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Mar 16
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Swallowing Awareness Day

By Adult Swallowing, Uncategorised No Comments

Did you know that humans swallow between 500-700 times a day, around 3 times an hour when sleeping and once per minute while awake? Swallowing is a reflex that happens from infancy all the way through to the end of our lives. However, around 1 million Australians have difficulty swallowing (a condition known as dysphagia). Despite this high prevalence, the knowledge of dysphagia, including its cause and impact, are not known by much of the population. Swallowing Awareness Day is held each year on the 16th March and is a good opportunity to reflect on a reflex that we do not think about, until it becomes a problem.

For many of us, food is a vital part of our lives. We need to eat and drink to sustain our bodies, to provide us with energy and nutrients but also to celebrate important cultural events with our friends and families. Dysphagia impacts sufferers significantly and can lead to a person becoming malnourished or isolated due to the fear of choking or coughing while eating or drinking.

Dysphagia can cause difficulties with chewing (the oral phase), swallowing (the pharyngeal phase) or with food entering the stomach (the oesophageal phase). Speech Pathologists generally focus on the Oral and Pharyngeal phases however we are learning more and more about the interaction of the Oesophageal Phase on our swallowing, particularly the effect of reflux.

How Do I Know If I Need a Swallowing Assessment?

Swallowing difficulties can start at any stage of life and for a variety of reasons. If you experience any of the following, a swallowing assessment is recommended:

  • Recurrent chest infections
    • These can be caused by food or fluid entering your airways and becoming infected.
  • Choking incidents
    • These can be caused by food or fluid blocking your airways and can be traumatic.
  • Coughing when eating or drinking.
    • This can be caused by food or fluid entering your airways and is the body’s natural reaction to ejecting matter out of your lungs. This can be extremely unpleasant and embarrassing, particularly when eating in public or with friends.
    • Coughing can also be caused by reflux when eating or drinking.
  • Modifying your diet to avoid coughing or choking.
    • Have you had an incident previously and now avoid that food and all similar textures? It might be time for a swallowing assessment!
  • Unplanned weight loss.
    • You may not be receiving the right level of nutrition as a result of the above. You would benefit from a swallowing assessment and consultation with a Dietitian.

How We Can Help

Our primary goal at HDST is to allow you to continue eating and drinking the food and drinks that you love as safely as possible and for as long as possible. We do this by:

  • Assessing the function of your cranial nerves. We do this by observing movements of the muscles of your face and throat, also known as an Oral Motor Assessment.
  • Observing you while you eat and drink your own foods. This can happen at our clinic or at your home.
    • Sometimes, this assessment may not give us enough information about what is happening when you eat and drink. You will be referred onto a Speech Pathologist who works in a hospital for an instrumental assessment, known as a Videofluoroscopic Swallow Study.
  • Trialling strategies that may assist you in increasing the safety of your eating and drinking. This may include taking single sips of fluid, having smaller mouthfuls or keeping your chin down while swallowing.
  • Changing your environment. This may include turning off the TV and eliminating distractions.
  • Modifying your food and fluids. Sometimes, the above strategies may not be sufficient to allow you to keep eating and drinking safely and the texture of your food and fluids may need to be changed. We use this as a last resort at HDST and only recommend this in collaboration with you, your family and your doctor.

I Have Further Questions and Would Like Assistance

Feel free to get in touch with our clinic at any stage by visiting www.hdspeechtherapy.com.au

Written for Swallowing Awareness Day 2023 by Caitlin Chaney

Mar 16
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Dysphagia. A difficult diagnosis to swallow!

By Adult Swallowing No Comments

The average Australian swallows 500-700 times a day. That’s around three times an hour during sleep, once per minute while awake and even more during meals.

Most Australians are unaware how difficulty with swallowing can be frightening and life threatening. It’s why on Wednesday 16 March 2022, Hills District Speech Therapy is campaigning to promote Swallowing Awareness Day.

Swallowing Awareness Day 2022 is an opportunity to bring attention to swallowing disorders and to connect people with speech pathologists, the professionals who can help. Speech Pathologists assess and treat people with Dysphagia (difficulty swallowing) – pronounced ‘dis-fay-juh’.

The theme for Swallowing Awareness Day in 2022 is: ‘Dysphagia. A difficult diagnosis to swallow!’

