Term
| what are the differences between compensatory v. restorative goals? |
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Definition
| Compensatory strategies compensate for deficits that aren’t going to be made up. Restorative strategies are deficits that can be made up. |
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Term
| what are four barriers to anticipate? |
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Definition
1. cognitive deficits
2. language deficits
3. caregiver understanding/follow-up
4. need for long-term follow-through |
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Term
| we draw on language and cognitive skills to figure out what their _________ skills are like |
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Definition
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Term
| when would we use the chin down compensatory position change? |
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Definition
| if you have concerns that the patient is losing control of the bolus - AIRWAY PROTECTION |
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Term
| when would we use the chin up compensatory position change? |
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Definition
| if you have someone who is having trouble clearing out their oral cavity - this will assist with gravity |
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Term
| when would we use the head tilt compensatory position change? EG: if the right side has a lot of stasis, we would use a head tilt. |
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Definition
| to steer the bolus to the STRONGER side - to allow gravity to allow the bolus into the stronger side of the pharynx |
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Term
| when would we use the head turn compensatory position change? |
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Definition
| turn your head to the WEAKER side - so the stronger side is more open |
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Term
| when would we use the lying down compensatory position change? |
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Definition
| if they lie down, they don't have gravity to pull down the bolus - this allows the patient a little more control over their swallow |
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Term
| what are three ways to amplify sensory input? |
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Definition
| taste cues, temperature cues, and tactile cues |
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Term
| why do we use taste cues? what is a good example of a taste cue? |
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Definition
| lemon - this give the client a sensation that "ok we're going to be eating something now" |
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Term
| why do we use temperature cues? |
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Definition
| if you give the client something cold or hot it perks up the nerve endings in the mouth |
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Term
| why do we use tactile cues? |
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Definition
| to wake up the mouth - we will take a dental mirror and put it in a cup of ice water and stroke the faucial pillars with it to "wake up" the faucial pillars for swallowing. We can also just touch the mouth, etc. |
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Term
| what are three ways to encourage maximum preparation? |
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Definition
1. self-feeding
2. encourage chewing regardless of texture
3. allow the patient to pace the feeding |
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Term
| when would we want to allow the patient to pace the feeding? |
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Definition
| when the patient needs to eat slowly for a safe swallow |
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Term
| is allowing the patient to pace the food always a good strategy? |
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Definition
| no - a patient with impulsive behaviors or a cognitive deficit may want to eat very quickly, which can be dangerous. |
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Term
| what is indirect therapy? |
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Definition
| patient practices without food due to known risk of aspiration |
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Term
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Definition
| patient swallows food and liquid during therapy |
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Term
| which structures will we work on range of motion? |
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Definition
| tongue, lips, jaw, larynx (adduction and elevation) |
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Term
| range of motion exercises are compensatory/restorative strategy? |
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Definition
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Term
| how could we strengthen the range of motion of the vocal folds? |
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Definition
| ask the patient to hold their breath |
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Term
| how could we have the patients increase their range of motion for the larynx (elevation?) |
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Definition
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Term
| do cognitive skills matter for voluntary movement of the larynx? |
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Definition
| YES - so do motor skills! |
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Term
| What is the shaker exercise? |
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Definition
| have the patient look down at their toes and hold it a then rest for a minute 30 times. This will strengthen the muscles of the neck in hopes of making the swallow stronger and more efficient. |
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Term
| what is the supraglottic swallow modification? |
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Definition
| you hold your breath before you begin the swallow and extend the breath during the swallow - hold your breath, sip, and then cough |
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Term
| what are downfalls to the supraglottic/super-supraglottic swallow? |
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Definition
| it's hard to think about all at once! |
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Term
| why would we use the supraglottic modification? |
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Definition
| because the VFs are adducted before the swallow starts to add airway protection and if your aspirate the cough will get rid of the food in the airway |
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Term
| why do we use a super-supraglottic swallow? |
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Definition
| to get a tighter seal! someone who has enough muscle weakness that you're concerned with severe aspiration |
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Term
| what is the super-supraglottic swallow? |
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Definition
| you take a breath, bare down, swallow, cough |
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Term
| what is an effortful swallow? |
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Definition
| you cue your patient to swallow hard |
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Term
| why do we use an effortful swallow? |
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Definition
| do help the patient increase their muscle involvement and get a greater movement of the tongue base |
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Term
| what is the mendelsohn maneuver? |
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Definition
| you teach the patient to feel the change in laryngeal position and have the patient hold the larynx up high for longer |
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Term
| what is the masako maneuver? |
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Definition
| the patient's tongue tip is held between the front teeth and then they swallow |
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Term
| does the patient use food or saliva in the masako maneuver? |
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Definition
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