[Dysphagia] Cross Training

[bklslp at earthlink.net (Brenda Logsdon)]

I went through this when I began teaching continuing education programs about 5 years ago.  ASHA sent me their policy statements, which I already had, and tried to convince me that educating people was unethical.  My opinion is that ignorance never solved any problems.  

EVERYONE starts out knowing nothing.  The only way to acquire knowledge is to learn.  Many of us practicing today did not even receive dysphagia education in college.  I learned some on the job from a mentoring therapist (who learned the same way), but most from reading journals, textbooks (from a variety of professions), educational websites, and a few convention classes.  So do I meet ASHAs qualifications of being "significantly and uniquely" qualified to provide this service?  ( I like to think so.)  

ASHA's own standards for "education and training of SLPs in swallowing and feeding" will not even be in effect until Jan 2005.  How can we demand that others not learn this information when we don't even our own standard in place?  

The "Knowledge and Skills" position paper includes use of the endoscope for fees and even use of topical anesthesia.  I can think of a couple of other professional organizations who might feel rather teritorial about ASHA members' self-proclaimed competence in performing these procedures.  

Finally, we / ASHA are in our infancy in regard to a thorough knowledge of dysphagia and its implications.  We are only just now recognizing and correcting our errors of the past two decades (and I don't want to get started on these topics): overuse of thickened liquids and tube feedings, lack of appreciation of the effects of poor oral hygiene, dehydration, malnutrition on dysphagia and vice-versa, and we still don't officially include the lower esophagus as part of our assessment or treatment plan of care.  How can we really claim this as our field of expertise and limit others access to this information when we don't have it all yet?  

I see ASHA has updated  its technical report and has a stronger statement admonishing its members that "SLPs should not train....(those) from other professions....."  So, I might have this conversation with them again, but for now, I sign myself

Brenda Logsdon, CCC/SLP; ASHA member since 1990; self-taught dysphagia therapist, and instructor of AOTA and ASHA approved continuing education seminars.


Brenda Logsdon CCC/SLP
http://home.earthlink.net/~bklslp/index.html
CE Instructor for Dynamic Online
www.dynamic-online.com
"First seek to understand, then to be understood"
bklslp@earthlink.net