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Alyssa Hazlegrove
CSDS 530: Ethics and Professional Issues
July 10, 2019

Professional Practice Paper

Every professional should make goals for themselves to meet somewhere along the road

within their career. Goals help to create a destination to reach. Hard work is necessary to push

through the journey and achieve the goal being worked toward. Speech-language pathologists

are fortunate enough to serve in a field that continuously provides many possibilities to learn,

achieve, and create goals. As a blooming professional in speech-language pathology, there are

many doors that are open to me as I unravel where my skills and aspirations reside within the

field.

Personal Goal

As a graduate student, there have been a variety of topics that peak my interest above the

others. One of these topics that have repeated stood out among the others has been the broad

topic of feeding and swallowing. Whether the population is pediatrics or geriatric, feeding and

swallowing skills can be applied in a large majority of settings. Understanding the facets of feeding

and swallowing can be a beneficial tool to possess, as the topic is a broad one that is ever

changing. I am beginning to understand that there is always more to learn in order to acquire the

skill set required to become proficient at treating feeding and swallowing disorders.

As I move forward in becoming a speech-language pathologist, I have set goals for myself to

become well rounded in the topic of feeding and swallowing. My journey forward will not be a

short endeavor but one that continues to bloom throughout the early part of my career and
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hopefully continue far after. A few personal tools I already possess as I seek to immerse myself

in the topic are my strengths of harmony, adaptability, empathy, includer, and connectedness.

As I learn to immerse myself within my chosen special interest, there is a quote that sums up

the way I view how this additional education may help me meet my career goals. I believe Nelson

Mandela said it best, “Education is the most powerful weapon which you can use to change the

world.” I feel as though this quote provides the most vivid picture of what I hope to accomplish in

my career in the years to come. With the help of education and the knowledge it provides, I hope

to become the best service provider possible in the special interest area of feeding and

swallowing. A foundation of education will make me aware of current evidence-based practice

and encourage carry over in many forms such as listening for wet voice quality in settings where

feeding and swallowing difficulties are unsuspected.

Specific Knowledge and Skills

The scope of the speech-language pathologist is broad. Feeding and swallowing happens

to be an area within the field that is also broad. The special interest area had progressed in many

ways since its infancy in the profession. Techniques have come and gone and some many

currently still exist because there is still more research needed to be done to explore this topic .

This being said, there are a variety of knowledge and skills that can be acquired in this area to

further an individual’s understanding of feeding and swallowing. Depending on the specific

setting, there are many ways to enhance the skill set of a clinician willing to work hard to have a

deeper understanding of feeding and swallowing issues and treatment. Through taking the

Strengths Survey provided by Gallup, I learned that I already possess a handful of qualities that

can help me to achieve my goal to become an expert in the area of feeding and swallowing.
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According to the strengths survey, my strengths are harmony, adaptability, empathy, include, and

connectedness.

A speech-language pathologist seeking to further their knowledge and skills in this topic

should first work to have a foundation of anatomy. As I have previously learned in anatomy and

physiology, adult dysphagia, and pediatric feeding and swallowing disorders, there are many

differences between the adult and child’s anatomy. The structure of the mouth, esophagus, and

face are different due to the development that needs to take place in a child versus an adult .

These subtle differences are important to master and note in order to grasp how each individual

feeds and swallows.

Second, after the understanding of anatomy, is the knowledge of diseases, disorders, and

structural differences. The basic knowledge of what may be causing difficulty is crucial when

evaluating clients feeding and swallowing. If a clinician can identify the underlying cause of the

issue it may help later in understanding the individual’s needs during treatment. Anatomy,

neuroanatomy, and diseases or disorders may overlap in this way. The information provided

within these give a full picture of the client’s deficits. The clinician also benefits from mastering

this information. By having knowledge based in a variety of diseases and disorders combined

with anatomy, the clinician sets themselves up for success in problem solving . These tools can

aid in problem solving if the necessary background knowledge of the difficulties associated with

specific disorders is present. For example, in geriatric patients, when a client has had a stroke we

want to be sure to understand where the lesion has taken place in order to understand how it

might be effecting their feeding and swallowing. A patient experiencing hemiparesis may be

suffering from a paralyzed vocal fold, which will affect them in many ways.
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Another skill necessary to develop a high level of expertise in the area of feeding and

swallowing is the ability to read and interpret Modified Barium Swallow Studies (MBSS) and

Fiberoptic Endoscopic Evaluation of Swallowing (FEES). A specialist in this area is required to

have the ability to interpret the results of these different evaluation tools. A modified barium

swallow study uses x-rays to investigate how an individual is swallowing. This tool gives

information from the oral prep stage through the esophageal stage. The speech-language

pathologist is responsible for interpreting the results in live time and gives instructions to the

radiologist and the client. During the fiberoptic endoscopic evaluation of swallowing, the speech-

language pathologist may possibly be responsible for passing the scope but in many cases is not

qualified to do so. Just as during the modified barium swallow study, the speech-language

pathologist should be able to interpret the results of the study during the procedure and give

instructions to the person passing the scope and the client.

