Hybrid Format: ASU Downtown Phoenix Campus - Health North
550 N. Third Street | Phoenix, AZ 85004
Virtual Attendance via Zoom also available
8:00 – 8:15 Introduction
Kathleen Cazzato, MA, CCC-SLP, BCS-S; Katrina Graf, MS, CCC-SLP, CLC – ArSHA Med SLP Committee Co-Chairs
8:15 – 9:00 Different Perspectives: FEES and MBSS in the Neonatal ICU
Katrina Graf, MS, CCC-SLP, CLC & Jaclyn Rogowski, MS, CCC-SLP, IBCLC
9:00 – 9:45 MBSS and FEES in the Evaluation and Treatment of Adult Dysphagia: When Both can be Twice as Nice
Kathleen Cazzato, MA, CCC-SLP, BCS-S
9:45 – 10:00 Questions for Panelists
10:00 – 10:15 Break
10:15 – 11:00 Diagnostic and Clinical Applications of High Resolution of Pharyngeal Manometry in the SLP-ENT Practice
Lisa Crujido, MS, CCC-SLP
11:00 – 11:45 Looking at Instrumental Evaluations from an Oro-myofunctional Lens: The Oral Phase Matters!
Ramya Kumar, MS, CCC-SLP, BCS-S, IBCLC
11:45 – 12:00 Questions to Panelists
12:00 – 1:00 Lunch
1:00 – 1:30 Treatment of Dysphagia in a young patient post CVA: Use of NMES and FEES
Megan Mesman MS, CCC-SLP
1:30 – 2:00 Intensive Dysphagia Rehabilitation using MDTP and EMST in Two Complex Patients with Head and Neck Cancer
Aubrey Dunlap, MS, CCC-SLP
2:00 – 2:30 The Use of Surface Elecgtromyography Biofeedback in a Clinical Setting
Christine Haryasz, MS, CCC-SLP; Rori McPhilliamy, MS, CCC-SLP
2:30 – 3:00 Trismus: What is it and What Can I Do About It?
Leah Mackie, MS, CCC-SLP
3:00 – 3:15 Questions for Panelists
3:15 – 3:30 Closing Remarks
Kathleen Cazzato, MA, CCC-SLP, BCS-S; Katrina Graf, MS, CCC-SLP, CLC
Different Perspectives: FEES and MBSS in the Neonatal ICU
Instrumental evaluations can be used in the NICU population to help identify and treat swallowing disorders. While they can provide much of the same information, each test has its own unique uses. In some patients, both studies may be indicated to assess an infant's swallow. In the case studies presented here, both FEES and MBS were used to direct an infant's feeding plan and overall care plan.
After completing this course, participants will: Describe the uses for instrumental swallow evaluations in the neonatal/infant populations
MBSS and FEES in the Evaluation and Treatment of Adult Dysphagia: When Both can be Twice as Nice
Instrumental assessment is a necessary component in the comprehensive evaluation of adult dysphagia. Although in most cases either FEES or MBSS can provide valuable information, there are instances in which one test is preferable, and times when both assessments can assist with thorough treatment planning. This presentation will include case study presentations in which both MBSS and FEES were used as part of comprehensive management in cases of adult dysphagia.
After this presentation, participants will be able to: Identify cases in which both MBS and FEES assessments can assist with differential diagnosis and treatment planning in patients with oropharyngeal dysphagia.
Diagnostic and Clinical Applications of High Resolution of Pharyngeal Manometry in the SLP-ENT Practice
High resolution pharyngeal manometry (HRPM) is a contemporary technique used to measure intraluminal pressure changes that occur in the pharynx during swallowing. HRPM provides numerical values that can serve as empirical baseline measures and measures of change. Specifically, HRPM provides an overall measure of pharyngeal contractile strength, relaxation pressure of the upper esophageal sphincter (UES) and duration of UES relaxation.
After completing this course, participants will: Demonstrate an understanding of the methodology and interpretation of data obtained using high resolution pharyngeal manometry
Looking at Instrumental Evaluations from an Oro-myofunctional Lens: The Oral Phase Matters!
Dysphagia is defined as disruption of the swallow sequence. This is a skill-based disorder and children with dysphagia can present with multiple variations of swallowing impairments affecting any or all of the phases of swallowing. When breakdown in swallowing is noted, instrumental evaluations are usually ordered, with a large emphasis on pharyngeal phase deficits. The intricate process of bolus extraction and manipulation however is largely influenced by the oral phase and the oral anatomy – especially in the developing child. With the growing body of evidence and clinical practice in the area of tethered oral tissues (TOTs) and orofacial myofunctional disorders (OMDs), clinicians who complete instrumental evaluations should consider impact of oral anatomy on disruption of the swallow sequence. This presentation will go over patient case studies where knowledge of OMDs and TOTs helped guide the instrumental evaluation, clinical differentials and subsequent plan of care recommendations.
After completing this course, participants will describe two ways in which oromyofunctional disorders impact swallowing
Treatment of Dysphagia in a young patient post CVA: Use of NMES and FEES
NMES can be used in combination with other evaluation and treatment modalities to maximize functional outcomes. This session will include a case study of a young stroke survivor’s progression from NPO to an unrestricted diet. Treatment included use of daily NMES and multiple FEES studies over the course of his 50+ day inpatient rehabilitation stay.
After completing this course, participants will describe the application of NMES as a therapeutic tool in an acute rehab setting.
Intensive Dysphagia Rehabilitation using MDTP and EMST in Two Complex Patients with Head and Neck Cancer
This session will focus on two complex head and neck cancer patients and the intensive dysphagia program used to treat them. Modalities discussed with include EMST and MDTP. Once case study will focus on a patient with chronic and severe post-radiation and post-surgical dysphagia for >20 years. The other case will present a patient with recent radiation treatment and severe dysphagia that did not respond to traditional therapeutic intervention. Presentation will include swallow studies from pre- and post-treatment, as well as objective outcome data and subjective patient report.
After completing this course, participants will describe how MDTP and EMST can be used to rehabilitate dysphagia in head and neck cancer.
The Use of Surface Elecgtromyography Biofeedback in a Clinical Setting
Biofeedback with the use of sEMG technology is emerging as a treatment tool for dysphagia. Among the different emerging technologies, the Synchrony system, is one that is becoming more widely available in the medical setting. While there are several contraindications for use of this device within a clinical setting, there is a plethora of research to support the use of biofeedback to improve swallow function within the neurological population.
After completing this course, participants will identify appropriate candidates for use of sEMG biofeedback for the treatment of dysphagia within a clinical setting.
Trismus: What is it and What Can I Do About It?
Trismus is a common side effect post head and neck cancer treatment. This webinar will discuss mechanisms that cause trismus, and methods to assess and treat the disorder.
After completing this course, participants will describe the methods for measuring maximum jaw opening and options for treatment as indicated.
Kathleen Cazzato, MA, CCC-SLP, BCS-S is a speech-language pathologist and Assistant Clinical Professor at the University of Arizona. She received her B.S. and M.A. degrees in speech-language pathology from Northwestern University, and is a Board Certified Specialist in Swallowing Disorders. Her areas of expertise include evaluation and treatment of swallowing disorders in adults and management of neurogenic communication disorders. In her current role she provides both classroom and clinical education to students in the MS program at the University of AZ and also provides clinical services at Banner University Medical Center in affiliation with the Department of Otolaryngology, Head and Neck Surgery.
Lisa Crujido, MS, CCC-SLP is a speech pathologist in the Department of Otorhinolaryngology at Mayo Clinic Arizona. Her clinical specialties include the diagnosis and treatment of voice and swallowing disorders in head and neck cancer as well as the general voice disordered population. Ms. Crujido completed her graduate study at Illinois State University in 1979. Post-graduate study includes participation in research in the in the Laryngeal and Speech Section of the NINDS of the National Institutes of Health, collaborative research on the effects of surface electrical stimulation and exercise in head and neck cancer patients with dysphagia following radiation therapy, and collaboration with the Dystonia Coalition on the development of a rating system and assessment tool for the diagnosis of spasmodic dysphonia. She is a co- author on a number of publications that include treatment outcomes using radiotherapy for head and neck, the effects of e-stim and exercise in chronic pharyngeal dysphagia, and treatment programs for total laryngectomees. She is a contributor to the text “Laryngeal Cancer: An Interdisciplinary Resource for Practitioners,” authoring a chapter on airway and respiratory challenges in larynx cancer.
Aubrey Dunlap, MS, CCC-SLP is a speech-language pathologist at Banner MD Anderson Cancer Center. She specializes in voice and swallowing in the outpatient and acute care settings. Aubrey is passionate about head and neck cancer, laryngectomy management, FEES, and evidence-based practice.
