Year of Award

2012

Document Type

Thesis - Campus Access Only

Degree Type

Master of Science (MS)

Degree Name

Speech-Language Pathology

Department or School/College

Department of Communicative Sciences and Disorders

Committee Chair

Laurie Slovarp

Keywords

dysphagia, interrater agreement, Modified Barium Swallow, treatment recommendations

Abstract

The Modified Barium Swallow (MBS) study is a commonly used radiographic procedure for diagnosis and treatment of swallowing disorders. Despite attempts by dysphagia specialists to standardize the MBS, most settings have not adopted such standardized procedures. High variability of assessment patterns arguably contribute to variability of treatment recommendations made from diagnostic information derived from the MBS. An online survey was distributed to SLPs participating in American Speech Language Hearing Association (ASHA) listservs. Sixty-three SLPs currently treating swallowing disorders participated. Outcome measures included 1) descriptive measures of participant demographics and 2) inter-rater agreement for treatment target and strategy recommendations made following review of MBS reports in low and high pathophysiology conditions, 3) chi-square analyses comparing target and strategy recommendations according to report stimulus, and 4) descriptive measures of clinicians’ ratings of four MBS reports, including the information they reported as most useful for making treatment recommendations. Results indicated wide variability among clinicians for recommended treatment targets and techniques. Chi-square analyses revealed associations between target selection and appropriate treatment recommendations except when comparing compensatory and restorative recommendations in the low pathology condition. Results indicated a difference in the distributions (p<0.05) of these variables in the low and high pathophysiology experimental conditions. Clinicians selected more treatment targets and provided more appropriate compensatory and restorative recommendations when provided with higher degrees of pathophysiological explanations of dysphagia impairment. Clinical implications of the results are discussed in terms of the study limitations.

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© Copyright 2012 Jennifer Dawn Danielson