Evaluation and Management of Dysphagia in Amyotrophic Lateral Sclerosis: A Survey of Speech-Language Pathologists' Clinical Practice

Abstract

OBJECTIVES: The aim of this study was to determine the evaluation and management of dysphagia in amyotrophic lateral sclerosis (ALS) patients by speech-language pathologists (SLPs). METHODS: A 15-question web-based survey sent to SLPs in general clinical practice. RESULTS: Forty-nine SLPs responded. Although only 8 (17.0%) of the SLPs worked in ALS clinics, 46 (93.9%) had worked with ALS patients. A variety of dysphagia evaluation protocols were used by 43 (97.7%) SLPs. Most SLPs, 40 (88.9%), recommended instrumental assessments, but timing and indication varied greatly: 19 (42.2%) SLPs recommended this at baseline even without bulbar symptoms, whereas others recommended this based on symptoms and/or clinical assessments. CONCLUSIONS: There is currently no uniform approach as to the indication, timing, and specific methods to use in the evaluation of dysphagia in ALS patients among SLPs. There is need for further research to assist in the development of definitive guideline recommendations for this population.