NUH will be organizing the following lecture:
Pharyngeal High-Resolution Manometry: Clinical Applications in Dysphagia Management.
Speaker: Dr Timothy McCulloch.
Dr McCulloch is a world reknown Otolaryngologist specializes in treatment of head and neck cancer, voice and swallowing disorders, trauma, reconstruction, and skull base surgery.
The lecture is opened to all healthcare professionals.
We are happy to announce that the follow up study on CTAR has been published online (online first version) in Dysphagia Journal.
Original Paper
pp 1-11
First online: 02 February 2016
In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science—muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.
Details of the journal can be found at http://link.springer.com/article/10.1007%2Fs00455-015-9678-2
We are happy to announce that we are starting our third CTAR research at the National University of Singapore.
Dear all,
JurongHealth Speech Therapy department will be organising a 2 day workshop next year entitled ‘Best Practices in the Management of Oropharyngeal Dysphagia’. The workshop will be conducted by Dr. Catriona Steele and will be held on 20 – 21 May, 2016 at Ng Teng Fong General Hospital, Singapore.
About the speaker:
Dr. Catriona M. Steele is a clinician scientist working in the area of swallowing and swallowing disorders. She has a background as a medical speech-language pathologist, and is Director of the Swallowing Rehabilitation Research Laboratory at the Toronto Rehabilitation Institute – University Health Network. Dr. Steele is a Professor in the Department of Speech-Language Pathology at the University of Toronto and is in demand as a teacher and workshop instructor around the world. Dr. Steele holds research funding from the National Institutes of Health (USA) and has more than 100 peer-reviewed publications.
Brief outline of workshop
> Best Practices in the Identification and Assessment of Oropharyngeal Dysphagia
– Sensitivity and specificity of different dysphagia screening tools
– Purpose, protocols and important technical considerations of videofluoroscopy
– Using information from research to quantify observations during a clinical bedside swallowing assessment
> Management and Rehabilitation of Oropharyngeal Dysphagia
– Evidence behind texture modification and postural approaches
– Direct and indirect swallowing/exercise approaches including the use of IOPI and sEMG biofeedback
– Other approaches in the literature: respiratory interventions, electrical stimulation, vibratory stimulation
Estimated cost: $400 – $500 per participant for the full workshop.
Registration Correspondent: Ms Wong Wan Xin
Wong Wan Xin| Speech Therapist, Rehabilitation | Ng Teng Fong General Hospital & Jurong Community Hospital | Jurong Health Services
1 Jurong East Street 21, Singapore 609606 | T: (65) 67161674 | E: Wan_Xin_Wong@juronghealth.com.sg
About the Workshop:
Oral motor impairment presents a variety of challenges for both the individual affected, and for the care team providing intervention. Often the individual experiencing oral motor difficulties is not able to follow commands. The person may not be eating or taking fluids orally, which reduces the opportunities for observation of oral movement patterns. The majority of baseline protocols currently available require at least minimal direction-following skills. The protocol developed by Beckman uses mechanical muscle responses, which are not mediated cognitively, to baseline the response to pressure and movement, range of movement, variety of movement, strength of movement and control of movement for the lips, cheeks, jaw, and tongue. In this two day course, participants will actively participate in hands-on practice for compensatory handling techniques for the following concerns: tonic bite, tonic bite on a utensil, slow oral transit, tongue thrust, cough, gag and vomit. The participants will complete an oral motor protocol with each other, analyze the results, and discuss data tracking. The participants will also complete hands-on practice for specific oral motor interventions to address the deficit areas discovered during baseline assessment. Additional topics of discussion may include: goal writing, diet texture progression, tube to oral issues, adaptive mealtime utensils, oral hygiene issues, medication administration issues, oral function for individuals with tracheotomy, facilitating improved articulation through oral motor techniques, research issues, videofluroscopy issues for motorically involved individuals.
Speaker: Mr Stephen Chan (Occupational Therapist)
Target Participants: Licensed Occupational Therapists AND Speech and Language Pathologists/Speech Therapists
Date &Time: 9th & 10th March, 2016 (Wed & Thur) 9:30am – 5:30pm
Venue: Room 706, Peninsula Tower, No. 538, Castle Peak Road, Kowloon, HONG KONG
Seat Availability: 30 seats
Course Fee:
Certification: Upon 100% attendance, participants are awarded the Certificate of Completion by Beckman & Associates, Inc. And after the completion of the course, participants’ name can be listed (optional) on the website http://www.beckmanoralmotor.com.
