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This 286-page manual no doubt will become a standard reference for health care and educational professionals involved in the care of infants and children with feeding and swallowing problems. The Videofluoroscopic Swallow Study (VFSS), although one component of a comprehensive feeding and swallowing evaluation, is the gold standard for instrumental assessment. The book is the first in-depth description of this specialized study that focuses directly on pediatric patients with dysphagia. Authors Dr. Joan C. Arvedson and Dr. Maureen A. Lefton-Grief are speech-language pathologists with extensive experience in pediatric dysphagia. They set the procedural guidelines into a broad context of clinic assessment and decision making for management, while stressing the importance of a team approach for the comprehensive care of patients who are at risk for respiratory problems, malnutrition, long-standing developmental concerns, and stressful child-caregiver interactions. The text begins with a review of instrumental assessment procedures and an overview of anatomy, physiology, and development of deglutition. The primary focus is the VFSS procedure, including:
indications for the procedure and determinants of patient readiness,
technical aspects of completing a VFSS,
interpretation of radiologic findings, and
management of dysphagia based upon VFSS and clinical findings. Case examples illustrate the VFSS process. Samples of documentation forms for recording VFSS results and summarizing management information are provided. The Caregiver Guidelines include handouts to educate caregivers about the process of deglutition in simple terms, provide a permanent record that reinforces technical information, and reassure caregivers that others have shared similar problems.
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Maureen A. Lefton-Grief, Ph.D., CCC-SLP, is an assistant professor in the Department of Pediatrics at the Johns Hopkins University School of Medicine. She has extensive clinical experience in evaluation and management of adult and pediatric dysphagia. Her current clinical and research efforts focus on the relationship between dysfunctional swallowing and respiratory diseases in children. Dr. Lefton-Greif has lectured, taught graduate level courses, and authored chapters and articles on pediatric dysphagia. She served on the American Speech-Language-Hearing Association (ASHA) Special Interest Division 13 committee for developing a graduate curriculum for swallowing and swallowing disorders, and is on the ASHA task forces for Clinical Indicators for the Instrumental Assessment of Dysphagia and Specialty Certification.
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