Can people mute their mics?
Simón David Vargas Pérez
can everyone mute their mic
Please MUTE your mike
Please MUTE the mics
Darleen M Molina Toledo
leyda mute your 🎤
can you mute everyone?
Please mute participants
admin should be able to mute everyone except the speaker
Please mute all. Thanks :)
Why is someone not taking care of this!!!
Thank you for offering this. Will this be offered to watch as a recording? I am not able to listen for the 2 hour duration. Thank you.
Howdy from Texas and I am excited to hear the presenters!!!!!
Does a facilitator need any special credentials? Can it be a family member? CNA?
can you give a little more detail about the role of the facilitator. Can you give me a an example of who selects the facilitator?
Do you provide a checklist for the patient or caregiver with respect to logistics and equipment?
Do you follow a specific protocol for the evaluation - such as using the MASA?
Great job you guys! Wonderful “seeing” you!
Any specific recommendations for the oral peripheral exam in pediatrics via Telepractice?
is there a national consent form for the teletherapy
Torch is the same as flashlight?
Would you be able to share with us your templates that you use to prepare the clients and facilitators for the sessions/assessment
Will we be getting your web guide?
Yes - all our resources will be shared!
Excellent thank you!
Great, Thank you
thank you very much
So excited to see you all! Amazing discussions. Thank you so much, Dr. Malandraki, Dr. Ward and Dr. Burns!
Yes - all the learning programs are accessible at the end of this webinar
Also we need to check our licensing laws for consent rules and emergency procedure rules.
State licensing laws.
Jasmine Lydia Selvaraj
I am Jasmine Lydia from India. I am glad to write to you. what are various “needs assessment” for tele-practices and is there any special considerations/ adoption for developing countries.
Will you address if clinicians can do a session with a patient, could it be recorded with patient permission of course, for students to learn? Seeing that students are now not in clinics/hospitals etc, could these sessions be recorded for “simulation” cases?
Does the facilitator need to be CPR or BLS certified?
Can you mute people that are not speakers please
such a good point!!!
Hi, I am Sany From QatarI am so glad to join youIs it better to have a preparation session or orientation with the facilitator to explain the procedure exactly before the actual procedure ?
what about if it was a silent aspiration with no signs ?
and how to assess hyolaryngeal movement ?
clinical eval will not help there; need instrumental
Have you evaluated someone who is on supplemental O2? If yes, do you take help of facilitator to take vitals etc.?
Arwa Bin salamh
how can i be sure of the consistency used by the patient during tele-practice?
If you can get things pre-packaged so no mixing is required, that is the most accurate.
Certain technology is not available right now because it is sold out. What does this mean for us, if we can't access a mobile webcam? Would we then be required to schedule face to face and then have to figure out PPE, refer to other facility? Or are there some technology work-arounds if the ideal equipment is not available?
Have we seen different swallowing issues with Covid-19 compared to the dysphasia issues that we normally encounter?
so how I check the hyolaryngeal elevation ?
Would be helpful to know if presenters entered into telehealth due to geographical restrictions rather than pandemic. What proportion of their patients convert from clinical swallowing evaluations to objective assessment (MBSS)?
@Arawa Bin salamh: are you doing IDDSI testing?
yes please.....how do you do an oral mechanism exam!!!
Great, thank you
to get a sense of lingual strength, I was thinking about making a rough judgment about how far they can push out their cheek with their tongue. We can't really use the facilitator to make a call about how much the patient's tongue resists pushing by tongue depressor......
EAT 10 is a great questionnaire
How would you adapt cervical auscultation during swallowing Ax?
cam facilitator is a tongue strengthening measuring device to get an objective measurement?
Arwa Bin salamh
No actually i assess it subjectively
thank you for answering the question on monitoring respiratory status as part of evaluation. How about cognitive status? How much would you consider this to continue with rest of the steps of CBSSE? and treatment plan? Assuming they might not assistance of facilitator all the time...
Thank you for presenting this alternative option of telepractice and dysphagia as we provide service access for dysphagia patients.
Ann Marie Arena
What do you use for sensory measures for taste?
Any lessons learned for situations where you might have underestimated a clinical concern. Given your number of years doing this, what have you learned?
Any specific online approved questionnaire or assessment that you can recommend?
Yes! Thank you, Dr. Malandraki. Just fyi - if you have permission to adapt questionnaires as appropriate, JotForm is offering free hippa compliant accounts with an npi number
Hi everyone. In Malaysia, I have had to use the mobile phone to do a session for a patient who had pulled out his feeding tube during the Covid lockdown. Family insisted he could feed orally but clearly the tele CSE found otherwise. So we have to innovate when equipment is not ideal!
Great job, Shobhaa Sharma!
Hi I was unable to join earlier. Will the recording be available for later viewing? Thanks!
yes - it will be available on the ASHA website.
Do you ever send thickener packets to patients before the evaluation to use during the assessment as needed?
Hi Dr Malandraki, in patients who have lost their sensation after COVID what would be the best treatment and since the patients are in bad psychology situation, is it necessary for us to have intervention in this case and if yes how we can do it ?
that's what I was planning to do. And a syringe for IDDSI flow test
If the patient demonstrates signs and symptoms of aspiration during the CDE and no diet consistency can be recommended do. you typically suggest NPO or have a quality of life conversation with the pt/family pending an instrumental examination which may take a bit of time to get scheduled.
