Bancroft NeuroRehab...The Psycho-Social Impact of Aphasia Social integration and relationships are...

Bancroft NeuroRehab

Bancroft NeuroRehab provides neurorehabilitation services for adults with

traumatic and acquired brain injuries and

other neurological Neurodisorders

Bancroft Neurorehab is a division of Bancroft

a non-profit organization founded in 1883

serving individuals with neurological and

developmental disabilities

Bancroft NeuroRehab

2

Aphasia amp Dysphagia

Making Their Voices Heard Presented by

Kimberly Baradei MA-CCC SLP CBIS

Cerise Karmondy MA-CCC SLP

3

Objectives bull Be able to identify the characteristics of AphasiaDysphagia

bull Gain insight into the etiologies of AphasiaDysphagia

bull Obtain understanding of various types of AphasiaDysphagia

bull Examine the role of the interdisciplinary team in promoting

education amp awareness to improve functional outcomes

bull Examine various strategies that may be employed for persons with

AphasiaDysphagia

bull Recognize the psycho-social impact of the AphasiaDysphagia

diagnoses

4

Aphasia What Aphasia is

bull An acquired language disorder that is caused by damage to the language areas in the left hemisphere of the brain (NIDCD 2017)

What Aphasia is NOT

bull A motor speech disorder the motor act of speech production

ndash Apraxia - an acquired oral motor speech disorder affects volitional movement

patterns (Wikipedia 2018)

ndash Dysarthria - a motor speech disorder resulting from neurological injury of the

motor component of the motor-speech system and is characterized by poor

articulation (Wikipedia 2017)

bull A cognitive disorder

ndash In Aphasia the thought processes and general intellect are well-preserved

5

Causal Diagnoses bull Stroke

ndash 25-40 of stroke survivors having the

diagnosis of Aphasia

bull Traumatic Brain Injury

bull Brain Tumors

bull Brain Surgery

bull Brain Infections

bull Progressive Neurologic Diseases (ie

Dementia Parkinsonrsquos)

(National Aphasia Association 2016)

6

Awareness bull About 85 of people polled have never heard the term lsquoAphasiarsquo

ndash From the 15 that have only about 9 can identify that itrsquos a language

disorder

bull One third of those who are lsquoAphasia awarersquo either have Aphasia themselves

or know someone who does

bull One third of people polled believe that the language difficulties associated

with Aphasia also indicate intellectual difficulties (which it does not)


7

What is Language

The method of human communication either spoken or written

consisting of the use of words in a structured and conventional way

(Oxford University Press 2018)

Expressive (Output)

bull Verbal (Speaking)

bull Graphemic (Writing)

8

Receptive (Input)

bull Auditory (Understanding what is heard)

bull Reading

9

Where is Language Located

Types of Aphasia

Non-fluentExpressive ndash Global

ndash Mixed transcortical

ndash Brocarsquos

ndash Transcortical motor

10

FluentReceptive ndash Wernickersquos

ndash Transcortical sensory

ndash Conduction

ndash Anomia

11

12

Exceptional Aphasias Crossed

Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal

brain tissue (thalamus

or basal ganglia) vs

surface tissue

Neurodegenerative

This is a dementia

with the gradual loss

of language abilities

Memory processing

and personality are

retained until the

later in the disease

process

Primary Progressive

13

Diagnosis amp Treatment Team

bull Physician

bull Nurse

bull Speech Language Pathologist

bull Neuropsychologist

bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14

Differential Diagnosis

(Goodglass amp Kaplan 1983)

Brocarsquos Aphasia

15

Brocarsquos Aphasia Receptive Characteristics

16

Preserved understanding of informal conversations

Comprehension declines as complexity and length of

communication exchanges increase

Repetition may be fine at for single words or at short phrase level but

is impaired for longer sentences

(ASA 2016)

(Ramirez 2017)

17

Brocarsquos Aphasia Expressive Characteristics

Nonfluent halted speech which sounds Telegraphic ldquoWant go bedrdquo

Lack of pronouns conjunctions prepositions (in the to his)