Concrete steps

In the early stages of my career, I feel it will be beneficial work toward receiving a certification

for and to maintain the Modified Barium Swallow Impairment Profile. This will aid me as I work

toward my overall goal of developing a high level of expertise in the area of feeding and

swallowing. Completing the MBSImP early on in my career as a speech-language pathologist will

provide me with foundational skills to be proficient in reading and interpreting modified barium

swallow studies while they are being carried out. Continuing to practice on the modified barium

swallow impairment profile will allow me to maintain and enhance my capabilities as a student

and continuing my education as a service provider.

Another concrete step I would like to engage in as a new clinician through to my third year of

working would be to shadow other clinicians working within the field, specifically speech-language
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pathologists working in the neonatal intensive care unit. Get a glimpse at the responsibilities may

enable me to become more comfortable and competent in providing services to that population

of feeding and swallowing clients. An experience of shadowing in the NICU would be a beneficial

resource to clinicians who have not been immersed in that setting hands on. Shadowing will

provide me with additional foundation in conjunction with my graduate education.

In my sixth year as a practicing speech-language pathologist, I hope to enroll in training

to become certified to pass a FEES scope is another step in order to become an expert in the

area of feeding and swallowing. This training would allow me to become more equipped to carry

through with evaluation procedures that need to take place without having to reach to outside

sources. Training would also give me a new awareness of how the technology should be used,

managed, and maintained. Understanding of the FEES technology opens up the opportunity for

me to note when it is being used incorrectly and correctly.

Finally, one big way to continue to learn and become well versed in feeding and swallowing

is to participate in continuing education requirements as a speech-language pathologist. In my

continuing education, I would like to continue to learn more about how to facilitate feeding therapy

with children who have aversions such as children with autism spectrum disorder. Another

specific area continuing education may benefit me in would be with infant feeding and swallowing.

Additionally, I hope to acquire continuing education in the area of cultural competence in

conjunction with field experience with a variety of culturally different individuals. Continuing my

education in all of these areas will help to increase my awareness of differences, as well as, my

ability to serve unique populations. A combination of continuing education and shadowing will aid

me as I move forward in gaining experience. I hope to become equipped to use current evidence-

based practices to benefit the unique needs of the clients I will be serving.
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In conclusion, my goal is to learn and be immersed in knowledge to meet my goal of

developing a high level of expertise in the area of feeding and swallowing. With the foundation of

knowledge and skills and a solid plan to follow, I hope to reach this goal within the first ten years

of practicing as a speech-language pathologist. Along my journey, I believe that my strengths will

allow me to glean important information from fellow professionals. Through striving to reach my

goal, I hope to learn new and inspiring ways to advocate for those in my area of interest to benefit

each individual. As I quoted before, Nelson Mandela provided the words of wisdom, “Education

is the most powerful weapon which you can use to change the world.” His words inspire me to

enrich my brain with the power of knowledge. The knowledge I receive will provide me with the

strength and tools to serve others in their times of difficulties. Being a speech-language

pathologist is not an easy task but a rewarding one as it means being opened to new ideas and

becoming a lifelong learner for the benefit of other.

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Resources

American Speech-Language-Hearing Association. (2002.). Knowledge and skills needed by

speech-language pathologists providing services to individuals with swallowing and/or
feeding disorders: dysphagia document review and revision working group.
https://www.asha.org/policy/ks2002-00079/
American Speech-Language-Hearing Association. (1990). Knowledge and skills needed by
speech-language pathologists providing services to dysphagic patients/clients. Asha,
32(Suppl.2), 7–12.
American Speech-Language-Hearing Association. Knowledge and skills needed by speech-
language pathologists providing services to infants and families in the NICU
environment: Ad hoc committee on speech-language pathology practice in the neonatal
intensive care unit (NICU). https://www.asha.org/policy/ks2004-00080/
American Speech-Language-Hearing Association. (2001). Roles of speech-language
pathologists in swallowing and feeding disorders: Technical report. ASHA Supplement,
22, 75–79.
American Speech-Language-Hearing Association. (2004b). Roles of speech-language
pathologists in the neonatal intensive care unit: Technical report. Rockville, MD: Author.
American Speech-Language-Hearing Association. (2016). Scope of practice in speech-
language pathology. Available from http://www.asha.org/policy/SP2016-00343/