But first! Some exciting news!
I am teaming up with Carrie Clark over at Speech & Language Kids to bring you an AWESOME medical extension to her incredible “The Speech Therapy Solution” Membership Site. I will be creating “The Medical SLP Solution” which will be a monthly membership site complete with videos, handouts, monthly CEU events, and plenty of resources all created by me, myself, and I. There will also be a private Facebook group, and another forum with experts in our field answering your questions on the spot to make your island a little less lonely.
If you would just like some additional support while trying to stay afloat on dysphagia island, please consider joining us for the Medical SLP Solution.
I’ve been asked repeatedly what books I would recommend the young bucks brush up on, or maybe you had pretty craptastic dysphagia training in grad school, or perhaps you graduated 10+ years ago and you’re really getting whacked repeatedly with the EBP stick upside the head, and you feel guilty that you’re still stuck in Dr. Jeri Logemann land circa 1998, so I’ve picked out a few of my faves for you.
But first, let’s get real here… by NO means would I ever disrespect the queen of dysphagia herself —Dr. Jeri Logemann, however a few things in her dysphagia “bible” are no longer considered best practice. Why is that you ask? Well for starters, because we’ve evolved. Our field has evolved. Our brilliant researchers have uncovered some really gnarly things about the swallow in recent years, and I’m pretty sure the vast majority of them would say that Jeri Logemaan has in some way, shape, or form inspired their work, so no, no one is dismissing all of the incredible work she has done for our field. So now that that disclaimer is out of the way, I hesitate to put her book here as one of my favorites, because I do have new favorites that contain a lot more recent evidence, but if you’re interested in diving in to a textbook that is nearly 20 years old, then by all means do, and sure the anatomy has not changed, but you get my point. The truth is, we know SOOOO much more about the muscle fibers that are used for swallowing now, and the physiology involved, that any source that is 20, even 10 years old, I would definitely question if this is the best we’ve got, or if we truly have more good stuff out there that just hasn’t made it to social media yet!
There are also some other workbooks and sources out there that people are heavily relying on for their treatment, and I have to ask — do you have any idea of the publication date? People look at me with 27 heads when I say that perhaps they should check that out before assuming that it contains the latest EBP, and then lo and behold they realize it was written 20 years ago. So I am not going to recommend any specific workbooks here, because in all honesty, I have not found any that are up to date, that I would want you to use on Gertrude. Unfortunately, Gertrude is so sick of wagging her tongue back and forth, and has heard in the beauty shop that there are better exercises that she can be doing to improve her swallow, so I’m really trying to refrain from recommending any books that don’t completely support the most up to date best practices. And before you throw stones at me and tell me i have no idea about the real world (in which I live, work, and breathe in every day), SEVERAL of the books referenced here have GREAT sections about TREATMENT!!!
I get asked all the time if there are some magic treatment strategies hidden in a far off land that only the elite SLPs have access to, and no, nope, there is no Candy Land for dysphagia treatment. Everything I know about and have learned is laid out in the books below. So I know some people just want to be spoon fed the information, but really our profession is so much cooler than that. If you told me your patient had X, and you ask if you should do Y, that doesn’t take very much skill. What does take skill is to know how to complete a thorough chart review, understand lab values, be aware of various medications, complete a thorough CSE, order the proper instrumental, and create a treatment plan from all of the aforementioned moving parts, that is not something that can easily be taught in a Facebook post, nor do I think I’m qualified to lead that charge.
So where should you even begin? Well, I am going to post several books here that have all been very valuable to me in my practice. Most of these books listed here are links to Amazon, and what I just love most about this great age in technology, is that most of the textbooks are available for Kindle, and most of them can be “rented” for a certain about of time right on your kindle or computer! People are always whining about how expensive books are these days, but now you can rent them through Amazon, and download them to your Kindle or computer instantaneously, so I really don’t think you have a right to whine any more. (Here’s a top secret “pro tip”: Amazon let’s you “rent” a book for as long as you want. If you rent it for $20 for 3 months, they let you keep extending the rental for free! I’m not telling Amazon how long I’ve had my one textbook rental for, so please don’t tell on me either!)
My top favorite pick for the Medical SLP:
Medical Speech-Language Pathology: A Practitioner’s Guide by Alex Johnson and Barbara Jacobson This is my *most* recommended “must have” for Medical SLPs. This is that one book that you do buy and keep in your office at work, and you will reference every so often. If you are new to Medical SLP, or you do not feel strong in all of the various areas of SLP that you might encounter, this a great book to help you delineate your strengths and weaknesses. This book is NOT solely dysphagia focused, but rather clearly illustrates assessment and treatment for Aphasia, Dementia, TBI, and Voice as well. This book also dives in to a great deal of clinical theories and “real world” scenarios.