Nouns are easier to produce than verbs

Acutely aware of their deficits which leads to frustration

More automaticoverlearned phrases are often preserved

ndash Eg counting days of the week prayers

Singing and profanity are often intact

Writing will often show the same patterns of errors seen in verbal

speech (ASA 2016)

(Ramirez 2017)

18 (Klein amp Thorne 2007)


19


20

Strategies for Communication Partners Brocarsquos Aphasia - Receptive Language

Make sure you have the personrsquos attention before speaking

Minimize or eliminate background noise (ie TV radio other people)

Keep your voice at a normal level (unless the person has a known hearing deficit)

Keep communication simple but adult

ndash Simplify your sentence structures and reduce your rate of speech

Strategies for Communication Partners Brocarsquos Aphasia - Expressive Language Be patient and give them time to speak

ndash Resist the urge to finish sentences or offer words

ndash If they are getting frustrated ask them if they would like help

Encourage them to write a letter or word to start what theyrsquore trying to say

ndash They can also point to letters on an alphabet board

Ask them to use gestures or point to what they want

Donrsquot pretend to understand what theyrsquore saying

ndash Ask YesNo questions to clarify

21

Wernickersquos Aphasia

22

Wernickersquos Aphasia Receptive Characteristics

Impaired understanding of they hear sometimes severely so in

many cases even at the single word level

Repetition is impaired for the same reason

23

Fluent sometimes excessively so (Logorrhea)

Often unaware of their deficits

Frequent paraphasias which may be so severe that it sounds like

jargon (eg forkrarr fort fork rarr spoon fork rarr sorf)


speech

24

Wernickersquos Aphasia Expressive Characteristics

25


26


Strategies for Communication Partners Wernickersquos Aphasia - Receptive Language Establish a topic first

Write down key words when speaking and use gestures pictures objects


Slow your speech a little when talking

27

Strategies for Communication Partners Wernickersquos Aphasia - Expressive Language

Establish topic first

Be close enough to maintain eye contact

Talk about things that are relevant to ldquoright nowrdquo

Encourage them to use other modalities to convey information

ndash Drawing writing gestures

Provide multiple choices

28

Expressive - Severely impaired

Receptive - Severely impaired

Repetition - Severely impaired

All modalities are impaired (both expressive and receptive language functions)

Exact symptoms vary from individual to individual

29

Global Aphasia Expressive amp Receptive Characteristics

30


Strategies for Communication Partners Global Aphasia - Expressive amp Receptive

Pay attention to facial expressions intonation patterns and gestures

Minimize distractions and allow time for the person to respond

Use simple sentences when talking repeat as needed and writing down key words

Use objects of reference

Use gestures to support spoken communication

Offer choices using pictures words or objects to support understanding and expression

Donrsquot ask ldquoquizrdquo questions (ie ldquoIs your name Johnrdquo)

Even if the person cannot fully understand or respond donrsquot speak as if theyrsquore not there

31

Communication The imparting or exchanging of information by speaking writing or using

some other medium

32

bull Share information

bull Comment

bull Ask questions

bull Express wants and needs

bull Develop relationships

The Psycho-Social Impact of Aphasia

Social integration and relationships are known to have positive influences on physical

and psychological well-being

Aphasia is a condition which can lead to isolation or a feeling of disconnect from both

established relationships and society as a whole

This separation has negative impacts on mental well-being and physical health

For individuals with aphasia who are already physically impacted by their causal health

issue a contributing Psycho-Social disorder can only jeopardize these mental and

physical status further

Pyscho-Social supports will decrease this tendency for isolation and improve physical

and psychological health 33

34

Support Groups National Aphasia Association

wwwaphasiaorg

American Speech amp Hearing Association

wwwashaorg

Aphasia Recovery Connection

wwwaphasiaarcorg

American Stroke Association

wwwstrokeassociationorg

Adler Aphasia Center

httpsadleraphasiacenterorg

(aphasiaorg)