Enquiry: To learn more about the course, please visit the website: http://www.beckmanoralmotor.com
Registration form can be downloaded from: http://www.crest.hk/wp-content/uploads/2014/07/Beckman-Certificate-Course-Information-by-CREST-2016.03-revised.pdf
For any enquiries, please feel free to contact Mr. Stephen Chan at stephen@crest.hk or (852) 3628 3443
Hosted by Speech and Hearing Association Singapore (SHAS)
Traumatic Brain Injury (TBI) commonly affects young people and can result in a lifelong disability. Singapore is unique compared to the commonly researched populations in Australia, UK and US – including our language background and healthcare system. In this talk, we will explore how bilingualism impacts TBI sequelae and discuss what we can learn from service delivery models in established TBI units in Australia. It will be a sharing and discussion session, so bring along your best thinking hats and come share your thoughts and experiences!
Outline of the talk:
– Brief overview of TBI
– Bilingualism and TBI: Assessment, management and sharing of PhD findings on code-switching behaviours in TBI
– The NSW BIRU experience and what we can learn from it
Please see below for more details and send all enquiries to Melissa from the SHAS Professional Development Team.
Click here to download the registration form then send it back to prodevelopment.team@shas.org.sg to secure your place at the talk.
Please RSVP by the 26 May 2015 (Tuesday)
Videofluoroscopy_Interpretation_Made_Easy_Registration_Form _1_
I will be conducting a talk titled Videofluoroscopy (VFS) Interpretation Made Easy for Speech-Language & Hearing Association Singapore.
Date: 24 April 2015 (Thursday)
Time: 6.15pm – 8.30pm
Venue:
National University Hospital
Group Therapy Room, Main Building Level 1,
5 Lower Kent Ridge Road, 119074
About this talk:
This talk is a short introduction to Videofluoroscopy (VFS) interpretation and is suitable for both clinicians who are experienced or inexperienced in performing VFS. I will introduce pathophysiologies commonly viewed in VFS with the use visual examples. I will also share on how I analyze VFS systematically, and how to select suitable strategies to be trialed during the procedure accordingly to patient’s presentation.
Outline of the talk:
The answer is NO.
Most patients have the perception that when they see or being referred to a speech therapist, they must receive some form of active treatment that involves active exercises. This may not be true all the time.
Why?
From speech therapy perspective, a medical diagnosis that explains the presentation of speech/ language/ voice / swallowing difficulties is required before any active therapy can be initiated.
That is because these difficulties are usually symptoms presented as a result of certain medical condition(s). For example, a new onset of swallowing difficulty is actually a symptom of neurological disorder(s) or brain related problem(s) that require further diagnosis by a neurologist. The causes may include stroke, neurodegenerative diseases, myasthenia gravis and etc.
Some active treatment may contraindicate the presenting medical diagnosis. For example, for myasthenia gravis (MG), the muscles will weaken further as one gets more tired/fatigue. As such strengthening exercises would not be appropriate for this condition. In fact, compensatory methods such as eating small amount but frequent meals if patient gets fatigue easily and unable to finish up full meal safely may be a better choice of management. In fact treatment for MG that has been shown to be more effective in improving functions include medical intervention and/or surgical intervention. Speech therapist plays the role in assessing suitability for oral feeding, teaching compensatory strategies and providing information counseling.
So for any presenting symptoms that do not associate with any preexisting medical diagnoses, perhaps the next best management is to refer the patient to see a medical specialist who can assess and potentially provide a diagnosis that may explain the presenting symptoms.
In summary, active speech therapy that involves exercises need not be the choice of management all the time especially if there is no confirmed medical diagnoses. Finding out the cause(s) of the symptom(s) / presentation(s) will allow us to make better clinical diagnosis which will lead to better management / treatment that is usually more cost effective. This is especially so with the rising cost of healthcare in Singapore and Worldwide.
Singapore Swallowing Specialists 