Around 15-30 per cent of people aged 65+ living in the community have a swallowing difficulty, with that figure rising to over 50 per cent for older Australians living in a nursing home. And after falls, choking is the second biggest killer of nursing home residents.

It is estimated around 1 million Australians have difficulty with swallowing. Swallowing disorders remain largely invisible, poorly understood by the general community, and rarely addressed in government policy.

Swallowing problems can mean food, drinks or saliva gets into the lungs (aspiration) and this can cause lung infections (pneumonia). Severe swallowing complications can lead to death, while other swallowing complications can lead to poor nutrition, dehydration, health complications, and social isolation.

The cost to affected individuals is measured in dollars through added health costs, limitations to their participation in the wider society, and in negative impacts on their social and emotional wellbeing. The cost to the wider community includes increased costs through longer hospital stay.

Australians with undiagnosed difficulties are frequently referred to other health practitioners — often for expensive and invasive investigations — when a speech pathologist could readily manage the problem.

A swallowing problem can occur at any stage of life. Swallowing is a skill developed from infancy.

Babies born prematurely or children with abnormalities with the structure of their head, neck and face, such as cleft lip or palate can have difficulty feeding. Both children and adults with developmental disabilities such as Down Syndrome, Autism and Cerebral Palsy can also require support with mealtime management.

Additionally, almost half of everyone who has had a stroke will have a swallowing problem. Sixty-nine per cent of people with Parkinson’s disease will have swallowing difficulties, as will 25 per cent of patients with Multiple Sclerosis.

Swallowing Awareness Day is an opportunity for all of us to learn more about swallowing difficulties and how they impact on the lives of our friends, neighbours and our wider community.

As speech pathologists, we are the professionals who assess and manage dysphagia.

Further information about dysphagia is available at https://hdspeechtherapy.com.au/swallowing-difficulties/

If you think you or your loved one may benefit from a swallowing assessment, you can submit an enquiry via our website or calling 9054 1996 or search for additional Speech Therapy providers at https://www.speechpathologyaustralia.org.au.

If your concerns are urgent or relating to an emergency, please contact your local hospital or 000.

Speech Pathology Australia is the national peak body representing more than 12,500 speech pathologists. The Association supports and regulates the ethical, clinical and professional standards of its members, as well as lobbying and advocating for access to services that benefit people with communication and swallowing difficulties.

Adapted from Speech Pathology Australia (2022) by Chloe Garrett & Tushar Prasad

Oct 14
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Developmental Language Disorder

By Language No Comments

Friday 16th October is world Developmental Language Disorder (DLD) awareness day.

DLD is a persistent and ongoing difficulty in an individual’s use and/ or understanding of language and affects both children and adults. These difficulties can apply to the understanding and/or use of sentence structures, grammar, vocabulary and conversation and impact all parts of an individual’s lives including their literacy, learning, friendships and emotional well-being. In 2020, the theme for DLD Awareness day is ‘See Me’, for all people to know of DLD and its impacts on individuals.

It is possible, perhaps even likely, that you have never heard the term Developmental Language Disorder before, so where does it come from? In 2017 an expert panel of Speech Pathologists, Psychologists, Paediatricians, Psychiatrists, Teachers and charity representatives met to come to a consensus regarding the various terminology and diagnostic criteria for language difficulties. The outcome of this, was the term ‘Developmental Language Disorder’ to be used to describe a language difficulty that is not associated with an additional biomedical condition (e.g. brain injury, Intellectual Disability, Autism Spectrum Disorder). This allowed for consistency of terminology across professions and replaced now outdated terms such as ‘Specific Language Impairment’.

Even though you may not have heard of the term, with a prevalence of approximately two students per classroom, increased awareness is critical for understanding and provision of supports. Research continues to show the breadth and significance of the impact of a DLD on individuals. There are close links between DLD and dyslexia (Bishop and Snowling 2004). It can also result in social difficulties, with research showing that by 16 years of age, 40% of individuals with DLD had difficulty interacting with peers (St. Clair, Pickles, Durkin & Conti-Ramsden, 2011) and those with DLD are 2.5 times more likely to report symptoms of depression than their typically developing peers (Conti-Ramsden & Botting, 2004). When leaving school, DLD increases the risk of unemployment and lack of independence in adulthood (Conti-Ramsden & Durkin, 2008).