35

Resources -National Institute on Deafness and Other Communication Disorders (2017 March 6) Aphasia Retrieved from

httpswwwnidcdnihgovhealthaphasia -Wikipedia the free encyclopedia (2018 February 12) Apraxia of speech Retrieved from httpsenwikipediaorgwikiApraxia_of_speech

-Wikipedia the free encyclopedia (2017 November 7)Dysarthria Retrieved from

httpsenwikipediaorgwikiDysarthria

-Aphasia Nova Scotia ldquoCauses of Aphasiardquo What is Aphasia Retrieved from httpswwwaphasianovascotiacawhat-

is-aphasia-1

-National Aphasia Association (2016) Aphasia Statistics Retrieved from httpswwwaphasiaorgaphasia-

resourcesaphasia-statistics

-Oxford University Press (2018) Language Retrieved from httpsenoxforddictionariescomdefinitionlanguage

-MK Holder (1995-2005) What does Handedness have to do with Brain Lateralization(and who cares) Retrieved from httpwwwindianaedu~primatebrainhtml -National Institute of Health (2015 December) Brocas and Wernickes area Publication no 97-4257 Retrieved from

httpswwwnidcdnihgovsitesdefaultfilesDocumentshealthvoiceAphasia6-1-16pdf) -National Aphasia Association Aphasia definitions Retrieved from httpswwwaphasiaorgaphasia-definitions -Goodglass amp Kaplan (1983) Boston Diagnostic Aphasia Examination Cookie Theft -Pyschology (2017 Jan 6) Figure 10-4 Retrieved from httpsneupsykeycomlanguage-processing-disorders

36

Resources cont -American Speech amp Hearing Association (1997-2018) Classification of Aphasia Retrieved from

httpswwwashaorguploadedFilesASHAPractice_PortalClinical_TopicsAphasiaCommon-Classifications-of-Aphasiapdf -Ann Rehabil Med (2017 February 28) 41(1) 16ndash24 Effect of a Caregivers Education Program on Stroke Rehabilitation Retrieved from httpswwwncbinlmnihgovpmcarticlesPMC5344819 -American Stroke Association (2016 November 22) Types of Aphasia Retrieved from httpwwwstrokeassociationorgSTROKEORGLifeAfterStrokeRegainingIndependenceCommunicationChallengesTypes-of-Aphasia_UCM_310096_ArticlejspWslXiOjwZPY

-Klein amp Thorne Biological Psychology (2007) Figure 1316 The handwriting of a person with Brocarsquos Aphasia -Ramirez Emily (2017 February 16) Brocas Area Functions Anatomy and Diseases Retrieved from httpswwwlifepersonacombroca-s-area-functions-anatomy-and-diseases - Eggert Gertrude H (1977) Wernickes works on aphasia A sourcebook and review Early sources in aphasia and related disorders Volume 1 The Hague Mouton Publishers - Oxford University Press (2018) Communication Retrieved from httpsenoxforddictionariescomdefinitioncommunication

- UKEssays (2018 January 4) Impact of Aphasia on Health and Well-being Retrieved from httpswwwukessayscomessaysnursingthe-impact-of-aphasia-on-health-and-well-being-nursing-essayphp - National Aphasia Association Communication Poster Retrieved from httpswwwaphasiaorgaphasia-resourcescommunication-poster

37

Dysphagia Swallowing

Disorders

Making their voices heard

Role of the Speech Language Pathologist According to the American Speech and Hearing

Association (ASHA) SLPs play a central role in the

assessment and management in individuals with

swallowing disorders

(ASHA 1997-2018)

Prevalence of Dysphagia

bull At least 1 in 25 adults experience dysphagia

bull Estimated 22 of adults over 50 years of age

bull 30 of elderly adults

bull 68 of residents long term care facilities (ASHA 1997-2018)

