Dysphagia Therapy: The New Generation



The new world of dysphagia therapy will have to yield greater results and shorter treatment times. Gone is the old treatment philosophy focused on compensatory strategies and downgrading of diets. The dysphagia therapist must learn to see the direct links between anatomy, physiology, kinesiology, and grading therapy up to challenging levels. This course will review the process of the swallow from anticipatory phase through esophageal, including muscle function and nerve innervation. A thorough chart review and medication history is critical to identify key information prior to a swallow screen and bedside eval. Sensory changes due to aging and disease processes impacting the patient's nutrition and diet selection will be discussed. Current research will be presented regarding stroke, Parkinson's Disease, ALS, MS, Head/Neck cancer and other disease processes resulting in dysphagia - what can we expect in each phase of swallow and how it relates to our therapy program. MBS and FEES clips of dysfunctional swallows will be reviewed and reports critiqued. Diet modification/selection, compensatory strategies and exercises are combined to provide optimum nutrition and hydration as well as muscle re-education to increase the effectiveness of the swallow. Documentation of patient, staff, and family education and therapy notes will be critiqued for content and skilled therapy documentation.

AOTA Classification Codes
OT Process: Intervention

Course Objectives

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

  • Describe the process of the normal swallow including the impact of the esophagus.
  • Identify the anatomical structures relevant to the swallowing function
  • Describe the involvement of types I and II muscle fibers and the impact of muscle disuse atrophy on the swallow system
  • Interpret the results of a MBS as applicable to treatment planning
  • Discuss the decision making process for both diet modification and diet progression
  • Discuss the components of a functional evaluation report and goals
  • Discuss selection of effective treatment plan and exercises

Course Instructor


Denise Dougherty

MA, CCC-SLP

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 www.dldspeechpath.com.

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

07:30 - 08:00
Registration (snack/refreshments provided)
08:00 - 10:00
Review of the normal swallow system and swallowing anatomy and physiology
10:00 - 10:15
Break
10:15 - 11:00
Swallow Timing and Coordination
11:00 - 12:00
Impact of Sensory Changes from Aging and Disease Processes
12:00 - 01:00
Lunch (on own)
01:00 - 03:15
Effective Assessment and Report Critique
03:15 - 03:30
Break
03:30 - 04:00
Effective Assessment and Report critique - continued
04:00 - 04:30
Diet and Liquid Modifications and Research
04:30 - 05:00
Need for Instrumental Assessments – Which Ones and Why
05:00 - 05:30
Q&A

Day 2

07:30 - 08:00
Arrival (snack/refreshments provided)
08:00 - 08:30
Review of Instrumental Assessments – What each reveal about the swallow
08:30 - 10:00
MBS and FEES Clips
10:00 - 10:15
Break
10:15 - 10:45
Importance of Report – MBS Imp and PA Scale Score
10:45 - 11:30
Putting it All Together
11:30 - 12:30
Lunch (on own)
12:30 - 01:00
What isn’t working, goals and review of documentation
01:00 - 03:00
Therapy interventions to address dysfunctions and research
03:00 - 03:30
Q & A

Contact hours pre-approved for:

  • 1.4 CEUs (14.0 Contact Hours) SLP/SLPAs, OT/COTAs
  • CIAO is an ASHA Approved Provider #AAWA (SLP/SLPA) Bubblesheet required
  • This course is offered for 1.4 ASHA CEUs (Intermediate level, Professional Area)
  • CIAO is an AOTA Approved Provider #4119 (OT/COTA)
  • This course meets PDU requirements for NBCOT (14 PDUs)
  • 14.0 Hrs. by the CA Board of OT for Advanced Practice (Swallowing): #25-S21
  • 16.5 Hrs for OT/COTAs in FL (20-610035)

Course meets requirements for:

  • Participants who successfully complete this course will receive a CEU Certificate at the end of the course


  • The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.



    This course is offered for 1.4 ASHA CEUs (Intermediate level, Professional Area)



    CIAO Automatically reports to CE Broker for Florida Occupational and Physical Therapists and Assistants. Florida SLPs can either use the ASHA CE Participant Form (Bubble Sheet) or self-submit through CE Broker.



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