Tiffani Wallace’s 2012 Top CEU Courses, Books and Apps Related to Dysphagia

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(Photo credit)

2012 was full of a lot of new experiences for me.  I was approached at the beginning of the year to begin speaking on dysphagia for PESI.  My first speaking engagements were in North Carolina in December.  I absolutely loved it!  Granted, I still have some kinks to iron out in the professional speaking world, but all in all, I thought it went pretty well.  I can’t wait for my next speaking engagement in January down south again, then in Illinois in June. I continued work on my BRS-S and finally was accepted!  Not only accepted, I passed my test!  I can now officially put BRS-S after my name.  Such long-sought and hard-earned letters!

Soon after I earned my BRS-S, I was promoted to Rehab Director of our department.  I’m still learning the ropes and working on improving our department.  I love the new job duties though.

I went to ASHA and had the opportunity to visit old friends and meet new friends.  As always, I had such a fun time!  I again had the opportunity to present a poster session.  It had a great turnout.  I worked in the SmartyEars booth, which is so much fun.  It’s always great to meet people and show off SmartyEars apps.  I always feel a lot of pride when people want to see a demonstration of Dysphagia2Go.  I would love to say that I attend the ASHA convention for the CEU’s, but I attend for the socialization.  That is one week of the year I feel like I am in “SLP heaven”.

I decided to end this post with a list.  Everyone always wants to know my recommendations.  Here are my top CEU courses, books and apps related to dysphagia.

Top CEU courses:

The VitalStim course by CIAO seminars is invaluable.  It’s absolutely great information, with such a huge emphasis on anatomy and physiology.  It is definitely worth the price whether you use the device or not.

MBSImP course by Bonnie Martin-Harris, provided by Northern Speech Services is another outstanding course.  Again, this course is based on the anatomy and physiology of the swallow and using it in interpretation of Modified Barium Swallow Studies.

Of course, my Dysphagia course.  I like to think that it is full of invaluable information.  :)

Top Books on Dysphagia:

Dysphagia Following Stroke by Stephanie K. Daniels and Maggie Lee Huckabee is absolutely excellent.  I’m in the process of re-reading it.  It is a book I will keep.


Drugs and Dysphagia
.  Great reference.


The Source for Dysphagia
by Nancy Swigert is my bible.  I love that book.


Clinical Anatomy and Physiology of the Swallowing Mechanism
.  Absolutely must-read!!


My Top Apps for Dysphagia

Of course my top vote goes to Dysphagia2Go.  I use this app all the time when I do a clinical evaluation of swallowing.  It lets me input all my data and then allows me to print a report of my findings.  This app is available for $39.99 on iTunes.

Dysphagia by Northern Speech Services costs $9.99 and offers amazing pictures of swallowing and swallowing deficits to share with your patients.

Lab Tests is a $2.99 app that allows you to look up lab values, their meanings and why the tests are performed.  This app does not require wi-fi to run.

Micromedex is a free drug app that is amazing and gives you not only information about the drug, but possible side effects, warnings, etc.  You can look up virtually any drug.

Cranial nerves is a $2.99 app that gives you information on all 12 cranial apps.  Not only does it give you the in-app information, but also allows you to, with the push of a button, access further information on the app on Wikipedia and Google.

 

I hope everyone has an amazing 2013.  I so look forward to all the new and great things to come!

This post is based on a post that originally appeared on Dysphagia Ramblings.

Tiffani Wallace, CCC-SLP, has been an SLP specializing in Dysphagia for over 11 years.  Tiffani has been very active in the social media world, creating 2 Facebook groups, Dysphagia Therapy Group and Dysphagia Therapy Group-Professional Edition.  Tiffani is also the co-author of the app Dysphagia2Go, available on iTunes.  She is preparing to travel nationally and speak on the topic of Dysphagia.  Tiffani writes a blog called Dysphagia Ramblings and is the author of www.dysphagiaramblings.com.  She is a 5 time ACE awardee and recently obtained her BRS-S.

Convention Must-Have: Twitter

I was really excited when I was selected to become an official ASHA blogger.  I blog anyway, so it was nice to get an official title.  I had planned on blogging a little everyday, but things have been crazy and before I know it, it’s time for bed.  I decided to go ahead and blog on Friday, the next to last day of the convention!

Throughout convention I kept hearing “how do you incorporate Twitter into therapy?” or “so how do you use Twitter?”  It seems there is either a lot of resistance to Twitter or people just really have no idea how to use it or how to get started.

Originally, I intended to write about my trip here, the sessions I attended, etc., but I think I’ll save that for later and instead write about Twitter.

I started my Twitter account about two or three years ago, around the time of my first ASHA Convention.  As much as I enjoyed the convention, I really didn’t socialize a lot or leave my hotel room other than to go  to sessions.   Through that convention, I started getting more involved in Twitter and started forming friendships there.

