The feasibility of a dysphagia procedure for identification, diagnosis, intervention and evaluation of dysphagia in adults with intellectual disabilities: a pilot study

Abstract

Title: The feasibility of a dysphagia procedure for identification, diagnosis, intervention and evaluation of dysphagia in adults with intellectual disabilities (ID): a pilot study. Background: Because of the high prevalence of dysphagia in adults with ID, the major health risks involved and the different challenges managing dysphagia, a health improvement project started in March 2014 led by Ipse de Bruggen, a care provider service for people with ID in the Netherlands. Aim and research questions: The aim of this study is to examine the feasibility of the dysphagia procedure in adults with ID. The accompanying research question is ‘Is it feasible to implement the dysphagia procedure within Ipse de Bruggen, Zwammerdam?’ Method: Fifty-eight professionals working with 24 adults with ID and an expected dysphagia participated in this study. All the relevant steps of the dysphagia procedure must be executed within three months. Feasibility was evaluated using criteria based on the three groups of participants: speech and language therapists (SLT’s), caregivers and multidisciplinary team members. All the criteria must be met to achieve feasibility. Results: The SLT’s and the multidisciplinary team members agreed for 100% with their role and content of the dysphagia procedure. The SLT’s did not manage to execute all the steps of the dysphagia procedure for the clients with dysphagia. Also, the caregiver criteria and the criteria for collecting post-test measurements were not achieved. In summary, five of twelve feasibility criteria have been met. Conclusion: The dysphagia procedure cannot be implemented yet, due to challenges in cooperation between the caregivers and both the SLT’s and the multidisciplinary team members. Recommendations: Improving cooperation with the caregivers through i.e. qualitative research to investigate the caregiver’s perspective, considering different organisational changes and investigate in train the trainer education.