SPHY301 - Mealtimes Feeding and Swallowing

Year

Credit points

Campus offering

Prerequisites

SPHY200 Neuroscience Speech Pathology AND SPHY205 Motor Speech Disorders (Acquired)

Unit rationale, description and aim

Swallowing and mealtime difficulties can have a profound impact on general health, nutrition, hydration and quality of life. Working with individuals who have swallowing, feeding and mealtime difficulties is a key aspect of speech pathology practice. As such, swallowing is a designated Range of Practice Area in which speech pathology students are expected to demonstrate competency in order to meet professional Entry-Level requirements..

In this unit, students will explore the socio-cultural importance, development, and maintenance of swallowing, feeding,, and mealtime, skills across the lifespan. This unit will cover normal development as a basis for understanding limitations of function and the impact on nutrition, general health, and psychosocial wellbeing. Causal and contributing factors to swallowing , feeding, and mealtime difficulties will be explored, including developmental and acquired conditions, congenital conditions, behaviours of concern, and personal and environmental factors. Students will be introduced to current evidence-based, person-centred, culturally responsive assessment and management approaches for swallowing, feeding and mealtime difficulties, Ethical and medicolegal considerations will be explored and discussed.

As such, this unit provides a theoretical base, and opportunities to apply knowledge in practical activities to ensure successful preparation for future professional practice in the area of swallowing, feeding and mealtime difficulties.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Demonstrate knowledge of common causes and factors influencing, swallowing , feeding and mealtime difficulties across the lifespan, to identify, describe and demonstrate approaches to assessment. (GA5);

LO2 - Analyse and interpret assessment information to accurately diagnose swallowing, feeding and mealtime difficulties across the lifespan (GA4, GA5, GA8);

LO3 - Formulate and justify person-centred, culturally responsive, interprofessional and evidence-based management plans for individuals with feeding and swallowing difficulties, guided by relevant frameworks for practice (including the ICF and E3BP) (GA4, GA5, GA8,) 

LO4 - Demonstrate evidence-based speech pathology intervention for swallowing disorders (GA5, GA9)

LO5 - Critically reflect on ethical and medicolegal implications of clinical decision making in the area of swallowing, feeding, and mealtime difficulties (GA3, GA4, GA5).

Graduate attributes

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media

Content

Topics will include:

Background to swallowing, feeding, and mealtime disorders     

• Contexts of clinical practice
• Working within an interprofessional healthcare team
• Application of the International Classification of Functioning, Disability, and Health (ICF) to the assessment and management of mealtime, feeding, and swallowing difficulties across the lifespan
• The social, cultural, psychological, medical, and nutritional impact of swallowing, feeding, and mealtime difficulties
• Epidemiology of mealtime, feeding, and swallowing difficulties
• Ethical and medicolegal issues in the management of swallowing, feeding, and mealtime difficulties

 The normal swallow

• Application of anatomy, physiology and neurology to the function of swallowing
• Embryonic development and swallowing function 
• Development of and change in normal mealtime, feeding, and swallowing skills across the lifespan
• The impact of the ageing on swallowing , feeding, and mealtime skills

 Common causes of mealtime, feeding, and swallowing difficulties across the lifespan

• Developmental swallowing, feeding, and mealtime difficulties (associated with prematurity; developmental disability; cleft palate/lip; respiratory conditions; cognitive and Behavioural difficulties etc.)
• Acquired swallowing , feeding, and mealtime difficulties (arising from acute neurological causes such as stroke and brain injury; progressive neurological conditions such as Parkinson’s Disease or Motor Neurone Disease; structural causes such as surgery, progressive transformations of pharynx/esophagus, following head and neck and chemotherapy/radiation; ; respiratory conditions, and associated with ageing).
• Tracheostomy – a basic introduction to principles of assessment and management

 Assessment and management of mealtime, feeding, and swallowing difficulties across the lifespan

• Evidence-based assessment principles, skills, and tools
• Clinical, medicolegal, and ethical considerations in assessment and management
• Undertaking and interpreting case history information
• Undertaking and interpreting non-instrumental assessment
• Rationales and principles underlying instrumental assessment: an introduction
• Integration of the principles of E3BP to develop an interprofessional management plan (including
• assessment information, client preferences clinical and research based evidence) Considerations for providing person-centred and culturally responsive management in paediatric and adult populations.
• Utilisation of outcome measures in the management of swallowing, feeding, and mealtime difficulties
• Rehabilitation and maintenance of swallowing, feeding and mealtime,   skills
• Compensatory considerations in the management of swallowing , feeding, and mealtime skills
• Assessment and management of personal factors and environmental influences on swallowing, feeding, and mealtime difficulties
• Assessment and management of swallowing, feeding, and mealtime, skills, and ethical considerations during end-of-life care

Learning and teaching strategy and rationale

This unit uses a blended learning approach supporting flexibility in student learning and placing the student at the centre of their learning. Teaching and learning strategies may include online lecture and learning modules; and face-to-face tutorials/workshops and simulations. Online lectures and learning modules will provide core theoretical content and opportunity for independent student revision throughout the unit.

Face-to-face tutorials/workshops and simulations will build on the theoretical knowledge presented in the online modules providing students with the opportunity to apply this knowledge in individual and small group discussion and case based activities. Throughout the unit emphasis is placed on self-directed learning and peer discussion to develop critical thinking, clinical decision making, and problem solving skills essential to speech pathology practice.

Students are expected to take responsibility for their learning, to prepare for, attend, and actively participate in all learning activities demonstrating respect for the individual as an independent learner, and respect for peer learning and engagement.  

Assessment strategy and rationale

This unit takes an authentic assessment approach allowing students to demonstrate their learning and competency in clinically relevant scenarios.

Assessment 1 and Assessment 2 are case based assessment tasks that require students to apply their theoretical knowledge and clinical reasoning skills consistent with the Speech Pathology Australia Competency Based Occupational Standards (CBOS); Units 1- 4. The format of Assessment 1 and 2 reflect skills required by speech pathologists working in clinical settings, such as the ability to present clinical handover to an inter-professional team and write client reports.

Assessment 3 provides an opportunity for students to demonstrate critical clinical skills and their ability to discuss and reflect on medicolegal and ethical considerations surrounding a case scenario in a facilitated peer environment.

The ungraded hurdle task provides students with an opportunity to demonstrate their skills in evaluation and/or remediation of swallowing, feeding and mealtime difficulties, prior to external professional practice placement with adult clients who may experience these difficulties.

Overview of assessments

In order to successfully complete this unit, students

must submit and make a credible attempt at all assessment tasks and are required to:

- obtain a cumulative mark that is equal to or greater than 50% of the possible marks available; AND

- pass the ungraded hurdle

Representative texts and references

Arvedson, J., Brodsky, L., & Lefton-Greif, M. (2020). Pediatric swallowing and feeding: Assessment and management. Plural.

Corbin-Lewis, K. & Liss, J.M. (2015) Clinical anatomy & physiology of the swallow mechanism, (2nd ed.). Cengage Learning

Evans-Morris, S., & Dunn-Klein, M. (2002). Pre-feeding skills: A comprehensive resource for mealtime development (2nd ed.). Therapy Skill Builders

Groher, M.E. & Crary, M.A. (2016). Dysphagia: Clinical management in adults and children (2nd ed.). Mosby