The 2011 convention was so much better having such a large group of friends to spend time with and share my ASHA Convention excitement.

This year has been a whole new experience.  I have a much larger group of friends, a really great roommate and amazing opportunities coming my way, all thanks to Twitter.   We had a great “Tweet up” this year with many new and familiar faces.  It’s always so nice to meet those people you’ve been talking to online.

How do I use Twitter?  I use it in so many different ways.   I ask and answer therapy questions through Twitter.  We have a whole network of SLPs called the #SLPeeps.  We have specialty people in various areas: literacy, fluency, technology, apps  and dysphagia.

I use Twitter to announce changes to my website, new blog posts, exciting news like earning my BRS-S, and to share links to videos or websites that I find relevant or interesting. I use it to share important information at ASHA from professional development sessions that I attend, or CEU events that I attend outside of ASHA.  If I find a really great session, I share that.  If I find a new product, I’m excited to talk about it and let others know.

So many people say they don’t have time for Twitter.  I can access Twitter on my phone and on my iPad, allowing me to post a Tweet any time of day.  I can post on Twitter in just a few minutes.  It’s really only as time-consuming as I allow it to be.

When I talk to people about Twitter, I tell them that’s it’s an excellent learning opportunity for me and a way that I have met many new friends that I may not have otherwise met.    I proudly wear my “I Tweet” and “#SLPeeps” ribbons on my badge and tell everyone who asks me about Twitter that it has been one of the most life-changing opportunities I have experienced.

(Tiffani is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Tiffani Wallace,CCC-SLP, has been an SLP specializing in Dysphagia for over 11 years.  Tiffani has been very active in the social media world, creating 2 Facebook groups, Dysphagia Therapy Group and Dysphagia Therapy Group-Professional Edition.  Tiffani is also the co-author of the app Dysphagia2Go, available on iTunes.  She is preparing to travel nationally and speak on the topic of Dysphagia.  Tiffani writes a blog called Dysphagia Ramblings and is the author of www.dysphagiaramblings.com.  She is a 5 time ACE awardee and recently obtained her BRS-S.

11 Tips for the 2012 ASHA Convention

I am officially excited about ASHA 12. (Not that I haven’t been since last year in San Diego). I hope to meet many of my readers, Facebook and Twitter friends at ASHA in Atlanta this year. I figured it’s that time of year that I should post a little bit about my recommendations in preparation for ASHA.

  1. If you don’t already have one, create a Twitter and Facebook account. Join SLP groups and on Twitter, find the #Slpeeps. I am @apujo5 on Twitter. Benefits of social networking for the ASHA convention? You get all the heads-up on the behind-the-scenes info. You meet great new friends so that you don’t have to be at the conference alone. You can also find someone to share a room and save a little money. There is a “tweet-up” on Friday at 5 pm in the Leader Lounge where you can meet the people behind the Twitter handles. This year we are having a “pre-conference” dinner and there are several that met up last year staying in the same hotel.
  2. Pack comfortable clothes and shoes. Yes, as professionals we often dress nicely, but trust me, you will appreciate the Nikes and jeans. Last year I was away from my hotel room from 7 a.m. until about 11 p.m. I was EXHAUSTED and just missing my comfy clothes. You can learn new information whether you are in a dress or in a pair of jeans! (Besides, if this is your first convention, the exhibit hall is ENORMOUS!)
  3. Bring a backpack. I personally am not a huge fan of the infamous Super Duper bags. Not only do they stink, they are not all that comfortable to haul around. There are so many freebies at ASHA, you definitely need something supportive to carry your stuff. If your backpack is big enough, you can stuff a Super Duper bag into it.
  4. Bring your phone, tablet and your charging cords. No matter how great your battery is, you will more than likely need to charge it at some point during the day. Especially if you are one of those #Slpeeps who tweet throughout the entire convention. There are also chargers you can bring for your phone that you don’t have to plug in during a session. Last year I purchased the iGo Green charger. You plug it in to charge overnight and can use it to charge up to two devices while it’s charging. While you’re sitting in a course, you can plug in your phone (doesn’t have to be an iPhone) and charge it from anywhere in a room. No mad dash for a seat close to an outlet needed. Also, by bringing a tablet, you eliminate the need to haul around pens and notebooks.
  5. The scheduler for ASHA is finally up! So many people are so overwhelmed by the seeming millions of available sessions to attend. I am a very visual person, so I have to do everything a little different for scheduling. I have to make my own calendar, then highlight all the sessions I want to attend and put the session number on the calendar. I then narrow my sessions down to two per time slot. Be sure you select some alternate courses as there are times you get to the convention and some of the courses/posters have been cancelled.
  6. It’s never too early to start packing. The more you plan what you need to take, the more prepared you will be! I personally do much better if I pack early because I will inevitably remember things I need to take later on. Also, the more room you can make in your bag the better. (Remember, the exhibit hall is ENORMOUS and full of wonderful FREE items. You can also purchase many items at a discounted rate!)
  7. Make sure you sign up for all the freebies. The opening party, awards ceremony and closing party are actually a lot of fun. Better yet, they’re also free! You are already spending all that money on registration anyway. The conference also offers a box lunch for a small price (I think $7 a day). It really beats having to fight crowds at restaurants and all the waiting (giving you more time at the exhibit hall). The boxed lunches are pretty decent and quite affordable.
  8. Prepare to have FUN. The ASHA convention is a blast. It takes forever for it to come around every year, but once it starts, the time flies. There is so much to do and so many people to meet. Prepare for one of the greatest  convention experiences of your life!
  9. Don’t forget, leave some time for socializing and the exhibit hall. You won’t regret it. There is an enormous amount of knowledge to learn from all the exhibitors. (Did I mention that many give away free items?)
  10. If you really can’t find a session you want to attend during a certain time period, you can always do poster sessions. Remember you can do six posters for every 90 minute time slot!
  11. Also, I have found the greatest app. If you are attending ASHA with friends, and split up, download Voxer. It turns your phone into a walkietalkie and is available for both the iPhone and Android phones.

