Speech-Language Pathology
The approach for treating patients with dysphagia in the HNC
Survivorship Clinic is shifting more to telepractice since the outbreak
of COVID-19. Telepractice has been deemed feasible in HNC patients and
other adult patient populations, who need continued support by a
speech-language pathologist.13, 14 Initially,
telepractice was intended to reach patients in remote areas where speech
services were not available. Now it is being used to help patients
continue with therapy programs in their homes while limiting exposure to
COVID-19. It is important to note that each state has its own policies,
laws, and professional regulations regarding the provision of
teletherapy by speech-language pathologists.
In the HNC Survivorship Clinic, speech-language pathologists are using
telepractice with individuals undergoing definitive or adjuvant
treatment. This begins after the initial swallowing evaluation has been
completed in the clinic and a treatment plan identified. Weekly sessions
are held via televideo to promote eating and swallowing exercise
programs, with the primary goal to prevent atrophy of the muscles and to
help maintain oral diets throughout the course of treatment. We are also
using telepractice to engage with individuals who suffer from long-term
treatment-related toxicities that impair swallowing function. In
addition to implementing a swallowing exercise program, televideo visits
allow us to complete a modified version of our typical clinical
swallowing assessment to monitor diet tolerance, swallowing function,
and use of compensatory strategies to reduce aspiration risk. Without
our intervention, these patients may be at risk for developing
aspiration pneumonia, malnutrition, or further decline with swallowing
function. Individualized treatment programs are established based on
patient needs, and close collaboration continues with the physical
therapy team.
Speech-language pathologists need to continue to monitor, coach and
treat individuals who need our help during and after HNC treatment.
COVID-19 has changed the way we are doing things, but we may discover
that these new methods will bring added value to what we do.