Telepractice and Dysphagia Management: The Era of COVID-19 and Beyond.
Elizabeth C Ward, Madeline Raatz, Jeanne Marshall and 2 others
PMID 35428923WHAT IT FOUND
Telepractice can safely deliver adult swallowing exams, remote fluoroscopy reviews, and pediatric feeding therapy.
It cuts travel burden and costs, with high patient and clinician satisfaction. Use it as a planned, integrated part of care rather than a temporary pandemic fix.
Key findings
01Clinical swallowing examinations for adults conducted via telepractice show high agreement with in-person assessments for oromotor function, food and fluid trials, and clinical decision-making.
02Telepractice-supported videofluoroscopy allows remote experts to review images and guide management, with high agreement on critical clinical features and decisions compared to in-person raters.
03Telepractice models for pediatric feeding and adult head and neck cancer care reduce travel time and financial costs for families and patients while maintaining clinical effectiveness.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so it may be subject to selection bias in the literature chosen. The authors state the intent is to highlight models rather than provide a comprehensive critical analysis of the literature. Evidence for some specific populations (e.g., severe dysphagia) suggests technical challenges that may limit applicability without skilled assistance. Long-term outcomes and cost-effectiveness data are still emerging, and the review calls for more robust large-scale trials.
Declared interests
The work was funded by The University of Queensland. The authors are identified as telepractice clinicians involved in supporting implementation and research during the pandemic, which may introduce a bias toward positive findings regarding telepractice adoption.
The easy way to misread this
Do not assume telepractice is universally superior or suitable for every patient. The review notes that some patients with severe dysphagia, significant sensory impairments, or inability to follow instructions may present challenges, and a small proportion of patients still prefer in-person care. It also warns that rapid, unplanned adoption during the pandemic led to service failures due to lack of training and infrastructure. Telepractice should be one option in an integrated service model, chosen based on individual clinical and personal needs.