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You Can Measure a Swallow?

Dr. Katherine Kendall, MD

The frame-by-frame x-ray recording showed the silhouette of a person swallowing a metallic barium solution that showed up on the x-ray. As the solution slowly made its way down the subject’s pharynx and esophagus, Dr. Katherine Kendall, MD and Dr. Rebecca Leonard, PhD explained to students the structures in the mouth and throat that make swallowing possible and ways to determine the type of swallowing problem the patient was experiencing.

Though this visual is foreign to most people, analyzing x-rays like these is common to these two experts and to other speech language pathologists. Speech- language pathologists routinely do X-ray tests of swallowing in hospitals. Often these tests are used when patients have additional complications such as strokes or other neurological problems.

Evaluating x-rays of swallowing is a skill graduate students in the communication disorders program learn as they prepare to become speech language pathologists as part of the Dysphagia Management class. The class teaches students about dysphagia—or difficulty swallowing—which can be due to many different causes. And this year, graduate students in Dr. Kristine Tanner’s class had the unprecedented opportunity to learn this from experts Kendall and Leonard as part of a hands-on seminar sponsored by the McKay School of Education.

Both Leonard and Kendall are talented researchers and professors in the evaluation and treatment of swallowing disorders who do workshops like this across the country. While teaching at UC-Davis they co-authored the textbook Dysphagia Assessment and Treatment Planning, which is now in its third edition; they are well qualified to enhance the instruction of the graduate Dysphagia Management class. Kendall and Leonard said they hoped their work, including this seminar, would promote standards of practice and training of swallowing measures.

Dr. Rebecca Leonard, Ph.D

This two-day workshop was the students’ first exposure to swallowing measures (the way pathologists calculate how effectively a patient swallowing)—an ability they may need in their future internships and jobs. Previously, students used only the class textbook accompanied with a DVD of swallowing x-rays as well as class instruction to learn the skills needed to evaluate and measure swallows.

Tanner, who works with Dr. Kendall on research, as well as at the University of Utah Voice Disorders Center, said the seminar was more than just an augmentation of normal classroom learning. “Students typically have to pay for this type of specialized training after graduate school at workshops for continuing education,” Tanner explained. “This was a unique opportunity for the students to receive post-graduate clinical training as part of the course.”

Another aspect of the training was that the course emphasized a multidisciplinary approach to care of swallowing disorder patients. A recent article published by the American Speech-Hearing Language Association challenges graduate programs to teach students “interprofessional teaming” that is usually only gained through on-the-job experience. Tanner said that “this seminar helped BYU meet that charge.”

The students benefited from this first-time interactive workshop. Claire Hanson, one of the students who participated, said she felt classroom learning can be “more abstract,” and she sometimes finds it hard to see real world application, but that performing the measures with Kendall’s and Leonard’s guidance helped her make that connection.

Another student, Katherine Morris, has an internship coming this fall at a hospital where she will be preforming swallowing measures. Morris said the seminar was very applicable to her. “When you’re actually with professionals and they’re training and interacting with you, you realize this is real and you can do this in a real professional setting,” Morris said.