This article describes the process and findings of a subcommittee of speech-language pathologists formed by the Consortium of Multiple Sclerosis Centers. Its purpose was to study MS patient-care issues as they relate to communication disorders and dysphagia. To determine "What We Know," a literature review of eighty articles was performed about MS care as it relates to aphasia (5), auditory deficits (7), dysarthria (7), dysphonia (2), dysfluency (1), dysphagia (9), language disorders (5), and cognitive deficits (43).However, because of the lack of current studies, "What We Believe" was examined through the development of a practitioner survey. Thirty-six speech-language pathologists who provide MS care responded. Results were analyzed, gaps were identified, and questions were raised. This information was presented at the June 1993 CMSC: MS Care Conference in Denver, Colorado. To address "What We Do Not Know," this specialty group then met with an interdisciplinary group and a research panel to facilitate the formulation of two research proposals. The questions developed were: (1) What is the prevalence of language and communication disorders in multiple sclerosis? (2a) Is dysphagia therapy effective in reducing medical complications? and (2b) Which dysphagia treatment is more effective: restorative or compensatory? Key Words: Communication Disorders—Cognitive-Language deficits-Auditory deficits—Dysarthia—Dysphonia— Dysphagia.Current scientific study of communication disorders and dysphagia in the MS population is lacking. There are many unknowns, such as the prevalence of various types of problems, natural history of these problems with MS type and disease progression, correlation with MRI results, interrelationship between deficit areas, adequacy of evaluation measures, and effectiveness of various frequency, duration, and types of treatments. The Consortium of Multiple Sclerosis Centers organized a conference in Denver, Colorado, in June 1993 entitled MS Care: Wlzat We Know, What We Believe, lvhat We Do Not Know. Its goals were to take a critical look at how we treat MS and to generate research questions to increase our knowledge about outcomes in MS care. All professional disciplines were represented. The speech-language pathology specialty group studied MS patient-care issues as they relate to communication disorders and dysphagia. Prior to the development of these questions, a five-part process was follocved:
