHO Definition of speech-language pathologist WHAT Core roles WHEN Eligibility determination WHERE Caseload management/Service delivery options WHY Guiding principles HOW “How to” techniques for each of the core roles are learned through pre-service training and clinical practicum experiences. In-service learning continues via clinical fellowships, continuing education programs, literature review, mentorships, Special Interest Division or other professional affiliations, study groups, and research. I. Introduction School-based speech-language pathology services have changed dramatically during the past decades because of numerous legislative, regulatory, societal, and professional factors. Meanwhile fiscal constraints and increased paperwork have made it more challenging to provide effective services. In order to provide appropriate speech and language services, it is important to understand and consider the corresponding changes in the development and management of the school-based speech-language pathology program. The current roles and responsibilities of the school-based speech-language pathologist require clarification, expansion, and readjustment. Core roles and responsibilities are described in Section II, while additional roles and opportunities are suggested in Section III. Purpose The purpose of this document is to define the roles and delineate the responsibilities of the speechlanguage pathologist within school-based speechlanguage programs. These guidelines were developed in response to requests by speech-language pathologists, school administrators, lobbyists, and legislators who seek guidance from the American Speech-Language-Hearing Association (ASHA) for a description of the roles and responsibilities of school-based speech-language pathologists.1 These guidelines can be used as a model for the development, modification, or affirmation of state and local procedures and programs. Parents,2 families, 3 speech-language pathologists, teachers, school administrators, legislators, and lobbyists may find the information helpful when advocating for quality services and programs for students with communication disorders. This document may also be used as a resource by program administrators and supervisors who wish to support and enhance the professional growth of individual speech-language pathologists. Guiding Principles The following premises guided the development of this document: 1 The ASHA School Services Division receives approximately 100 requests each year for such guidelines. Many requests represent the interests of entire school districts or local and state education agencies. Additionally, requests for this type of information are received by other divisions at the ASHA National Office for use in state and federal advocacy efforts. 2 Within this document parent refers to the biological parent(s), legal guardian(s), or surrogate parent(s). 3 Within this document family may include relatives or individuals with a common affiliation, such as caregivers or significant others. 4 Further citations of the U.S. Congress 1997 Amendments to the Individuals with Disabilities Education Act (IDEA) will be denoted by section numbers only. Unless otherwise stated, IDEA refers to the IDEA 1997 Amendments. At this writing, the final federal regulations for the IDEA 1997 legislation have not been promulgated by the Department of Education. Guidelines • Roles and Responsibilities of the School-Based Speech-Language Pathologist • “Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.” (U.S. Congress, 1997 [Sec. 601(c)]).4 • Society’s trends and challenges affect the role of speech-language pathologists. • Educational success leads to productive citizens. • Language is the foundation for learning within all academic subjects. • School-based speech-language pathologists help students maximize their communication skills to support learning. • The school-based speech-language pathologist’s goal is to remediate, ameliorate, or allevi- • • • • 1999 / III - 251 ate student communication problems within the educational environment. A student-centered focus drives team decisionmaking. Comprehensive assessment and thorough evaluation provide information for appropriate eligibility, intervention, and dismissal decisions. Intervention focuses on the student’s abilities, rather than disabilities. Intervention plans are consistent with current research and practice. Although speech-language pathologists are bound by federal mandates, state regulations and guidelines, and local policies and procedures, they are also influenced by ASHA’s policy statements. School-based speech-language pathologists are encouraged to refer to ASHA’s Code of Ethics (Appendix A) when making clinical decisions. As indicated in Figure 1, ASHA’s Code of Ethics encompasses all ASHA policy. Source: Scope of Practice in Speech-Language Pathology. (ASHA, 2001) III - 252 / 1999 ASHA 2002 Desk Reference Volume 3 • Speech-Language Pathology The guidelines in this document are consistent with ASHA’s Scope of Practice, Preferred Practice Patterns, and position statements, yet are specific to issues relating to school-based speech-language pathologists. Additional complementary documents, such as ASHA guidelines, technical reports, tutorials, and relevant papers, are available through the ASHA National Office (see Appendix B). These guidelines reflect the Committee’s review of current law related to providing services to students with disabilities; policy and procedure documents from a variety of geographic areas; current professional literature; contemporary practices from rural, suburban, and urban areas; and extensive feedback from peer reviewers in the profession. Likewise, the terminology used within this document mirrors current widespread use; however, regional or geographical variations may occur. In the interest of clarity, the various aspects of school-based speech-language pathologists’ roles and responsibilities are discussed separately. However, school-based speech-language pathology services are interrelated, as are all aspects of communication. The field of speech-language pathology is dynamic and evolving, therefore the examples within this document are not meant to be all-inclusive. Additional emerging roles or responsibilities should not be precluded from consideration if they are based on sound clinical and scientific research, technological developments, and treatment outcomes data. Definitions The range of the profession of speech-language pathology has been defined by many sources, including ASHA, federal legislation, and such other sources as the World Health Organization. ASHA Definition Speech-language pathologists are professionally trained to prevent, screen, identify, assess, diagnose, refer, provide intervention for, and counsel persons with, or who are at risk for, articulation, fluency, voice, language, communication, swallowing, and related disabilities. In addition to engaging in activities to reduce or prevent communication disabilities, speechlanguage pathologists also counsel and educate families or professionals about these disorders and their management (ASHA, 1996c). Federal Definitions The Individuals with Disabilities Education Act (IDEA) includes speech-language pathology as both a related service and as special education. As related services, speech-language pathology is recognized as “developmental, corrective, and other supportive ser- vices. . . as may be required to assist a child with a disability to benefit from special education. . .and includes the early identification and assessment of disabling conditions in children” [Section 602(22)]. Speechlanguage pathology is considered special education rather than a related service if the service consists of “specially designed instruction, at no cost to the parents, to meet the unique needs of a child with a disability, including instruction conducted in the classroom, in the home, . . . and in other settings.” State standards may further specify when speech-language pathology services may be considered special education rather than a related service. According to the IDEA definition, speechlanguage pathology includes: • identification of children with speech and/or language impairments • appraisal and diagnosis of specific speech and/or language impairments • referral for medical or other professional attention necessary for the habilitation of children with speech or language impairments • provisions of speech and/or language services for the prevention of communication impairments or the habilitation of children with such impairments • counseling and guidance for parents, children, and teachers regarding speech and/or language impairments. IDEA similarly identifies the early intervention services provided by speech-language pathologists for children from birth to age 3 with communication or swallowing disorders and delays. In Part C of IDEA, early intervention services are defined as being “designed to meet the developmental needs of an infant or toddler with a disability in any one or more of the following areas: physical, cognitive, communication, social or emotional and adaptive development” [Section 632(c)]. An infant or toddler with a disability may also include, at a state’s direction, at-risk infants and toddlers [Section 632(5-8)]. World Health Organization Definitions School-based speech-language pathologists prevent, identify, assess, evaluate, and provide intervention for students with speech, language, and related impairments, disabilities, and handicaps. The World Health Organization, in an effort to describe what may happen in association with a health condition, defines impairment, disability, and handicap and differentiates outcome measures for each. See Table 1. Guidelines • Roles and Responsibilities of the School-Based Speech-Language Pathologist 1999 / III - 253 Table 1. World Health Organization (WHO) classifications. IMPAIRMENT DISABILITY HANDICAP Definitions Abnormality of structure or function at the organ level Functional consequences of an impairment Social consequences of an impairment or disability Examples Speech, language, cognitive, or hearing impairments Communication problems in context of daily life activities Isolation, joblessness, dependency, role changes Outcome Measures Traditional instrumental and behavioral diagnostic measures Functional status measures Quality of life scales, handicap inventories, wellness measures Source: International classification of impairments, disabilities, and handicaps. (World Health Organization, 1980) School-based speech-language pathologists focus on all three aspects of a student’s communication needs: impairment, disability, and handicap. The school-based speech-language pathologist (a) prevents, corrects, ameliorates, or alleviates articulation, fluency, voice and language impairments; (b) reduces communication and swallowing disabilities (the functional consequences of the impairment); and (c) lessens the handicap (the social consequences of the impairment or disability).5 Ultimately, the school-based speech-language pathologist’s purpose in addressing communication and related disorders is to effect functional and measurable change(s) in a student’s communication status so that the student may participate as fully as possible in all aspects of life—educational, social, and vocational (ASHA, 1997e). History The roles and responsibilities of school-based speech-language pathologists have changed over the years in response to legislative, regulatory, societal, and professional influences. Traditional Role School-based speech-language programs have a long history. Records indicate that in 1910 the Chicago public schools were the first schools to hire “speech 5 The World Health Organization (1997) has drafted a revision of its classification of impairments, disabilities, and handicaps for field trials only. If finalized in current form, the dimensions will include impairments of structure and impairments of function, activities (formerly disabilities), and participation (formerly handicaps). correction teachers” (Darley, 1961). In the 1950s, speech-language pathologists who worked in a school setting, formerly referred to as “speech correctionists,” “speech specialists,” or “speech teachers,” worked primarily with elementary school children who had mild to moderate speech impairments in the areas of articulation, fluency, and voice. Later, with increased knowledge about language development, the “speech therapist” developed skills in identifying and remediating language disorders, thereby expanding the range of the profession (Van Hattum, 1982). Students were typically treated in large groups, contributing to caseload sizes that in most situations significantly exceeded those of today. The speech-languag ...
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