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2023/2024

Swallowing and Related Disorders: Assessment and Intervention

Code: 104147 ECTS Credits: 9
Degree Type Year Semester
2500893 Speech therapy OB 3 2

Contact

Name:
Andreu Sauca Balart
Email:
andreu.sauca@uab.cat

Teaching groups languages

You can check it through this link. To consult the language you will need to enter the CODE of the subject. Please note that this information is provisional until 30 November 2023.

Teachers

Carlota Faixa Sol
Laura Auge Domenech
Raquel Garcia Ezquerra

External teachers

Poden intervenir empreses i/o professionals externs a petición del docent.

Prerequisites

Have studied the subject "Neurology of Language"

 

THIS TEACHING GUIDE ALSO CORRESPONDS TO ALTERNATIVE TEACHING FOR STUDENTS ENROLLED IN THE SUBJECT OF THE OLD CURRICULUM 101712.- Dysphagia and related disorders


Objectives and Contextualisation

At the end of the course students must be able to:

  • Evaluate and diagnose eating disorders and swallowing in all ages and etiologies.
  • Know how to manage MECV-V and other tests such as EAT10 and the Payne Technique.
  • Know the anatomical bases involved in rehabilitation processes for swallowing and the remainingpost-surgery with dysphagia.
  • Know and know how to apply manoeuvres and therapeutic techniques to treat disorders of feeding and swallowing being studied.
  • Know the specific products for the feeding of patients with dysphagia.
  • Understand the most common tools and products for both the assessment and the treatment of problems swallowing.
  • Know how to identify the associated disorders involved in order to make therapeutic decisions. 
  • Understand the consequences of laryngectomy (partial and total) on swallowing in patients.
  • Understand the mechanisms of rehabilitation of smell in laryngectomized.
  • Know the issues of personal care that the speaker needs to know to treat patients with total laryngectomy.
  • Know the basics to rehabilitate the esophageal, prosthetic and electron speech in total laryngectomy.
  • Know the individual difficulties of the esophageal or erigmophonic voice through the attempt of its production.

Competences

  • Critically evaluate the techniques and instruments of evaluation and diagnosis in speech therapy, as well as its procedures of intervention.
  • Demonstrate an understanding of disorders in communication, language, speech, hearing, voice and non-verbal oral functions.
  • Demonstrate knowledge of the limits of competence and be able to identify whether interdisciplinary treatment is required.
  • Explore, evaluate, diagnose and produce a prognosis of development for disorders of communication and language, from a multidisciplinary perspective.
  • Identify, analyze and solve ethical problems in complex situations.
  • Innovate in the methods and processes of this area of knowledge in response to the needs and wishes of society.
  • Make decisions and take responsibility for them.
  • Understand, integrate and relate new knowledge deriving from autonomous learning.

Learning Outcomes

  1. Assess the usefulness of the main techniques of assessment and diagnosis of speech-therapy disorders of neurological origin and be able to interpret related results.
  2. Describe and explain the theoretical basis of the techniques of rehabilitation for disorders of speech, language and deglutition, of neurological origin.
  3. Describe aspects of the rehabilitation of disorders in speech, language and deglutition that require joint action by professionals from various disciplines (neurologists, physiotherapists, psychologists, etc).
  4. Describe the main techniques in the assessment and diagnosis of disorders in language, speech and deglutition of neurological origin.
  5. Explain the origin and characteristics of language speech and deglutition disorders caused by brain damage.
  6. Identify, analyze and solve ethical problems in complex situations.
  7. Make decisions and take responsibility for them.
  8. Propose new experience-based methods or alternative solutions.
  9. Understand, integrate and relate new knowledge deriving from autonomous learning.
  10. Use the most appropriate techniques to diagnose and issue a prognosis for the evolution of language, speech and deglutition disorders of neurological origin.
  11. Weigh up the risks and opportunities of both one's own and other people's proposals for improvement.

Content

1. Anatomophysiology of swallowing:

  • Pathophysiology of swallowing.
  • Semiology of swallowing disorders.

2. Clinical and instrumental exploration of swallowing:

  • EAT10
  • Exploration without bolus
  • MECV-V
  • T. de Payne
  • Other explorations

3. Identification and management of dysphagia in preterm infants:

  • Development of the oral functions of the feeding
  • Child feeding: normality, reflexes and evolution
  • Orofacial stimulation in the ICU (Intensive Care Unit)

4. Oropharyngeal dysphagia of neurological origin and associated disorders

  • Exploration and rehabilitation of the dysarthria

5. Dysphagia of organic origin and associated disorders:

  • Exploration and rehabilitation of the dysglosies

6. Dysphagia vs. atypical swallowing and associated disorders:

  • Clinical and instrumental evaluation of atypical swallowing
  • Interaction between atypical swallowing, speech disorders and associated orofacial dysfunctions
  • Differential diagnosis: dysphagia and atypical swallowing