Research is clear on the significant impacts of DLD. However, it can be difficult to comprehend these statistics and translate this to what an individual’s everyday experience may be. What does it mean that people with DLD have social difficulties? What are the impacts on schooling? As professionals working with these individuals, we see the daily frustrations of ‘it’s too hard’ simply because trying to keep up with schooling expectations, is too tiring. We see the distress when a parent can’t understand what has happened in their child’s day because it can’t be communicated. We see the frustration when accessing information from websites is too difficult. We see the pain when an adolescent has not understood a sarcastic comment and has been isolated by peers. DLD may be a hidden, and little heard of, disability, but the impacts are pervasive and devastating.

However, we are not without hope! Support from Speech Pathologists, Teachers and Educational Psychologists is available and effective for these children, adolescents and adults. Advocacy continues to occur at the local level (as professionals continue to support and advocate for, individuals in their classroom and workplace), national level (where ongoing advocacy is occurring for funding to be available) and international level (for a consensus of terminology across countries).

If you would like to learn more about DLD and its impacts, RADLD (Raising Awareness of Developmental Language Disorder) and NAPLIC (National Association of Professionals concerned with Language Impairment in Children) are excellent places to start.

 

References:

  • Bishop, D. V. M., & Snowling, M. J., (2004) Developmental Dyslexia and Specific Language Impairment: The same or different? Psychological Bulletin. 130 (6), 858-886.
  • St Clair, M. C., Pickles, A., Durkin, K., & Conti-Ramsden, G. (2011). A longitudinal study of behavioral, emotional and social difficulties in individuals with a history of specific language impairment (SLI). [Article]. Journal of Communication Disorders, 44(2), 186-199.
  • Conti-Ramsden, G., & Botting, N. (2004). Social difficulties and victimization in children with SLI at 11 years of age. Journal of Speech, Language, and Hearing Research, 47, 145-161.
  • Conti-Ramsden, G., & Durkin, K. (2008). Language and independence in adolescents with and without a history of Specific Language Impairment (SLI). Journal of Speech, Language and Hearing Research, 51, 70- 83.

 

Written by Claire Offord

Jun 26
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Aphasia Awareness Month 2020

By Adult Communication No Comments

Have you ever had that infuriating feeling of a word being on the tip of your tongue? Where no matter what you do, you just can’t quite remember what word you wanted to say? How about when someone is telling you something really complicated and no matter how hard you listen, you just don’t understand? This is what it feels like to have aphasia.

June is Aphasia Awareness Month which seeks to raise awareness of the symptoms, difficulties and isolation experienced by people with aphasia. Aphasia can be caused by a number of conditions that damage the ‘language centres’ of the brain. These include stroke, brain tumours, acquired brain injuries or degenerative conditions.

There are several types of aphasia, each with their own characteristics and symptoms. These include global aphasia, Broca’s aphasia, mixed non-fluent aphasia, Wernicke’s aphasia, anomic aphasia, primary progressive aphasia and others. Aphasia primarily affects a person’s ability to recall words and understand spoken and written language to differing degrees. This can seriously affect a person’s ability to communicate their daily needs and wants, including their participation in everyday conversations, to fulfil their employment needs and to perform daily tasks independently. It is important to remember, that although aphasia can severely limit communication, it does NOT affect their intelligence.

A person with aphasia can receive support from a Speech Pathologist. An assessment will first determine the type of aphasia they have and then strategies that they and their families can use to increase their communication on a daily basis. As with all neurological conditions, the sooner a person receives therapy the better!

Therapy focuses on functional goals to help the person communicate in a way that is meaningful to them. Goals are centered on the Life Participation Model, meaning that therapy seeks to increase a person’s participation in the activities that matter to them. This might include having conversations with family, being able to order food independently at their local café or participating in regular meetings with their local community group.

When a person acquires aphasia, their families and carers are often affected, too. Much of our personality is related to our ability to use language, so a loss of language can often be devastating for the person and their family. Evidence shows that many people with aphasia experience feelings of frustration, loneliness and isolation.

Some helpful strategies for caregivers to use include:

  • Keeping language simple- make sure your sentences are short and to the point. Try not to use figurative language or long, complex sentence structures.
  • Wait and be patient when having a conversation- give the person plenty of time to produce a response.
  • Clarify and confirm what the person is trying to say- do not talk for the person or try to guess what they are saying; instead, listen to what they are saying and confirm that you understand. For example, they might say ‘Wednesday…doctor…’. You can say, ‘Yes, you have a doctor’s appointment on Wednesday.’
  • Help the person to produce the correct words by talking about the different features. For example, ‘Where would I find it?’ ‘What does it do?’ ‘What does it look like?’
  • Minimise distractions while having a conversation- turn off radios and TV in the background.
  • Use Alternative and Augmentative Communication (AAC)- this may be in the form of visuals or communication boards to help the person communicate.

