D’Angelo, E. C. (2024). Clinical feeding and swallowing evaluation for the school-based speech-language pathologist. Language, Speech, and Hearing Services in Schools, 55(2), 409-422. (available open source on Google Scholar)
This recent article provides a comprehensive holistic look at a school-based swallowing and feeding evaluation process. It thoughtfully details the critical thinking required on the part of the school-based SLP in evaluating swallowing and feeding, and developing a plan for team implementation. Even if you are not employed in the schools, but see school-aged children, the information will inform your practice. Congratulations to our colleague, Elizabeth D’Angelo MS/CCC-SLP!
Quote from the article:
Children in school settings require nutrition and hydration for learning. Children with significant medical and behavioral issues are in neighborhood schools, and many have eating issues related to swallowing, feeding, or both. In the past, SLPs chose to pursue school-based careers or medical careers: educational and academic versus neurological and physiological. This is no longer a clear choice: Children with medical and behavioral concerns are mainstreamed and included in the schools. The whole child is in school, including all of their medical, behavioral, social, and educational needs. Eating is part of the school day, and as such, the child is in our care and responsibility. Children with swallowing and/or feeding concerns or differences must be appropriately evaluated to provide adequate nutrition and hydration in the safest manner. Safety is the primary concern. Collaboration as a team is integral to the process. In this evaluation process, a holistic view of the child should be utilized, with a focus on the four domains: medical, skills, nutrition, and psychosocial. The school SLP should lead the team to evaluate PFD and support the child, family, and school team in safety and maximize the child’s ability to learn and participate in the school day.
This clinical focus article explores the evaluation process in the educational setting for the school SLP in identification of pediatric feeding disorders (PFDs), which can involve dysphagia. Detailed descriptions of the related U.S. educational law, PFD, assessment processes for the multiple systems relating to eating, and collaboration with an interdisciplinary team are highlighted. Using the four overlapping domains of PFD (medical, psychosocial, feeding skill-based systems and associated nutritional aspects), medical and background history gathering; integration with instrumental results; and the need to consider the complex interaction of developmental, physical, cognitive, social, behavioral, family, and cultural aspects in the evaluation are detailed.
I hope you enjoy reading this as much as I did~