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At MGH, Speech-Language Pathologists function as part of an interdisciplinary medical team. The Inpatient team specializes in managing the speech, language, cognition and swallowing related difficulties of adult and pediatric patients. Patients in the hospital receive a diagnostic assessment and follow-up intervention according to their individual needs throughout the inpatient stay. The inpatient SLP helps to facilitate a safe discharge to the most appropriate setting and provides recommendations for further services upon discharge from the hospital as needed. Medical teams across the entire hospital may consult the inpatient speech-language pathology service for a variety of reasons including stroke, head trauma, surgery, cancer, respiratory difficulties, tracheostomy, failure to thrive/medical frailty, pediatric feeding in premature infants, and craniofacial anomalies. Swallowing evaluations may include imaging studies such as Video-swallow studies (VSS) and Fiberoptic Endoscopic Evaluations of Swallowing (FEES)
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Speech-language pathologists use FEES to assess individuals with suspected difficulty swallowing where the problem is caused by decreased airway protection during swallowing. In this test, a very thin endoscope is inserted gently into the nostril while the patient eats or drinks various consistencies of food or liquids. This exam also enables the clinician to see how well the food or liquid is cleared from the throat and to determine which therapeutic strategies improve swallowing safety and efficiency. The study is digitally recorded for later analysis.
Video Swallow Study (also called Modified Barium Swallow Study)

A speech-language pathologist together with the Radiology staff evaluate swallowing by taking a video X-ray while the patient drinks and/or eats liquids and/or soft foods that contain barium. Barium is a type of contrast that allows us to see the muscles of the throat during swallowing. We use barium liquid, pudding and a cookie as needed. No special preparation is necessary for this swallowing study. Patients do not have to refrain from eating or drinking prior to the test. Patients are positioned upright during the test. Even though the test itself lasts a few minutes patients should plan to spend an hour with us. We conduct a thorough interview with the patient before the study so we can gather other relevant medical information. The video X-rays are analyzed to find out the reason for the swallowing problem and often treatment strategies are prescribed to improve the swallowing. The speech pathologist will discuss the results with the patient after the test and make recommendations for treatment. A report of the findings is also provided to the referring physician.

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