In Summary, remember:

  • Aphasia is caused by damage to the language centres of the brain.
  • Aphasia does not affect a person’s intelligence.
  • There are several types of aphasia that affect communication in different ways.
  • Speech Pathologists can assist with diagnosis and management of aphasia.

For further information, please see:

If you or someone you know is affected by aphasia, please contact one of our adult therapists for further assistance on 9054 1996 or by contacting bookings@hdspeechtherapy.com.au

Post written by HDST Senior Speech Pathologist, Caitlin Chaney.
Apr 22
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Shared Book Reading – Benefits & Book Selection Tips

By Literacy, Uncategorised No Comments

Shared book reading is the act of ‘sharing or reading a book with your child’ (Noble et al., 2019). There are enormous benefits to reading books with your infants and children on a regular basis. These include but are not limited to:

  • Exposure to and greater retention of new vocabulary (Flack et al., 2018; Sigal, 2011).
  • Understanding the meaning of less familiar words using textual and visual clues (Wesseling et al., 2017)
  • Acquisition of new vocabulary that can be used in verbal communication (Sigal, 2011).
  • Improved grammar skills (Wesseling et al., 2017).
  • Commencing Kindergarten with a larger vocabulary and more success in reading than their age-related peers (Cates et al., 2017).
  • Increased opportunities to encourage bonding and build parent-child relationships (Colmar Brunton, 2012).
  • Improved emergent literacy skills including greater familiarity with letter formations (Wesseling et al., 2017) and improved print awareness (Reese & Cox, 1999).
  • Improved development of empathy skills and greater understanding of and ability to regulate own emotions (Aram et al., 2012).
  • Improved cognitive development (Raikes et al., 2006)

Parents and caregivers are advised in Paul & Russo’s recent article ‘How to Raise a Reader‘ to introduce their own childhood favourite books, as well as books that stand out to them in libraries, bookshops and the homes of family and friends.

Some other important considerations when picking books:

  • Engage your child in alphabet books as a focus point for introducing letters and sounds to your child (Lowry, 2016).
  • Select storybooks rather than alphabet books if your child has a language delay/disorder and use them as a basis for building on your child’s vocabulary, sentence construction, and story recall and comprehension skills (Lowry, 2016).
  • If your child is not talking, pick books with lots of bilabial sounds (i.e. ‘m’, ‘p’, and ‘b’ sounds). These sounds often appear in animal themed books with words like ‘moo’ and ‘baa’ (Sigal, 2011)
  • Picture books with vibrant, realistic photographs help build symbol recognition skills in younger children (Lowry, 2016)
  • Books that contain the element of surprise, often in the form of lift the flaps and exciting page turns; this facilitates a greater interest in reading (Paul & Russo, 2019)
  • Books that repeat new words and phrases help engage your child in the reading experience and cements their understanding of new vocabulary (Lowry, 2016; Sigal, 2011)
  • To help build your child’s pre-literacy skills including word prediction skills, introduce them to books with lots of rhyme, such as Dr Seuss’ classics (e.g. The Cat in The Hat) (Sigal, 2011).
  • If your child is attending speech pathology, select books that reinforce concepts taught in therapy, including prepositions, verbs and colours (e.g. ‘Where Is the Green Sheep’ by Mem Fox and Judy Horacek) (Book Share Time, 2019; Sigal, 2011).
  • Use paper books rather than electronic books for a more beneficial reading experience. A study by de Jong and Bus in 2002 found that children between the ages of 4-6 who read paper books were more likely to finish the book, follow the story in the correct order, read more words and recall more story content than those who read electronic books.
  • Introduce more interactive books containing sound effects, pops ups, flaps and moving parts if your child is a late talker or has a language delayed. These features can help engage them in the reading experience and build their verbal and non-verbal communication skills (Lowry, 2016).
  • Pick books with imaginary/fictional topics (e.g. pirates, princesses, dragons, goblins, fairies). This encourages conversation between child and parent.

Post written by Speech Pathologist, Remona Mekdessi Sarkis.