Katrina Graf, MS, CCC-SLP, CLC is a Speech-Language Pathologist at St. Joseph's Hospital and Medical Center in Phoenix, AZ. She attended graduate school at the University of Arizona and completed her Clincial Fellowship at the South Texas VA Medical Center and San Antonio Military Medical Center in San Antonio, TX. She currently specializes in working with the neonatal and infant populations. She is part of a team that started a FEES program in the Neonatal ICU at St. Joseph's in 2018. She is also a Certified Lactation Counselor.
Christine Haryasz, MS, CCC-SLP went to Northern Arizona University for her Masters of Science in speech, language, and hearing sciences where she graduated with honors. She now works at Barrow Neurological Institute with over ten years of experience in inpatient rehabilitation. There, she works on a comprehensive brain injury team treating patients with a variety of varying diagnosis, specializing in traumatic brain injury (TBI), behavior management, cognitive and feeding impairments and caregiver training and education.
Ramya Kumar, MS, CCC-SLP, BCS-S, IBCLC is a certified Speech Language Pathologist specializing in infant and pediatric feeding difficulties. She currently works in a Level III NICU and a primary care office in Phoenix, Arizona. Ramya is a Board Certified Specialist in Swallowing and Swallowing Disorders (BCS-S), Certified Neonatal Therapist (CNT) and an International Board Certified Lactation Consultant (IBCLC). In addition, she has received the Developmental Care Specialist Designation through the National Association of Neonatal Nurses and is also certified in Neonatal Touch and Massage (NTMTC). She is a graduate of the Caring Essentials Quantum Leap program and earned her designation as a Trauma-Informed Professional (TIP). With a focus on whole body approaches to intervention, Ramya is also trained in modalities like the Tummy Time Method, Orofacial Myofunctional Disorders and Cranial Sacral Therapy.
Ramya is passionate about creating long term developmental and mealtime successes for her patients and families and is constantly involved in continuing education, teaching and mentoring. Her philosophy to patient care is deeply rooted in the belief that every patient – no matter how small, has a voice; and that families should be empowered to be active participants in their care plan.
Leah Mackie, MS, CCC-SLP has been a practicing speech language pathologist for for 29 years and has been specializing in the area of Head and Neck Cancer for 20 years. During this time she has had the privilege of treating these patients in the acute post surgical care setting as well during and post chemoradiation in the outpatient setting. One aspect of her treatment includes the assessment and treatment of trismus and she has been certified in this area since 2017
Rori McPhilliamy, MS, CCC-SLP went to University of Arizona for her master's of science in Speech, Language, and hearing sciences where she obtained an additional bilingual certificate. She now works at St. Joseph's hospital and medical center in Phoenix, AZ in the inpatient neurorehabilitation unit as a part of Barrow Neurological Institute. There, she works on a comprehensive brain injury team that specializes in treating patients following lung transplant and LVAD surgeries.
Megan Mesman MS, CCC-SLP received her bachelor’s degree from Arizona State University in 2011. She was an SLPA for 5 years working for a private practice specializing in mTBI. While working as an SLPA she received her masters degree from NAU. She worked for 5 years at Encompass Health Rehabilitation Hospital of Scottsdale and recently started working at Valleywise Health. Megan is passionate about dysphagia and use of instrumentals.
Therapist (CNT) and an International Board Certified Lactation Consultant (IBCLC). In addition, she has received the Developmental Care Specialist Designation through the National Association of Neonatal Nurses and is also certified in Neonatal Touch and Massage (NTMTC). She is a graduate of the Caring Essentials Quantum Leap program and earned her designation as a Trauma-Informed Professional (TIP). With a focus on whole body approaches to intervention, Ramya is also trained in modalities like the Tummy Time Method, Orofacial Myofunctional Disorders and Cranial Sacral Therapy.
Jaclyn Rogowski, MS, CCC-SLP, IBCLC is originally from central Illinois and attended Illinois State University, graduating with a Bachelors in Science in 2007 and earning a Masters of Science in Speech-Language Pathology in 2009. She then moved to Arizona to pursue better weather and her Clinical Fellowship. She began her career at Tucson Medical Center in Tucson, Arizona, working in both outpatient and inpatient settings, including the NICU. In 2013, she moved to Phoenix, Arizona and began working at Phoenix Childrens Hospital where she continues to practice. She is the lead SLP in the Level III NICU, and also practices in various other units. In 2020, Jaclyn earned the International Board Certified Lactation Consulting certificate.