Risks Related to Dysphagia

bull Aspiration pneumonia

bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy

bull Trachea aka the ldquowindpiperdquo

is a tube surrounded by

cartilage that connects the

larynx and pharynx to the

lungs

bull Esophagus A muscular tube

that connects the throat to

the stomach

bull Pharynx the portion of the

throat behind the oral and

nasal cavities leading to the

esophagus and larynx

Brief Overview of Anatomy

bull Larynx aka the

ldquovoice boxrdquo

responsible for

protecting the airway

from the passage of

food liquid and

responsible for voicing

bull Epiglottis A flap

made of cartilage

that covers the

trachea

A closer look at the larynx

Swallowing and the brain bull Swallowing is controlled

by parts of the cerebral

cortex the brain stem

and the cranial nerves

bull Swallowing is a

combination of

voluntary and reflexive

movements

bull Damage to these areas

can result in dysphagia

What does normal swallowing look like

Phases of the swallow

1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)

Oral Preparatory Phase

bull Eating is anticipated

bull Food is brought to the oral cavity bitten off or take

from utensil

bull Food is chewed and mixes with saliva to create the

bolus

bull Liquids are sipped or sucked through a straw (ASHA 1997-2018)

Oral Phase

bull Food is collected with the tongue bull Bolus is held between the hard palate and the

tongue

bull The tongue pushes the bolus back towards the

pharynx

bull This is the beginning of the swallow (ASHA 1997-2018)

Pharyngeal Phase

bull The soft palate rises

bull The back of the tongue retracts to make contact with the

pharyngeal wall

bull The larynx rises and moves forward

bull The epiglottis flap over to cover the airway

bull The breath is held

bull The vocal cords come together to close off the airway

bull The pharyngeal muscles contract to push the bolus towards the

esophagus

bull The opening of the esophagus relaxes allowing food to enter the

esophagus

(ASHA 1997-2018)

Esophageal Phase

bull Contractions in the muscular esophagus move the

bolus down

bull The opening to the stomach relaxes and the bolus

enters the stomach

(ASHA 1997-2018)

Etiologies The causes of dysphagia

bull Stroke

bull Brain Injury

bull Progressive Neurological Diseases

bull Aging

bull Brain tumors

bull Head and Neck Cancers and related treatments (chemo radiation

surgery)

bull Medications

bull Respiratory conditions

bull Intubation (emergency or prolonged)

bull Developmental Disabilities

bull Esophageal disorders(ie GERD esphageal stricture etc)

Signs and Symptoms of dysphagia what to look for

bull Coughing and throat clearing during after eating and drinking

bull Wet gurgly vocal quality during after eating and drinking

bull Choking

bull Difficulty with chewing

bull Pocketing food

bull Facial grimacing

bull Reddening of the face

bull Complaints of food stuck in the throat

bull Reduced intake

bull Fearful of eating and drinking

bull Impulsive eating and drinking

bull Weight loss

bull Dehydration

Aspiration bull Aspiration is when food liquid secretions

or gastric contents passes into the airway

below the level of the vocal folds

bull When aspiration takes place a person

is at risk for developing aspiration

pneumonia

bull Can be described as overt or silent

Aspiration Overt Aspiration There are outward visible signs that

aspiration is taking place coughing throat clearing

chokinga wet gurgly voice

bull Coughing and throat clearing are our bodyrsquos

reflexive responses in an attempt to protect our

airway

bull Observation of these symptoms can lead to

diagnosis of dysphagia

Aspiration Silent Aspiration There is no obvious outward sign that

aspiration is taking place

bull This can be due to impaired sensation and or

impaired reflexes which can occur as a result of

neurologic disorders

bull Silent aspiration may not be identified until a person

develops pneumonia

Aspiration Pneumonia Whatrsquos the big deal The Facts

bull It is a bacterial infection in the lungs caused by inhalation of food liquids secretions or gastric contents

bull Diagnosed with a chest x-ray or CT scan of chest sputum sample etc

bull Treated with antibiotics bull Can cause damage and scarring to the

lungs bull Can result in respiratory failure and even

death

bull Can lead to sepsis (aka ldquoblood poisoningrdquo) bull The mortality rate in individuals with

aspiration pneumonia in the hospital setting is 10-20

( Mayo Foundation for Medical Education and Research 1998-2018)