I very much appreciate that the speakers are sharing that so much of what we are doing in rural or underdeveloped settings is "the best we can" and not for research!
agreed, evidenced based is fine for some arenas and then there is providing resources, immediate support and caregiver education which is invaluable to family
I also appreciate that it is person centered care based in the home environment with the tools/resources that are available in the home!
Thank you for your information
sorry for going back to the assessment part, but what about if the pt needed an innstrumental tool for example MBSS ?
-how about pharyngeal resistance exercises? thermal stimulation? how about co-treating with PT or OT in terms of assessing positioning/posture and feeding adaptive devices via telepractice? Thank you!
typically what's the duration of a telehealth swallow session?
Thank you Dr. Malandraki, this is an important point!!!!
then what options do we have? Seeing them in person and have to figure out PPE....refer elsewhere?
As a private practitioner, access to PPE isn't really possible...so I guess I would refer someplace where they have access to PPE??
What about application to snf and you are not in the same facility
Amen Dr. Malandraki!!
I've heard (ASHA webinar last week) that facilities are "going blind" without any instrumental assessment availability due to it being an AGP (Aerosol Generating Procedure) and considered too risky. Has that lightened up any?
Great question Carolyn! At the SNF level we have limited/no access to instrumentals with all this…really really tough to navigate
Is there any way to assess muscle tone in pediatric population during telepractice?
CSE is AGP as well. In private practice, my plan is to do the CSE, give diet recommendations (because frankly, if we can keep patients safe and out of the hospital, we should), hydration & oral care concerns, brief follow-up plan for tolerance and understanding, and holding off on therapy until instrumental assessments are available again.
Best recommendations for communicating evaluation results to other medical providers, especially if referrals and/or additional testing is recommended?
Yes, we know him very well
A F1 racer
Regards from Colombia
to Jenna Pellegrini- agree re AGP aspect. But the limitation of NO follow up with instrumental assessment has been worrisome to many
Thank you very much for this information about telepractice
Tele IPE!!!! Love it
Agree - this is a specific skill providing telehealth! Also the rules for student and using telehealth vary by state to state
agreed to many telerx is simply anotg
another venue for service delivery-
We use IPE very much but will be adding tele IPE component!
PLEASE!! Amen Dr. Malandraki
thank you for considering students and their needs!!!!! WE ARE REALLY in a BIND prior to COVID_-19!!!!!
We need more session recorded from experienced SLP’s! Would love to see some with H&N CA pts, etc.
Are graduate students able to observe only through telepractice and/or are we able to provide intervention with appropriate supervision?
YES! I second that! Having a visual of how to apply everything! I had to laugh at myself trying to get acoustic data via telehealth...wish I had seen an experienced telehealther do it first!
there are states that do not have an actual regulation/law in regard to telepractice and graduate student clinicians
students can provide therapy in some states. multiple students (2-3) can count but must have 100% supervision
CFCC is supporting telehealth sessions for clinical clock hours , and the supervisor does not need to be in the same room as the student clinician. So call your local University or your alma mater and offer to help get students their clock hours.
absolutely - such at great way to train the students, get clock hours and support patient care
True Phyllis, but states do vary on the supervision rules
national standard is 100% supervision to count for contact hours for students
any Feeding Therapy by Telepractice courses
And we get to see “experts” or advanced experienced people in our field do great work, what a wonderful way for students and newer clinicians to learn…please record you guys, we need to “see” you in action.
Amen!! Georgia we need the allowance to be permanent
Thank you so much!
thank you all, excellent presentation.
Debbie Yaker Spellman
Amen… Permanent.. and Hybrid approach when needed..
EXCELLENT work, thank you so much!!
where can we find the recourses you have mentioned :)
Thank you all! Wonderful presentation!
Thank you all so much. This was fabulous!
wonderful information! you have given me much to think about for student preparation!!!!!!
Thank you - great presentation!
Thank you very much-so exciting to have
Thank you very very much!! This was beyond excellent!!
Thank you very much
Yes, THANK YOU!! This was wonderful information
Thank you! You've given me the courage to get this rolling!
appreciate what you have shared with us
Thank you Liz, Clare and Georgia. This was so great.
Thank you so much! Very helpful.
The telepractice jenie will NOT go back into the bottle!!!!!!
Thank you so much!
Absolutely fantastic information! So grateful to hop on the trail you’ve blazed.
Erin Redle Sizemore
Thank you. This was excellent !
Thank you very much. Very, very helpful information.
Arun Balaji K D
Thank you for sharing all your knowledge! Wonderful!
Thank you very much!!
Thank you for all the information!
Thanks so much all, very helpful information!
This was very helpful; thank you so much! We have a lot to think about and apply at our university clinic!
Thanks for your time and dedication. Very helpful information!
Rinki Varindani Desai
Thank you to the panelists for a very informative talk. We appreciate you taking the time and expertise to educate us!
what was the last website mentioned?
Dawn Wetzel!!! Hi!!! I went to Purdue (Jenna Olson...2012)
Thank you very much!