For first-timers, the ASHA convention can be very overwhelming, but in the end is definitely worth the exhaustion!

(Tiffani is one of the official ASHA Convention bloggers. These three bloggers were selected to blog about the ASHA Convention in exchange for complimentary registration. Stay tuned for more insights from her and the other bloggers before, during and after convention.)

 

Tiffani Wallace, CCC-SLP, has been an SLP specializing in Dysphagia for over 11 years. Tiffani has been very active in the social media world, creating two Facebook groups, Dysphagia Therapy Group and Dysphagia Therapy Group-Professional Edition. Tiffani is also the co-author of the app Dysphagia2Go, available on iTunes. She is preparing to travel nationally and speak on the topic of Dysphagia. Tiffani writes a blog called Dysphagia Ramblings and is the author of www.dysphagiaramblings.com. She is a five time ACE awardee and recently obtained her BRS-S.

Using Your iPad in Dysphagia Therapy

iPad fascination

Photo by rahego

So many people are using iPads, iPhones and iPods in therapy. While there are many other devices out there, I’m focusing on the “iDevices” because those are the devices that I know the best. It is very easy to find apps for pediatric speech therapy, even apps for adult language therapy. There are apps for language, articulation, AAC, voice, fluency, and a few for dysphagia, but not many. It seems that few therapists are using their devices for dysphagia therapy. In lieu of the small number of apps available for those of us specializing in dysphagia therapy, we can very effectively use our iDevices for treatment.

One feature that comes with any of the iDevices is the notepad. This looks like the yellow legal pads that I’m sure we’ve all used. You can use the keyboard or dock your device to a keyboard to type notes. Once these notes are done you can then choose the option to print or you can email it to yourself to print. You can also use Evernote (which is free) to create documents and access everything from any of your smart devices or from the computer.

I use Dropbox quite often. Dropbox is a cloud storage app. I have it installed on my computer, iPad, iPod and Android phone. I save files from my computer including journal articles, forms, documents, etc and can access them through any of my mobile devices or can access them via the internet on any computer. In addition to Dropbox (which is free for 2 gb), I use Carbonite. Carbonite is a yearly subscription (around $60 a year) that is a backup system for your computer, it backs up all of your documents, plus you can log onto your account from any computer via the internet to access all of your backed-up items and there is an iOs and Android app to access your files from your mobile device.

Dysphagia2Go is the new Dysphagia evaluation app that lets you use your iPad during your Clinical Dysphagia Evaluation to write a report with all of your findings. If you already have a computerized version of your report, you can email the results to yourself and copy and paste your findings. This app is available through SmartyEars and will have some exciting new updates soon!

iSwallow is available for Apple devices. iSwallow is a free app that allows you to show videos of each exercise for your patient and allows your patient to track their exercises and lets the therapist see how many times each exercise was completed at home. This hasn’t been a very functional app for me; fortunately it was free. You have to email the company to get a password to unlock the app and I tried many times, unsuccessfully, to get the password from them. Fortunately, I ended up finding another therapist that had the password to get it. Also, it would be helpful if you had patients that owned iDevices so that they could utilize it. At this time, I’m not willing to loan out my devices to allow patients to track. Most of my patients are 70 or older and don’t own iDevices.

Lingraphica offers 2 apps for dysphagia. One is a communication aid for the iPhone/iPod Touch that can also be used on the iPad. It allows a patient with dysphagia to communicate regarding their dysphagia, for example, “I need my dentures” or “I need to be sitting up to eat”. This would be helpful if you have an aphasic patient with dysphagia that would be able and/or willing to communicate these items with others. Lingraphica also has an oral motor app which has videos of each exercise being completed.