Recommended Textbooks: If I had to pick the best textbooks out there right now for dysphagia, these are the ones I would pick:
Dysphagia Clinical Management in Adults and Children 2nd Edition By: Dr. Michael Groher, and Dr. Michael Crary There’s a few reasons that I totally dig this book: 1. It’s probably the most up to date evidence-based book we have right at this moment. 2. It also covers infants and children, which a lot of these others do not! 3. And you can RENT it on Amazon for like $20! It’s also available on Kindle too which makes my life way more organized.
Anatomy and Physiology of the Swallow Mechanism By: Kim Corbin-Lewis and Julie Liss This textbook was a total godsend in helping me pass my BCS-S test. The diagrams alone really helped me get a grasp on what I’m actually doing and why. The treatment section of this book is also VERY thorough, and whenever people ask me treatment questions, this is usually the first place I look.(P.S. – This one is even available on iBooks which allows you to print out sections, so I may have printed out all of the chapter summaries and studied them and memorized them and I may be a total nerd for doing so, but I feel like I’m totally winning at life when I figure out cool things like that.)
Comprehensive Management of Swallowing Disorders (SECOND EDITION!) By: Ricardo Curran, Thomas Murray, and Rebecca Howell I will be 100% honest with this one, and let you know that I had the first edition of this book when I was in grad school. When I was reviewing it recently I thought it was quite a snooze, so naturally I couldn’t recommend it, HOWEVER my good buddy Dan Weinstein informed me that the *SECOND* edition of this is out and it is VERY comprehensive! (Dan’s name may actually be found in the FEES chapter 😉
A little more anatomy and phys:
Netter’s Atlas of Anatomy: If you totally missed the boat as far as learning dysphagia and you really need to get back to square 1 to figure out how the hyoglossus differs from the hippocampus, check this out. If a picture book is more your style, the Netter’s books are always great books full of graphics and diagrams.
Standardized Training in Swallowing Physiology By: Dr. Bonnie Martin-Harris: Then of course the amazing Dr. Bonnie Martin-Harris who created the MBSImP has written this excellent manual for us. As important as knowing the anatomy and where what is and what does what, you have to know how everything moves and works. (That’s what physiology means, and that’s so you can fix it!) If you have the chance to take the MBSImP course, I can’t recommend it enough, but if you just want to dive in to great book on a Friday night with a glass of wine, this might be your deal!
Now, full disclosure here, if I had to pick the 2 books that made the MOST immediate impact in my practice, it would be these two:
Dysphagia Following Stroke By: Stephanie Daniels and MaggieLee Huckabee I never in my life thought I would brag about reading an academic book so fast (nerd alert!), but I literally finished the Dysphagia Following Stroke book in less than 48 hours. Granted I had a gigantic fire lit under my butt as I was trying to consume anything and everything under the sun in preparation for my BCS-S test, but this book was SUCH AN EASY READ!! Like really how many academic books can you say were easy reads — this one though, super easily digestible. Although this book is ALL about stroke, there is SO much in here that is relatable to a variety of populations that we treat, so if the thought of whipping out a textbook is beyond daunting to you, but you know you need to start somewhere, start here, consider it your training wheels to dysphagia textbook land.
Communication and Swallowing Management of Tracheostomized and Ventilator Dependent Adults (Dysphagia Series), By: Karen Dykeman and Marta Kazandjian This book is really where I learned that I’m going to be OK treating patients with vents and trachs. No, this book was not my license to working in LTACHs, but it gave me a solid foundation when I was considering working with this population, and luckily I had 2 experienced mentors working with me for several months, but I really can’t recommend this book enough if you are currently working with this population or you desire to. I really totally despise “scaring” people away from working with a certain population, I just really, truly want you to understand the harm that you can unknowingly be causing a patient, which absolutely NONE of us desire to do, and this book was very eye-opening and gave me confidence to work in this population.
Let’s dive in to dysphagia assessment, shall we?
Dysphagia Assessment and Treatment Planning: A Team Approach 3rd Edition By: Rebecca Leonard and Katherine Kendall This first book is again the most evidence-based up to date book we have right now. The reason I am so passionate about diagnostics is because it sets the stage for our treatment plan. If we’ve mis-diagnosed, or improperly diagnosed, or if the ever-dreaded yet oh so common occurrence of over diagnosis occurs, how on earth can we expect to make progress with our patients and demand the respect we deserve from others in our medical space? We have to have a solid evaluation to be able to set our patients up for success! If you’ve been doing the same boring mundane exercises, thickened liquids for all approach, maybe it’s time to throw it in reverse, back the truck up, and hone in on your assessment skills which I promise will open your eyes to an entire new world of dysphagia deliciousness.