Diagnosis of Dysphagia bull Referral to the SLP

bull Clinical evaluation by the SLP

ndash In the office or at the bedside

ndash Instrumental Assessment used to evaluate what is taking place

internally during the swallow and can identify the occurrence of

aspiration

ndash MBSS Modified Barium Swallow Study

ndash FEES Fiperoptic Endoscoptic Evaluation of Swallow

bull SLP makes recommendations for diet treatment and management

MBSS Modified Barium Swallow Study

May also be called a

Videofluoroscopic Swallowing Study

(VFSS)

bull Takes place in the radiology

department and is done by an

SLP with a radiologist present

bull Food and liquids of various

textures and consistencies are

mixed with barium and

ingested

bull A real-time x-ray records a

video during the swallow

Modified Barium Swallow Study

MBSS Video

FEES Fiberoptic Endoscopic Evaluation of Swallow

bull A flexible endoscope is

passed through the nasal

passage into the pharynx

This allows the examiner to

visualize the structures and

functions of the pharynx and

larynx during the swallow

bull The equipment for this

procedure is portable and is

more frequently used at the

bedside in a hospital rehab

or nursing home

FEES video

Management and Treatment ORAL CARE bull There is a correlation between poor oral care and pneumonia

bull Often forgotten missed in individual with disabilities

bull We have bacteria and other organisms in our mouths

bull We talked about aspiration of saliva and secretions oral secretions

contain bacteria and aspiration will result in this bacteria entering the

lungs

bull Thorough oral care

ndash At least 2x day

ndash Use a toothbrush and toothpaste

ndash Mouthrinses

ndash Flossing

ndash Also includes denture care (International and American Associations for Dental Research 2015)

Management and Treatment NPO

NPO= No food by mouth

Recommended when the risk of aspiration is high

Alternative means of nutrition

bull G-Tube

bull J-Tube

bull NG tube

bull IV

Diet Modifications Diet Levels

There is not one standard list of diet levels Different programs and

facilities use their own diet levels

The various diet levels may use different terminology to describe the same

diet or they may have different foods included in what appears to be the

same diet

This can easily lead to confusion when a person transfers from facilities

that use different diet levels

National Dysphagia Diets (NDD)

httpwwwmobileendoscopixcomassetspdfNational20Dysphagia20

Dietspdf

(American Dietetic Association 2002)

NDD Level 1 Dysphagia Puree

Pureed homogenous and cohesive foods Foods

should be smooth and ldquopudding likerdquo No chewing

should be required for pureed foods


NDD Level 2 Mechanically Altered

Foods that are soft and moist Meats should be ground

or minced and moistened with gravy or sauce (American Dietetic Association 2002)

NDD Level 3 Dysphagia Advanced

Foods are moist and cut into bite-sized pieces Dry

hard crunchy and sticky foods should be avoided

NDD 3 is a transition to a regular diet


Regular Diet

This diet includes all foods

A person with dysphagia may be on a

regular diet There may be specific

modifications or foods that they avoid


Management and Treatment

Thickening Liquids Liquid consistencies

Rationale (Why do we thicken liquids) Thickened liquids

move more slowly and allow us to control the liquid better This can

compensate for delayed or slower swallowing function and reduce the

risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick

How to thicken liquids thickening agents

There is a variety of commercially available thickening agents They can

be purchased at pharmacies wholesale stores or ordered online Price

varies based on product and brand and expenses may be covered by

insurance

bull Powders

bull Gels

bull Pre-Thickened drinks are also on the market though they are more

expensive (water juices lemonade etc)