There are also several apps which show the structures, from a scope view. You can use iLarynx, LUMA ENT and URVL to look at the structures, or to use for patient education. They are also fun to play and see if you can “insert” the scope appropriately.

Lab Tests is a relatively inexpensive app, I think it’s $1.99 that describes the lab values and has normative data for lab values. This is nice if you work in an acute care hospital, where they typically draw daily labs to interpret what the lab values indicate.

Pill Identifier lets you search medications by shape, color or score. Telling you what the pill is, what the indications are, how it is available OTC or prescription. You can view images of the pill or look at information of each pill via Drugs.com.

3D Brain is a wonderful view of the brain to educate patients on lesions and where their lesions are located. It’s also a fun app to play with giving you views of the brain and descriptions of the areas of the brain.

I’m sure this is not a comprehensive list of the apps however, hopefully it’s a start to help you utilize your iDevice in your dysphagia therapy. Also, keep watching SmartyEars for possible new dysphagia apps.

 

Tiffani Wallace, MA, CCC-SLP, currently works in an acute care hospital in Indiana.  Tiffani is working to specialize in dysphagia and is working to achieve the BRS-S.  She is also a member of the Smarty Ears Advisory Board and co-author of Dysphagia2Go, and has a website about dysphagia, Disphagia Ramblings.

Recent Dysphagia Surveys

(This post originally appeared on Dysphagia Ramblings)

I have often wondered what others that work in the area of dysphagia do during therapy.  I always want to know what tools they use and what books they recommend, so I made a survey.  Actually I made two.

First, I sent out 75 surveys, in the surrounding areas in Indiana (mostly central).  I received 13 of the surveys.  Ok, 12 because technically I did one as well.  Most of the surveys came back to me partially completed.  I have the results posted on Scribd.

As a whole, we had an average of 10 years of practice, with the shortest time being 2 years and the longest being 30 years or more.  Most therapists work in a SNF (Skilled Nursing Facility).  One concerning factor for me was the lack of use of a standardized bedside assessment.  In our realm of changing and more evidence-based therapy/healthcare, can we really continue to afford to use only our judgement with no real data to back up our findings??

Another concerning finding to me is that the most widely used therapy technique is diet alteration at 85%, which tied with oral exercises.  Perhaps, a new survey should be devised to determine what people consider oral exercises.  I realize that in SNF’s there will always be those patients that require a diet change and are not appropriate rehabilitation candidates, however SNF’s are also becoming widely known for rehabilitation.

Techniques that actually engage the swallowing function and tax the system to bring about an actual change, such as the Mendelsohn, the effortful swallow, etc, were only reported to be used 46-38% of the time.  I guess this would also explain why the average percentage of return to a normal diet was only 50% with most likely, spontaneous return accounting for some of the return.

Expiratory Muscle Strength Training (EMST) is an emerging therapy incorporating respiration strengthening with swallowing exercises.  Items such as The Breather were only incorporated into therapy by 1 therapist.  Of course, keep in mind, this was a very limited survey response, it still, I believe, paints a big picture of how our therapy looks.

With the limited number of surveys that were returned to me per mail, I decided to also create a survey by Survey Monkey.  This survey had a response from 44 therapists.  Again, the majority of the therapists from this survey work in a SNF.  The most widely used therapy “tool” is tongue depressors.  I’m guessing because it’s the most accessible tool we can get.  The Breather/Spirometer for EMST was still fairly low on the list with 14-17% usage and the Iowa Oral Performance Instrument (IOPI) was at 9.5%.

Again, the most popular therapy technique is diet alteration at 95%.  Some of the rehabilitative strategies we use such as the effortful swallow, Mendelsohn, etc.were used by 50% or more of the respondents.

I think that one important thing we can learn here is that diet changes, head turns, chin tucks, double swallows are not “rehabilitative”.  They create a safe swallow for the present time while we rehabilitate the swallow for a diet upgrade.  While we may have our patients on an altered diet or have them employ compensatory strategies, we also need to work the patient, use that effortful swallow, the Mendelsohn.  Work the swallow system and make it work like it should.  That is rehabiltiation.  When we bring about a change, we rehabilitate.

Most of us do recommend The Source for Dysphagia by Nancy Swigert as our favorite book.

I think the main thing we need to ask ourselves when treating our patients with dysphagia is, “Am I doing everything I can to rehabilitate my patient?”  Then ask yourself do you feel comfortable in saying yes you are.  Treat your patients as you expect to be treated.

Tiffani Wallace, MA, CCC-SLP, currently works in an acute care hospital in Indiana.  Tiffani is working to specialize in dysphagia and is working to achieve the BRS-S.  You can find Tiffani’s blog at http://apujo5.blogspot.com.