Guest guest Posted January 18, 2006 Report Share Posted January 18, 2006 I remember that years ago, OT worked with Dysphagia/ cognitively impaired patients. I am unsure of the total capacity that OT performed such services and do not want to minimize the Role of ST with our patients. However, with the Caps in place, I am wondering if it is some value to revisit this again? This would allow ST to focus on more of the specifics and allow OT to work on other areas. I would like any info and educational resources in the area. Tamera J Bounds Regional Rehad Director --------------------------------- Yahoo! Photos – Showcase holiday pictures in hardcover Photo Books. You design it and we’ll bind it! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2006 Report Share Posted January 18, 2006 As a point of reference, you might want to visit the aota site. They have guidelines for dysphagia treatment with OT. Here is a link to a fact sheet published by AOTA. I would keep something like this handy, along with training certificates in case of denial or medical complications. http://www.aota.org/featured/area6/docs/DysFact.pdf I also saw that AOTA is listing continuing ed on dysphagia. The SLPs frequently don't graduate with sufficient clinical experience in dysphagia; however, they can pick up the experience in their CFY time. Your OTs may or may not have sufficient clinical training in dysphagia. ST and OT each make arguments re academic training (I have even talked to some PTs who work in the area). It's a hot topic but I never saw a lot of need to tie it strongly to the Part B cap argument. I always thought the majority of dysphagia was tied to an acute episode with Part A implications....but I may be wrong. Steve Passmore PT Healthy Recruiting Tools spass@... Medicare Caps I remember that years ago, OT worked with Dysphagia/ cognitively impaired patients. I am unsure of the total capacity that OT performed such services and do not want to minimize the Role of ST with our patients. However, with the Caps in place, I am wondering if it is some value to revisit this again? This would allow ST to focus on more of the specifics and allow OT to work on other areas. I would like any info and educational resources in the area. Tamera J Bounds Regional Rehad Director --------------------------------- Yahoo! Photos - Showcase holiday pictures in hardcover Photo Books. You design it and we'll bind it! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2006 Report Share Posted January 19, 2006 It has been my practice over the last 35 years to ALWAYS use a speech-language pathologist with the Certificate of Clinical Competence (CCC-SLP) to work with Dysphagia. In the older decades OTs did work with feeding issues. I have supervised thousands of OTs, PTs & SLPs and would never allow OT to work with Dysphagia if a SLP is available. The ASHA Code of Ethics prohibits one working with something they aren't competent to do, so you would/should be/are seeing requests for CEU monies to get advanced training for those who have not had much hands-on experience. In the last 7years it has been brought to my attention that some OT schools are teaching some dysphagia coursework. I have evaluated a couple of syllabi and found them not nearly as comprehensive as those used to teach SLPs. (I also now teach grad school, have taught grad Dysphagia; am on the Va licensure board as well as an ASHA Legislative Councilor & Chair of the ASHA Financial Planning Board. ) I know & respect a SLP who runs rehab in a CCare Co.all over the USA. She uses OTs for dysphagia work in rural areas sometimes. My advice to you is to have the OTs handle getting the food/arm, etc up to the mouth & the SLPs handle everything from the lips back through the system, etc. There was an attempt a few years ago to obtain legal injunctions to prohibit OTs from working with Dysphagia. That was not possible because their Scope of Practice does address feeding. Leaders in the field of Dysphagia are all SLPs...Logemann, Crary, Groher, Sonies, Perlman, VA folks. Many now prohibit OTs from attending their advanced Dysphagia training courses that DID allow this earlier. If you need a text, use one of Groher or Logemann's; they are the best & I have them all. It has been my experience that many non -clinical owners/admin-type folks often attend workshops, hear that it's ok to solve their lack of SLP problems by having OT handle Dysphagia, & the next Monday their entire co./staff has a memo telling them OTs are to see dysphagia pts. The main issue here is that since not knowing what to do CAN & DOES result in death, appropriate training is key. NO clinically competent SLP has less than 7-8 years in training; most OTs I know don't have masters degrees although I know that is changing. Certainly entire semester courses are absolutely essential to cover the material needed before seeing pts. There should be a course in Adult Dysphagia & one in Pediatric Dysphagia. Clinical work with patients is also needed for one to feel competent treating them, in my humble (yet very-experienced )opinion. Sally -McNamara, MCS, CCC-SLP, CCP Consultant - Virginia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2006 Report Share Posted January 23, 2006 I do understand what you are saying in your e-mail, and I am fortunate to have a full time SLP on staff. However, with the shortage of SLP and the lack of ASHA's vision to use SLP-A patient are the ones that loss out on services. What should a company do that needs to offer SLP services, but their isn't a SLP to be found? Pruitt Therapy Director >>> Sallyjmac@... 01/19/06 10:40AM >>> It has been my practice over the last 35 years to ALWAYS use a speech-language pathologist with the Certificate of Clinical Competence (CCC-SLP) to work with Dysphagia. In the older decades OTs did work with feeding issues. I have supervised thousands of OTs, PTs & SLPs and would never allow OT to work with Dysphagia if a SLP is available. The ASHA Code of Ethics prohibits one working with something they aren't competent to do, so you would/should be/are seeing requests for CEU monies to get advanced training for those who have not had much hands-on experience. In the last 7years it has been brought to my attention that some OT schools are teaching some dysphagia coursework. I have evaluated a couple of syllabi and found them not nearly as comprehensive as those used to teach SLPs. (I also now teach grad school, have taught grad Dysphagia; am on the Va licensure board as well as an ASHA Legislative Councilor & Chair of the ASHA Financial Planning Board. ) I know & respect a SLP who runs rehab in a CCare Co.all over the USA. She uses OTs for dysphagia work in rural areas sometimes. My advice to you is to have the OTs handle getting the food/arm, etc up to the mouth & the SLPs handle everything from the lips back through the system, etc. There was an attempt a few years ago to obtain legal injunctions to prohibit OTs from working with Dysphagia. That was not possible because their Scope of Practice does address feeding. Leaders in the field of Dysphagia are all SLPs...Logemann, Crary, Groher, Sonies, Perlman, VA folks. Many now prohibit OTs from attending their advanced Dysphagia training courses that DID allow this earlier. If you need a text, use one of Groher or Logemann's; they are the best & I have them all. It has been my experience that many non -clinical owners/admin-type folks often attend workshops, hear that it's ok to solve their lack of SLP problems by having OT handle Dysphagia, & the next Monday their entire co./staff has a memo telling them OTs are to see dysphagia pts. The main issue here is that since not knowing what to do CAN & DOES result in death, appropriate training is key. NO clinically competent SLP has less than 7-8 years in training; most OTs I know don't have masters degrees although I know that is changing. Certainly entire semester courses are absolutely essential to cover the material needed before seeing pts. There should be a course in Adult Dysphagia & one in Pediatric Dysphagia. Clinical work with patients is also needed for one to feel competent treating them, in my humble (yet very-experienced )opinion. Sally -McNamara, MCS, CCC-SLP, CCP Consultant - Virginia Quote Link to comment Share on other sites More sharing options...
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