Practice Patterns in Pediatric and Adult Dysphagia: Implications for Clinical Training

Objective: Most speech language pathologists (SLPs) receive training to work with patients with swallowing disorders in graduate school, focusing primarily on adult dysphagia. Although SLPs share common foundational knowledge and skills for adult and pediatric dysphagia populations, there are considerable differences in these two specialized areas of practice. We aimed to query SLPs’ practice patterns for dysphagia assessment and management for adults and pediatric populations to consider differences and guide training efforts. Methods: We distributed two comprehensive anonymous surveys to explore practice patterns of SLPs who provide assessment and management of dysphagia for adult or pediatric populations. The 118 respondents, 62 for the adult survey and 56 for the pediatric survey, completed five-point Likert scale questions about how often they address swallowing across aspects of clinical practice and use several assessment tools and management techniques for dysphagia. Results: Assessment patterns were similar for the adult and pediatric surveys as clinical swallowing evaluation and video fluoroscopic swallowing studies were most commonly used. Several other assessment tools were rarely used in clinical practice. Management techniques for adult and pediatric populations varied considerably as pediatric techniques focused on oral-motor development, posturing, and food acceptance, while adult intervention primarily used effortful swallows and oral motor exercises. Conclusions: Our results provide a greater understanding of practice patterns of SLPs working with adults and pediatric patients with dysphagia and inform future areas of focus in clinical training for preservice and in-service SLPs.