Esophageal Dysphagia Part 3: Implementing an Esophageal Screen in the MBSS
Presented by Joy E. Gaziano
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This course is part 3 of 5 lectures designed to assist clinicians in becoming informed dysphagia team members, allowing them to engage with gastroenterologists evaluating and treating esophageal dysfunction leading to dysphagia. Assessment and treatment of the complex swallowing continuum have traditionally been dichotomized into oropharyngeal and esophageal phases that are managed by speech pathologists and gastroenterologists, respectively. However, as we recognize the interdependence and interrelationships that exist within the aerodigestive system, SLPs are increasingly providing valuable input in the assessment and treatment of esophageal dysphagia. They are expanding the videofluoroscopic swallow assessment to include cursory esophageal views when using a structured protocol. In turn, they can offer behavioral eating strategies for various esophageal swallowing disorders like those employed in oropharyngeal dysphagia.
Mastery of this course content should help clinicians identify oropharyngeal–esophageal swallow interrelationships and provide a rationale for expanding their role in dysphagia management. Clinicians will have a working knowledge of standardized esophageal screens and their role in the SLP’s instrumental swallow assessment. They will rate esophageal screen swallows using the standardized Robust Esophageal Screening Test (REST) protocol.
Learning Objectives
- Analyze the interrelationships between the oropharyngeal and esophageal domains of swallowing
- Organize your rationale for expanding dysphagia assessment to include all domains of swallowing
- Distinguish between various esophageal screening options to incorporate into a videofluoroscopic swallow assessment
- Integrate the Robust Esophageal Screening Test (REST) into the modified barium swallow
- Analyze modified barium swallow studies with the REST esophageal screen
Meet your instructor
Joy E. Gaziano
Joy E. Gaziano is a medical speech pathologist and board-certified specialist in swallowing and swallowing disorders (BCS-S) through ASHA. She has served the USF Center for Swallowing Disorders for more than 30 years, focusing on the management of complex upper aerodigestive disorders. She has an active clinical practice,…
Chapters & learning objectives
1. Interrelationships Across Swallowing Domains
This chapter outlines the interrelationships and interdependence found within the complex swallow continuum, which provides a rationale for expanding the SLP’s role in team management of dysphagia. It offers research to extend to other healthcare professionals, making the case for the expanding role within a team or organization.
2. Incorporating an Esophageal Screen Into the Modified Barium Swallow Study
This chapter introduces the clinician to a summary of published esophageal screens. It outlines how to incorporate the screens and provides practical applications for an esophageal screen in clinical use.
3. Expanding the Utility of the MBSS by Adding the Robust Esophageal Screening Test (REST)
This chapter integrates the REST esophageal screen into the modified barium swallow. It demonstrates the scoring rubric and offers attendees an opportunity to score REST screens. It concludes with two case studies that demonstrate how adding the REST esophageal screen may facilitate timely and accurate dysphagia management.
More courses in this series
Esophageal Dysphagia Part 1: Anatomy, Physiology, and Assessment
Joy E. Gaziano
Esophageal Dysphagia Part 2: Esophageal Disorders and Their Management
Joy E. Gaziano
Esophageal Dysphagia Part 3: Implementing an Esophageal Screen in the MBSS
Joy E. Gaziano
Esophageal Dysphagia Part 4: Belching and Rumination Disorders
Joy E. Gaziano
Esophageal Dysphagia Part 5: GERD Concepts for the SLP
Joy E. Gaziano