Thickening agents

Thick liquids special considerations and things to avoid

Considerations

bull All liquids should be thickened soups and broths milk for cereal etc

bull Canned fruits should be drained

Avoid

bull Foods that melt in your mouth Ice cream milkshakes water ice jello

chocolate hard candies mints and cough drops

bull juicy fruits (peaches oranges tomatoes watermelon etc)

bull Do not add ice to thickened liquids

How to thicken liquids

bull Know what liquid consistency is prescribed for the

individual they are not interchangeable

bull The instructions vary depending on the brand of

thickener you are using

bull Read the label and follow the instructions

bull Ask an SLP for training

Administering Medications

How are medications given This must be specified by

physicianrsquos orders

bull Whole

bull Crushed

bull With applesauce or pudding

bull With a drink

bull Do they take any liquid medications that would

need to be thickened

bull Via feeding tube

Compensatory swallowing strategies and

maneuvers

Strategies

bull Small bites and sips

bull No straw cup sips only via tsp

bull Alternate solids and liquids

bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups

Maneuvers and Postural Techniques

Maneuvers Intended to change the timing and strength of the

movements

bull Mendelsohn Maneuver

bull Supraglottic Swallow

bull Super-Supraglottic Swallow

Postural Techniques Redirect the movement of the bolus by altering the

shape of the oral-pharyngeal structures

bull Chin Tuck

bull Head Turn to either right or left

bull Head tilt (combination of chin tuck and head turn)

Swallowing therapy With the SLP

bull Therapeutic trials of various solid textures and liquid

consistencies

bull Trial and practice compensatory strategies

bull Exercises to increase strength coordination and range

of motion for the structures involved in swallowing

bull Electrical Stimulation an electrical current is used to

stimulate and strengthen the muscles used in

swallowing

Electrical Stimulation

Other factors to consider What impacts outcomes

bull Cognitive considerations

ndash Ability to follow directions

ndash Memory and carryover

ndash Impulsivity

ndash Awareness of impairment

Support

Motivation

Compliance with recommendations

Psycho-social implications

Quality of life

Role of the Caregiver

bull Observing for signs and symptoms of dysphagia and

referring to an SLP

bull Providing consistent cues and feedback for use of

strategies and maneuvers in order to increase

carryover

bull Assisting with swallowing exercise program

bull Observing for changes

bull Providing cues and assisting with regular thorough

oral care

What do caregivers need to know about

someone with dysphagia bull Diet and how to prepare it

bull How medications are to be administered

bull Level of assistance and supervision required while

eating

bull Strategies and maneuvers to be used

bull How to perform swallowing exercises and provide

cues for home exercise program

Ethical considerations bull Quality of life The impact of dysphagia being on a modified diet or

thickened liquids

ndash Having to eat different food than others

ndash Missing foods that they enjoy

ndash Reduced variety of foods available to them

ndash Always being watched while they eat

bull A person or their familyrsquos wishes

bull Tailoring our plan of care to the individual The goal is to keep them

as safe as possible while they are eating drinking

Think about your favorite foods

How would you feel if someone told you that you were

no longer able to eat these things What if you had to

watch other people eat them while you ate

applesauce

references

American Speech-Language Hearing Association (1997-2018) Adult Dysphagia Retrieved from httpswwwashaorgPRPSpecificTopicaspxfolderid=8589942550ampsection=Roles_and_Responsibilities Animed (2016 August 4) How Swallowing Works Animation Video - Stages of Swallowing Process - Swallow Anatomy amp Physiology Retrieved on April 27 2018 from httpswwwyoutubecomwatchv=adJHdrQ4CRM Flexible Nasolaryngoscope [online image] (2017) Retrieved from URL httpswwwquickmedicalcombr-surgical-flexible-naso-laryngoscopeshtmlgc