7. Objectives, programming and planning of the rehabilitation of swallowing according to basic pathology:

  • Manoeuvres and direct and indirect techniques of rehabilitation of dysphagia

8. Laryngectomy:

  • Dysphagia inherent in the condition of the laryngectomized
  • Basic care.
  • The voice without a larynx:
    • prosthetic voice:
    • Esophageal vein. Procedures and conditions.
    • The electrolaryngx
    • Other alternatives (communicators)

9. dysarthria

  • concept
  • prevalence
  • Etiology
  • Semiological traits
  • classification
  • Dysarthria vs. apraxia
  • Exploration: Objectives, levels, types, Protocols
  • Therapeutic Plan

 


Methodology

The subject will consist of a theoretical module of each subject and a module in which the student will be trained in the practice of the use of the main evidence of swallowing and its disorders.

Training activities, with approximate hours of dedication and corresponding learning outcomes, are specified below.

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.


Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
Classes of theory amb suport TIC 61.5 2.46 3, 2, 5, 1
Practical classes of exploration and critical analysis and discussion of practical cases 6 0.24 6, 7
Type: Supervised      
Tutories programades amb the professor per revisió d'activitats dirigides 3.5 0.14 9, 2, 7
Type: Autonomous      
Bibliographic and documentary consultations 36 1.44 4, 5
Completion of summaries, diagrams and conceptual maps 15 0.6 5
Comprehensive reading of materials 47.25 1.89 9, 3, 2, 4, 5, 10, 1
Participation in peer communication forums 23 0.92 3, 2, 7
Tasks realization 30 1.2 4, 5

Assessment

https://www.uab.cat/web/estudiar/graus/graus/avaluacions-1345722525858.html

Continued avaluation:

[EV1] Evidence 1: First evaluation period. Individual exam, face-to-face, test type. It is not a eliminatory matter, which is included again in EV3.
[EV2] Evidence 2: First evaluation period. Individual, on-line, oral examination of erigmophonic voice production.
[EV3] Evidence 3: Second evaluation period. Individual exam, online, test type. Cumulative of all the matter of the theoretical part.
[EV4] Evidence 4: Second evaluation period. Individual examination, on-line, type test or of brief development, of all the matter seen in the practices.

All the online evaluations will be made from an UAB classroom.


(see evaluation guidelines)

Evaluation guidelines:

The score obtained in the exam of the subject taught in the practices, will only be computable if you have attended all the practical sessions of the course assigned.
Non-assessable student: if he / she has not delivered at least evidence of learning with a minimum weight of 40%.

Passed subject: pass with a 5 (scale 0-10) taking into account the percentage weight of each evidence mentioned above.

Reassessment Tests: In the recovery period. Individual, on-line, test-type and cumulative examination of all the subject, both theoretical and practical.

Students who have not met the criteria established to pass the subject and who have been assessed with a minimum of 2/3 of evidence of learning may choose to take the make-up test.
The reassessment may consist of two parts: a test-type test and the oral resolution of a case study or, alternatively, the student, in case of having failed a single test, may choose to be re-evaluated from the test not passed.

Single Assessment:

  • Evidence: 
    • At the end of the second evaluation period.
    • The test of the single assessment will consist of a test that will consist of the parts described in the evidence of the continuous assessment, with the same weight, and which will last 3 hours.
    • The written part will be done online in a computer room at the UAB.
    • The questions will correspond to the theoretical part and the practical part of the subject (oral explanations in the classroom; drawings, graphs, etc. on the board; videos viewed in the classroom; PowerPoint; Forums on the Virtual Campus; Bibliography; practical exercises; practical learning) and ends with an oral test of esophageal voice production (erigmophony) of about two minutes.
  • Recovery: The same recovery system as for the continuous assessment will be applied.
  • Review of the final grade: The review of the final grade follows the same procedure as for the continuous assessment, through an individual interview with the teacher.

Final qualification: The teacher reserves the option of supplementing the students' grade by evaluating aspects such as interest in the subject, dedication, among others.

Languages: The exams are in Catalan, they will not be translated. In the oral exam, the student will be able to express himself in his language (as long as it is one of the following: Catalan, Spanish, English, French, Italian or Portuguese).

Honors: In any case, the maximum achievable mark will be a 10, although the relative mark and the involvement of the student will be taken into account when awarding possible Honors.

Chrono: EV3 and EV4, in the Second Assessment Period, will be separated by at least one week.

 

 

 

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
EV1. Oral examination of erigmophonic voice 5% 0.25 0.01 9
EV2. Examination. Type Test. Not eliminatory 25% 0.5 0.02 9, 3, 2, 4, 5, 6, 7, 10, 1
EV3. Examination. Type Test. Accumulative of all the subject matter seen in the theoretical classes. 40% 1 0.04 9, 3, 2, 4, 5, 6, 7, 10, 1
EV4. Examination. Type Test, of all the matter seen in the Practices. 30% 1 0.04 9, 4, 6, 11, 7, 8, 10, 1

Bibliography

1. FONAMENTAL

   Reference Manuals:

  •        D. Bleeckx. Disfagia. Evaluación y reeducación trastornos de la deglución. Mc Graw Hill, 2004. (Esgotat, però hi és a la Biblioteca d'Humanitats de la UAB, inclouent-hi el CD-ROM)
  •        J.A. Logemann. Evaluation and Treatment of Swallowing Disorders. Pro-ed, Austin, Texas, 1998
  •        G. Heuillet-Martin, L. Conrad. Hablar sin Laringe. Rehabilitación de la voz en laringectomizados. Ed. Lebón 2003.
  •        Paniagua J., Susanibar F., Giménez P., Murciego P. García R. Disfagia: De la evidencia científica a la práctica clínica. 2 Vols. Giuntieos Psychometrics, 2019.
  •        García R., Paniagua J., Giménez P., Murciego P., De Almeida M. Abordaje de la Disfagia Pediátrico-Neonatal. Elsevier, 2022.

   BOOKS:

  •       M. Velasco. V. Arreola, P. Clavé, C. Puiggrós. Abordaje clínico de la disfagia orofaríngea: diagnóstico y tratamiento. Nutrición Clínica en Medicina, Novembre 2007.
  •       N. Melle. Guía de intervención logopédica en la disartria. Colección Trastornos del lenguaje, n. 4, Editorial Síntesis, Madrid, 2008

 

2. COMPLEMENTARY:

   BOOKS:

  •       S. Borras y V. Rosell. Guía para la reeducación de la deglución atípica y trastornos asociados. Nau Llibres, 2005
  •       P. Clavé y P. García. Guía de diagnóstico y de tratamiento nutricional y rehabilitador de laDisfagia Orofaríngea. Nestlé Nutrition. Editorial Glosa, S.L. Barcelona 2011
  •       Glaucia del Burgo. G. de la Aleja. Rehabilitación de problemas de deglución en pacientes con daño cerebral sobrevenido. Editorial EOS, Madrid, 2004
  •       D. Grandi i G. Donato. Terapia miofuncional. Diagnóstico y tratamiento. Ed. Lebón. Barcelona, 2008. (Inclou CD-ROM i làmines)
  •       Nestlé Nutrition. EAT 10, Herramienta validada para el cribado de la disfagia. Nestlé, 2011
  •       I. Queiroz Marchesan. Fundamentos de la Fonoaudiología. Aspectos Clínicos de la motricidad oral. Editorial Medica Panamericana, 2002
  •       J.M. Ustrell et al. Terapéutica multidisciplinaria de las maloclusiones dentarias en el paciente infantil. Laboratorios KN, Barcelona, 2001
  •       N. Zambrana. Logopedia y ortopedia maxilar en la rehabilitación orofacial. Tratamiento precoz y preventivo. Terapia miofuncional. Masson. Actualidades Médico Odontológicas Latinamérica.2000
  •       F. Le Huche. Trad. Asociación Española de Laringectomizados. La Voz sin Laringe.
  •       F. Le Huche, A. Allali, G. Miroux. La Voz sin Laringe. Marnual de Reeducación Vocal. Ed. Médica y Técnica. 1982.
  •       L. Arrazubi, L. Royo. Servei ORL de l'Hospital de la Santa Creui Sant Pau. UAB. Guia d'ajuda per a la persona intervinguda de Laringectomia Total. 2001

   ENT Manuals:

  •       P. Abelló y M. Quer. Manual d'Oto-rino-laringologia. Manuals de la Universitat Autònoma de Barcelona, n. 8. Bellaterra, 1992.
  •       R. Ramírez et al. Manual de Otorrinolaringología. McGraw-Hill-Interamericana. Madrid, 1998.
  •       C.A. Rosen & C.B. Blake Simpson. Técnicas Quirúrgicas en Laringología. Amolca. Caracas. 2013.

   Anathomy Atlas:

  •       J.E. Muscolino. Atlas de músculos, huesos y referencias óseas. Fijaciones, acciones y palpaciones. Paidotribo. Badalona. 2012.
  •       A. Biel. Guía topográfica del cuerpo humano. Cómo localizar huesos, músculos y otros tejidos blandos. Paidotribo. Badalona. 2012.

   Webs:

  •       http://www.dysphagiaonline.com
  •       http://www.logopediamail.net
  •       http://www.voiceandswallowing.com
  •       http://www.fresenius.com/407.htm
  •       http://www.nestle-nutrition.com/Public/Default.aspx
  •       http://www.nutriciaclinico.es
  •       http://www.myessd.org
  •       http://www.essd2013.org
  •       http://www.soclogopedia.org
  •       https://sensorialitat.blogspot.com

   Papers:

  •       Related papers.

Software

- Praat (Freeware: www.praat.org) Mac, Windows, Linux

- DISFAPP (https://disfapp.es)