Understanding Dysphagia Care in Pakistan: A Survey of Current Speech Language Therapy Practice.
Rohma N Akhtar, Nicholas Behn, Sally Morgan
PMID 38006420WHAT IT FOUND
In Pakistan, most speech therapists assess dysphagia using informal clinical exams rather than instrumental tests.
They frequently modify food and fluid consistencies, often without clear evidence, and report significant barriers like limited resources and low awareness among physicians and families.
Key findings
01Most speech therapists in Pakistan rely on clinical swallow examinations (CSEs) to assess dysphagia in both children (34.2%) and adults (30.8%).
02Therapists frequently modify food and fluid consistencies, particularly for children, with 64.5% modifying food and 75.3% modifying fluids for at least half their caseloads.
03Barriers to care include limited resources, lack of physician awareness of the speech therapist role, and reduced family knowledge about dysphagia.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Recruitment was via snowball sampling through professional networks, introducing potential selection bias. The survey was in English, which may have excluded therapists with lower proficiency or those in remote areas with limited internet access. Self-reported data may be subject to recall and social desirability bias. The questionnaire was adapted from an Australian survey, which may not fully capture the Pakistani context. Some reported practices, like citric acid cough reflex testing, were noted as unavailable in Pakistan, suggesting potential misunderstanding of questions.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the high usage of consistency modification and the Free Water Protocol as evidence of their efficacy. The study reports current practice, not outcomes, and explicitly notes that evidence for these interventions is inconsistent or lacking, particularly for children.