Speech-Language Pathology

Education requirements

Master’s degree or M. Ed followed by clinical education and passing boards

Clinical fellowship

9 month program after completing degree. Operate under supervision of SLP

Required to receive Certificate of Clinical Competence

Dysarthria

Slurred speech

Aphasia

Difficulty understanding or expressing ideas

Swallowing evaluation

Check for mastication, bolus control, timely transit, timely swallow trigger, good airway protection, no residue after swallowing

Modified solid diet (thickest to thinnest)

Regular, chopped, minced, puree

Modified liquid diet (thin to thick)

Thin, nectar, honey, pudding

Nasogastric tube

Temporary alternative feeding method used when pt is ventilated

Tube enters nose and continues directly to stomach

Alternative nutrition

Used if oral diet is unsafe or not tolerated

Bypasses oral feeding

Percutaneous endoscopic gastrostomy (PEG)

Long term alteernative feeding method

Surgical placement of tube required

Cuffed tracheostomy

Air can only move in and out through trach

Cuffless tracheostomy

Air can move in, out and around trach

Implications of open trachea and PT

Vocal speech difficult or impossible, reduced intrabdominal pressure, impaired swallow, risk of infection

Passy-Muir Valve (PMV)

Trach valve designed to prevent air leak

Improved communication, improved oxygenation, reduced risk of aspiration, positive airway pressure and restored closed-loop system