Random Thoughts: McNeill Dysphagia Therapy Program

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Last weekend I attended the McNeill Dysphagia Therapy Program (MDTP) certification workshop. For readers who don’t know, MDTP is a systematic, exercise-based dysphagia treatment program. Patients improve swallow function by swallowing vs. more traditional treatments based on compensatory strategy and facilitative maneuver training. Certification is required, and I am bound by agreement not to divulge details of the treatment protocol.

The workshop I attended was presented during a very long day filled with an incredible amount of information! It has taken me a couple of days to begin to wrap my mind around this “paradigm shift” in thinking about the treatment of swallowing disorders. I’m not quite ready to enter into lengthy discussions about it with certified providers, but I definitely have a few random, mostly “one-liner” thoughts I can share.

MDTP…

…is very different than our traditional methods of treating dysphagia.

…certified clinicians do not necessarily view aspiration as a catastrophic event.

…is based on the premise that “the best treatment for swallowing is swallowing.”

…is not suitable for every patient.

…has been studied for neurological population adults with history of traumatic brain injury, stroke, etc.

…has not yet been studied and may not be suitable for patients with progressive neurological disorders, e.g. Parkinson’s disease, Multiple Sclerosis, etc.

…may be suitable for patients with progressive neurological disorders during the early stages before function has severely declined.

…can be implemented by those of us out in the trenches of outpatient rehab, skilled nursing, and long-term care facilities.

…seems like it would be well (better?) suited for therapists who have the ability to conduct their own swallow studies.

…will be easier to implement when more SLPs are certified and can collaborate effectively.

I also have several thoughts about background and off-the-cuff comments by the presenters.

…SLPs need to stop talking so much during therapy!

…the Masako is a “non-exercise.” (I was confused by this, & it was never clarified. I’d still like to understand why one of our “standards” has fallen out of favor with the presenters, but I did not have an opportunity to ask for details.)

…Dr. Carnaby has completed new research in the process of publication that focuses on the use of neuromuscular electrical stimulation (NMES) in dysphagia therapy. I look forward to reading this research study.

…The background we were given regarding differences in Type I and Type II muscle fibers was very interesting and will be important to review when Dr. Carnaby’s new research article is available.

…Silent aspiration isn’t really all that “silent.” There are always subtle signs we can learn to read.

As I said, it was a 10 hour day packed full of new material to absorb. There is plenty of information available via online search engines. I recommend you explore the topic that way to obtain more specific details about the program.

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Cynthia Williams Bowen, MS, CCC-SLP owns Bowen Speech-Language Therapy, LLC in Clearwater, FL.  Cyndee provides quality, creative, collaborative treatment to adults and adolescents with communication, swallowing, Parkinson’s, and related disorders.

3 thoughts on “Random Thoughts: McNeill Dysphagia Therapy Program

  1. I took the course too! At first, I was disappointed because I don’t work in an outpatient setting with high-level cognitive patients and don’t have the ability to perform before/after swallow studies. I work in a SNF setting where the majority of my patients have dementia. Traditional exercises certainly don’t work with those folks and not all of them are NMES candidates. So, at first I thought “here’s one more thing I can’t use with my caseload”. However, I still feel I can apply many of the principles to what I’m doing, although it may not be exactly the way the program was designed. I’ve only been back one week and am doing a modified version for 3 of my current clients.

    The only criticism I have of the class is that it was rushed. I think it should have been 2 days!

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