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ABSTRACT: Speech-language pathologists employed in public schools are increasingly being faced with serving students with dysphagia because schools are serving students who may have previously been served in health care or institutional facilities. Students with significant health problems, severe disabilities, or orthopedic impairments may require the services of a school team-- a team that may not include any person With adequate training in swallowing evaluation and treatment. Speechlanguage pathologists should not provide services to students with dysphagia without pursuing continuing education to acquire the necessary knowledge and skills. To do so would compromise the speech-language pathologist's ethical standards, jeopardize the student's health, and create undue liability for the school division.
KEY WORDS: speech-language pathologist, dysphagia, continuing education; public schools
The entitlement nature of special education has resulted in the enrollment of many children in public education who, in previous eras, would have received their education and treatment in health care or institutional facilities. It is becoming more common for speech-language pathologists in public school settings to have students requiring dysphagia services on their caseloads, creating the need to develop expertise in the assessment and treatment of pediatric dysphagia. This article addresses the issues associated with serving students with dysphagia in the public education setting, the role and preparation of the speech-language pathologist, and the accompanying continuing education and ethical requirements.
BACKGROUND
The passage of Public Law 94-142 in 1975 (now the Individuals with Disabilities Education Act) resulted in the enrollment of many students with severe disabilities or orthopedic impairments in public education, many of whom had previously been served in other settings. Some of these students had difficulties with feeding themselves, requiring school personnel to feed them. In more recent years, medical advances and legal challenges have increased the enrollment of children with significant health care needs in public education. Children with ventilators, feeding tubes, and other health care needs are attending schools along side children without disabilities. As a result, public school speech-language pathologists are serving students with dysphagia on their caseloads.
The 1997 Omnibus Survey of the American SpeechLanguage-Hearing Association (ASHA) (ASHA, 1997) revealed that 19% of school-based speech-language pathologists work with clients with dysphagia. Although this is substantially less than the number of speechlanguage pathologists working in hospital or residential...