Manual of Dysphagia Assessment by Dr. Joe Murray. So putting the above rant aside, my most favorite book about assessment that really opened up my big bright blue eyes was this one by Dr. Murray, who happens to just be a really, super cool dude to boot. Again, just a really solid book about what the heck we’re even looking for in there so we aren’t just handing out tongue wagging exercises to everyone we meet.
Endoscopic Evaluation and Treatment of Swallowing Disorders by Dr. Susan Langmore And then last, but absolutely certainly not least, I still reference this book at least once/week while doing FEES. Many people question what we can and can not see with endoscopy and this book helps to clear the mud. Not all of us live in areas where access to MBSS runs rampant, so FEES is another great visualization tool to see what we need to do or don’t need do with Sally and why. If you’re wanting to know a little bit more about FEES, I can’t recommend this one enough either.
My Medical SLP Starter Pack:
In my perfect little swallowing world, where every SLP was trained superbly to work in a medical setting, I would wrap a big obnoxious pink bow around these 3 books and tell you to keep them safe and sound in your clipboard.
Drugs and Dysphagia;How Medication Can Affect Eating and Swallowing By: Lynette Carl and Peter Johnson This book was very eye opening to me early on in my career that maybe there was a whole lot more to this dysphagia thing than just being hospitalized and having a weak tongue and needing thickened liquids. Nope, there’s a WHOLE lot more than goes in to this condition. It is BOTH a symptom and a diagnosis! We now know a lot more about various drugs that can directly impact swallowing functioning, or they can cause different signs and symptoms that we often jump to conclusion and assume it means aspiration. This book can help to rule in or out certain factors and give us a hint as to what else we might be dealing with. Some may or may not know how wildly inaccurate some patient’s charts can be. For some unknown reason, some conditions are blatantly left out of charts and we’re left to play detective as to why Sally can’t swallow a thing. I’ve often had to reverse engineer many a patient charts because I noticed they were on a specific medication with no explainable diagnosis to match. Oh but wait, if they are on Aricept? Perhaps we are working with some sort of dementia here? Yup, you guessed it. And you know what is usually VERY accurate? That med list! There are also some great apps available that have much more up to date drugs in them, but this is a great start for your thick skull.
The Yale Swallow Protocol By; Dr. Deb Suiter and the late great Dr. Steven Leder If you’ve listened to any number of the Swallow Your Pride podcasts, you’ve probably heard this book discussed. I know above I begged and pleaded you to do a very thorough assessment of your patient which I still very much stand by, but this protocol helps to streamline everything we know with a very high specificity. This helps us yay or nay the lady and get on with our next guy. I can’t recommend this protocol enough, but I really do encourage you to read the book and use it properly. Some people have tried to take bits and pieces and mash it up and make it work, and no, that’s not how it was intended to be used, not how it was normed, and just no, let’s do things the way they were intended.
The Swallowing Pocket Guide By: Dr. Ianessa Humbert Rounding up my list of great resources is this little guy. Dr. Humbert did an awesome job with this one. Muscles and cranial nerves are the basis of what we do, and if we don’t know everything they affect, we can’t be as good as we can be in formulating and adapting our treatment plan. I know picture books are all the rage and this one is a great reference when your brain is the consistency of pudding thick liquids on a Friday afternoon.
But Theresa, what about cognitive communication?
Well its a good thing I know people. Our dear friend Megan Sutton over at Tactus Therapy didn’t want to leave you out in the cold with cognitive communication resources, so these are her top picks.
For stroke and right hemisphere disorders, Margaret Blake is the woman!
For all things TBI, this book should be your go to!
This brand new book which goes on sale next week will help you with your patients with dementia. (And I’m a huge fan of Michelle Burgeois and her work with patients rights and ethics!)
Hopefully this list provides you with a little more guidance in treating your patients in the medical setting. If there are any others that you think are “must haves” let me know and I can add them to the list!
If this entire post is completely greek to you, or if you would just like some additional support while trying to stay afloat on dysphagia island, please consider joining us for the Medical SLP Solution. We provide brand new weekly resources in the form of handouts and videos, a panel of experts to answer ALL of your Medical SLP questions (anonymously, and not limited to dysphagia) and monthly webinars for ASHA CEUs.