Use of the ICF in Dysphagia Management

Abstract

The evaluation and intervention of persons with dysphagia represents a significant percentage of speech-language pathologists' caseloads in medical settings. Because of its overtly medical nature, there has been considerable focus dealing with the direct physical health aspects of dysphagia management. This article argues that the use of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) by clinicians can expand and greatly enhance the outcomes for persons with dysphagia. The different components of the ICF are discussed in relation to dysphagia assessment and management. The article concludes by noting that speech-language pathologists can use the ICF framework beneficially to justify and strengthen their role in the management of dysphagia.

The lived experience of dysphagia following non-surgical treatment for head and neck cancer

“…Traditionally the assessment and management of dysphagia has been medically driven (Threats, 2007) with the majority of interventions for dysphagia focused on rehabilitation of the swallow (Cousins, MacAulay, Lang, MacGillivray, & Wells, 2013). However both the current data and prior evidence (Larsson et al, 2003;McQuestion et al, 2011;Ottosson et al, 2013) supports the need for active intervention for both the physical and psychosocial issues, and for services that extend beyond the acute recovery phase.…”

The ICF-CY and children with communication disabilities

“…To date, it appears that there are few, if any publications that have specifically linked ICF to children's difficulties with hearing, voice, or swallowing. However, papers have addressed these areas of difficulty in adults (e.g., Hickson & Scarinci, 2007;Ma, Yiu & Verdolini Abbott, 2007;Threats, 2007).…”

Reliability of the Danish version of the McGill Ingestive Skills Assessment for observation-based measures during meals

“…In order to provide adequate management, dysphagia requires careful and comprehensive examination (6). Dysphagia is currently assessed using clinical bedside assessments which includes anamnesis, evaluation of oral, pharyngeal, and laryngeal sensory and motor function, and water swallow tests (7).…”

“…Also instrumental techniques such as videofluoroscopic or fiberoptic endoscopic examination of swallowing (7) are used. However, these assessments are often performed in an artificial environment (6,7) and may not fully reflect the complexity of eating and drinking in a natural context (6). Therefore, it would be beneficial to complement these methods with information on the dysphagic patient's task performance during a natural meal (6,7).…”