Peg Tubes History and Decision Making


  1. Attend as part of the LIVE STUDIO AUDIENCE in Gulf Breeze, Florida - Studio audience seats are limited - so register today!
  2. Attend via LIVE STREAM from anywhere around the world. Live stream participants will login to access the event from their computer.




Making a recommendation for alternate forms of nutrition/hydration (ANH) is not one that professionals should take lightly. There are numerous concerns that must be considered – NOT just the bedside evaluation and/or the instrumental assessment. The patient is concerned about the quality of life, religious and cultural issues while the medical professional is more focused on the disease process and the outcomes – positive and negative. This course will provide a review of the history of enteral/parental nutrition as well as the factors involved in the decision making process. Various Advance Directives will be reviewed specifically looking at their nutrition/hydration choices. The bedside eval (standardized and “your own”), instrumental assessments and resources to utilize for chart review and patient education will be provided.

Course Objectives

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

Course Instructor(s)

Denise Dougherty


Denise Dougherty, MA, CCC-SLP
Denise owns and operates a private practice in Indiana, PA, where she conducts therapy with both children and adults. She is a legal consultant/expert witness in wrongful death/negligence lawsuits involving dysphagia. Denise is a co-editor of Private Practice Essentials: A Practical Guide for Speech-Language Pathologists, published by ASHA Press. She has presented workshops and written numerous articles appearing in the ASHA Leader on the topic of private practice. Denise served as a consultant for The Arijah Children’s Foundation in Anguilla, BWI, providing evaluations and therapy programs for special needs children. Ms. Dougherty was an adjunct faculty member at York College of Pennsylvania and Wesley College in Dover, Delaware. She is a past President of the American Academy of Private Practice in Speech Pathology and Audiology (AAPPSPA), and received the Academy’s 2007 Honor Award and 2014 Award of Excellence for her achievements. Ms. Dougherty is a member of the Technical Experts Panel for Quality of Insights of Pennsylvania, working on initiating quality measures for CMS to improve effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. She received her bachelor’s degree in communication disorders from Marywood University in Scranton, Pennsylvania; a master’s degree in communication disorders from St. Louis University. Ms. Dougherty is certified in VitalStim® therapy and is a VitalStim® instructor, has completed additional training in orofacial myology, is a member of the American Speech, Language and Hearing Association and has received numerous ASHA ACE Awards. For more information, please visit

Financial Disclosure Denise receives honoraria from CIAO for the presentation of her live courses and royalties for the sale of her online courses. Denise is in private practice and receives legal consultant/expert witness fees
Non-Financial Disclosure: There are no non-financial relationships to disclose.

Course Agenda

Day 1

11:30 - 11:40
Course overview/objectives
11:40 - 12:30
History of Enteral/Parental Nutrition
12:30 - 12:45
Cultural and Religious Influences in Decision Making
12:45 - 01:30
Attitudes and Advance Directives
01:30 - 01:45
01:45 - 02:20
Impact of Medical Professionals Beliefs/Values in Decision Making tools for ANH
02:20 - 02:55
Resources and Dysphagia
02:55 - 03:30
Evaluations Assessments and Recommendations
03:30 - 03:45

Contact hours pre-approved for:

  • 4 Hours
  • CIAO is an ASHA Approved Provider (0.4 ASHA CEUs) bubble sheet required
  • ASHA CE Provider Approval and use of the Brand Block does not imply endorsement of course content, specific products, or clinical procedures.
  • This course meets PDU requirements for NBCOT (4 PDUs)
  • 4.0 Hours OTs in CA - Advanced Practice Swallowing #25-S16
  • CIAO is an Approved Provider for the Florida Board of Occupational Therapy
  • 5 Hrs. OT/COTAs in FL (CE Broker #20-934624)
  • 4 Hrs. Registered with CEBroker for OT/COTAs in AL, AZ, GA, LA, MS, SC, TN

Course meets requirements for:

  • OT/COTAs in AL, AK, AZ, AR, CA, CO, CT, DE, GA, HI, ID, IA, IN, KS, ME, MD, MA, MI, MN, MS, MO, MT,
  • OT/COTAs in NE, NV, NH, NJ,, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WV, WY

  • Intermediate Level
    0.4 ASHA CEUs

    CIAO is recognized on the NBCOT Provider Registry (meets PDU requirements for NBCOT)