Food Network (nd) Steakhouse steaks [Digital image] Retrieved April 27 2018 from httpswwwfoodnetworkcomrecipesina-gartensteakhouse-steaks-recipe2-1923191 Kobe Ichiban (2018) [Image of sushi roll] Retrieved April 27 2018 from httpskobesteakhousecomtypes-of-sushi Lanspa JM Jones EB Brown S Dean NC (Feb 1 2013) Mortality morbidity and disease severity of patients with aspiration pneumonia Journal of Hospital Medicine 8(2)83-90 Retrieved from httpswwwncbinlmnihgovpmcarticlesPMC3774007 Mayo Foundation for Medical Education and Research (1998-2018) Pneumonia Retrieved from httpswwwmayoclinicorgdiseases-conditionspneumoniasymptoms-causessyc-20354204 MBS Imaging LLC [online image] (2017) Mobile Modified Barium Swallow Study (MBSS or VFSS) Retrieved from httpswwwmbsimagingcommobile-modified-barium-swallow-stud Medicalook (2018) Aspiration pneumonia signs and symptoms Retrieved from httpwwwmedicalookcomLung_diseasesAspiration_pneumoniahtml Metro (nd) Spicy Juicy Jumbo Pizza [Digital image] Retrieved April 27 2018 from httpswwwmetrocaenrecipes-occasionsrecipesspicy-juicy-jumbo-pizza

references Modified Barium Swallow Test [digital video] Retrieved on May 27 2018 from httpswwwyoutubecomwatchtime_continue=4ampv=AOlOGW4svEE Muller F (March 2015) Oral Hygiene Reduces the Mortality from Aspiration Pneumonia in Frail Elders Journal of Dental Research 94(3 Suppl) 14Sndash16S Retrieved from httpswwwncbinlmnihgovpmcarticlesPMC4541086

N (2018 January 30) TRULY CRISPY OVEN BAKED BUFFALO WINGS [Digital image] Retrieved April 27 2018 from httpswwwrecipetineatscomtruly-crispy-oven-baked-buffalo-wings-my-wings-cookbook National Dysphagia Diet Task Force (2002) National Dysphagia Diet Standardization for Optimal Care Chicago IL American Dietetic Association Northern Speech Services (2016 October 5) Anatomy amp Physiology of Swallowing - MBSImP Animation Retrieved on April 27 2018 from httpswwwyoutubecomwatchv=QvNA53Ky2qQ Original Thick-it Food Thickener [digital image] Retrieved April 26 2018 from URL (httpswwwamazoncomOriginal-Thick-Food-Thickener-OuncedpB003MT0Q4Qlid=EAIaIQobChMIl4SS98TV2gIVlrrACh0HcwqUEAQYAiABEgIS4fD_BwEampsku=52481amputm_campaign=google_shoppingamputm_medium=shoppingamputm_source=google Simply Thick (2014) [digital image] Retrieved on April 27 2018 from httpstar-medicalnetproductsimply-thick Southwest Rehabilitation (2016) Modified Barium Swallow Retreived from httpsouthwestrehabilitationcommodified-barium-swallow-2 Step to Health [digital image] (2018) 11 Daily Habits that Damage the Brain Retrieved on April 27 2018 from httpssteptohealthcom11-daily-habits-damage-the-brain Thick and Easy Variety Pack [online image] (2018) Retrieved from (httpwwwhomecarenutritioncomthickened-beverage-variety-nectarfee=4ampfep=188amputm_source=googleamputm_medium=CSEamputm_campaign=productampgclid=EAIaIQobChMIqberwKSy2gIVyrfACh0bzwZ1EAQYBSABEgI5cvD_BwEampgclsrc=awds

VitalStim Therapy Eases Swallowing Difficulty [digital image](2018) Retrieved on April 27 2018 from httpwwwlfhorgvitalstim_therapy_eases_swallowing_difficulty

88

Visit us at

BNRinfoorg

Bancroft NeuroRehab provides neurorehabilitation services for adults with

traumatic and acquired brain injuries and

other neurological Neurodisorders

Bancroft Neurorehab is a division of Bancroft

a non-profit organization founded in 1883

serving individuals with neurological and

developmental disabilities

Bancroft NeuroRehab

2





3







AphasiaDysphagia


diagnoses

4



What Aphasia is NOT









5





bull Brain Tumors

bull Brain Surgery





6



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





3







AphasiaDysphagia


diagnoses

4



What Aphasia is NOT









5





bull Brain Tumors

bull Brain Surgery





6



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg







AphasiaDysphagia


diagnoses

4



What Aphasia is NOT









5





bull Brain Tumors

bull Brain Surgery





6



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



What Aphasia is NOT









5





bull Brain Tumors

bull Brain Surgery





6



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





bull Brain Tumors

bull Brain Surgery





6



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



disorder






7

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

What is Language




Expressive (Output)



8

Receptive (Input)


bull Reading

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

9


Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Types of Aphasia



ndash Brocarsquos


10



ndash Conduction

ndash Anomia

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

11

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

12


Language

impairment that

presents from

damage to the

Right hemisphere

(ASHA 1997-2018)

Subcortical

Language

impairment that

presents from

damage to internal



surface tissue

Neurodegenerative

This is a dementia



Memory processing

and personality are

retained until the


process

Primary Progressive

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

13


bull Physician

bull Nurse



bull Case Managers

bull Social Workers

bull Patient

bull Family Members

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

14



Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Brocarsquos Aphasia

15


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


16






(ASA 2016)

(Ramirez 2017)

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

17










speech (ASA 2016)

(Ramirez 2017)



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



19


20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

20















21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg









21


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


22





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





23






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






speech

24


25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

25


26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

26






27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





27








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg








28






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






29


30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

30











31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg










31


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


some other medium

32


bull Comment

bull Ask questions














34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg












34


wwwaphasiaorg


wwwashaorg


wwwaphasiaarcorg





(aphasiaorg)

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

35






is-aphasia-1






36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

36





37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

37


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


Disorders






(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





(ASHA 1997-2018)








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg








bull Choking

bull Malnutrition

bull Dehydration

bull Weight loss

bull Death

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Overview of Anatomy





lungs



the stomach






bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


bull Larynx aka the

ldquovoice boxrdquo

responsible for


from the passage of

food liquid and



made of cartilage

that covers the

trachea







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg







combination of


movements





1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



1 Oral Preparatory

2 Oral

3 Pharyngeal

4 Esophageal

(ASHA 1997-2018)




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg




from utensil


bolus


Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Oral Phase


tongue


pharynx


Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Pharyngeal Phase



pharyngeal wall






esophagus


esophagus

(ASHA 1997-2018)

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Esophageal Phase


bolus down


enters the stomach

(ASHA 1997-2018)


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


bull Stroke

bull Brain Injury


bull Aging

bull Brain tumors


surgery)

bull Medications








bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg




bull Choking


bull Pocketing food




bull Reduced intake



bull Weight loss

bull Dehydration






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






pneumonia







airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






airway









develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg







develops pneumonia






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






death









aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






aspiration







(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg




(VFSS)







ingested




MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


MBSS Video













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg













or nursing home

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

FEES video






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






lungs




ndash Mouthrinses

ndash Flossing






bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





bull G-Tube

bull J-Tube

bull NG tube

bull IV






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






same diet





Dietspdf















Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg














Regular Diet











risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






risk of aspiration

bull Thin liquids

bull Nectar- thick

bull Honey-thick

bull Pudding-thick





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





insurance

bull Powders

bull Gels



Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg

Thickening agents


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


Considerations



Avoid















bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg











bull Whole

bull Crushed


bull With a drink





maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


maneuvers

Strategies




bull Double swallow

bull Hard swallow

bull Tongue sweep

bull Special cups



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



movements






bull Chin Tuck





consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



consistencies






swallowing






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg






ndash Impulsivity


Support

Motivation



Quality of life



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg



referring to an SLP



carryover




oral care





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





eating





thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg


thickened liquids












applesauce

references






88

Visit us at

BNRinfoorg





applesauce

references






88

Visit us at

BNRinfoorg

references






88

Visit us at

BNRinfoorg




88

Visit us at

BNRinfoorg

Bancroft NeuroRehab...The Psycho-Social Impact of Aphasia Social integration and relationships are...

Documents

Transcript of Bancroft NeuroRehab...The Psycho-Social Impact of Aphasia Social integration and relationships are...