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Working with School-Aged Children with Neurodisability and Oropharyngeal Dysphagia Who Require Mealtime Assistance: A Survey of Speech and Language Therapists' Clinical Practice

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Title: Working with School-Aged Children with Neurodisability and Oropharyngeal Dysphagia Who Require Mealtime Assistance: A Survey of Speech and Language Therapists' Clinical Practice
Language: English
Authors: Sally Morgan (ORCID 0000-0002-7573-4290), Kathleen Mulligan (ORCID 0000-0002-6003-3029), Kelly A. Weir (ORCID 0000-0002-5042-1925), Katerina Hilari (ORCID 0000-0003-2091-4849)
Source: International Journal of Language & Communication Disorders. 2026 61(3).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 19
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Students with Disabilities, Physical Disabilities, Motor Reactions, Nutrition, Speech Language Pathology, Allied Health Occupations, Foreign Countries, Neurological Impairments, Counseling Techniques, Child Caregivers
Geographic Terms: United Kingdom
DOI: 10.1111/1460-6984.70254
ISSN: 1368-2822
1460-6984
Abstract: Background: School-aged children with neurodisability and oropharyngeal dysphagia who need mealtime assistance have an increased risk of premature death. Speech & Language Therapists (SLTs) provide assessment and recommendations to optimise mealtime nutrition and hydration, but little is known about current clinical practice including mealtime recommendation provision and carer adherence support strategies. Before developing any intervention, the context needs to be known. Aims: This survey aimed to explore the practice of UK SLTs working with school-aged children with neurodisability and oropharyngeal dysphagia that require mealtime assistance. This included describing workforce and service delivery; assessment practices; mealtime recommendations targeted for example, carer use certain pace, specific utensil; current approaches used to provide mealtime recommendations including the people worked with, delivery modality and adherence support techniques. Methods and Procedures: An online ethically approved survey was developed using research literature, with SLT stakeholder consultation and piloted prior to dissemination. The survey comprised 36 questions focusing on demographic and caseload information, typical assessment and intervention practice. Questions were multiple choice and free text responses with an upload option for intervention implementation documents. The survey was disseminated using professional networks and social media (summer 2021). Descriptive statistics were used with qualitative analysis for free text and submitted documents. Outcomes and Results: SLT participants consented and completed demographic and assessment practice questions (n = 139) with 102 continuing to the final question. Participants worked across all UK regions, with different employers (NHS, education, independent) and in acute, school and community settings and frequently shared care. Some SLTs had no access to instrumental assessment; videofluoroscopy (n = 5, 4%) or FEES (n = 88, 63%), and there was limited published assessment use. Participants (n = 122) commonly used 17 different mealtime recommendations, most frequently targeting carers to change pace, environment, food consistency (n = 120-121, 98%-99%, sometimes-often). Qualitative analysis identified two practice styles: 'collaborative creation' or 'informative prescription'. 37 SLTs provided 59 intervention documents, (n = 39, 66%) were accessible information mealtime mats. There were 28 unique mat templates with 19 different names. Formats and recommendation target frequency differed for example, drink texture (n = 27, 96%), pace (n = 14, 50%). Conclusions and Implications: This work provides contextual information on UK SLT practice with school-aged children with neurodisability and oropharyngeal dysphagia who require mealtime assistance. Further work is required to support research into practice implementation (e.g., assessments), alongside exploration and evaluation of meal mat use and potential SLT consultation styles. These findings contribute to a project creating a resource to improve SLT-family-carer working.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1506932
Database: ERIC
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  Data: Working with School-Aged Children with Neurodisability and Oropharyngeal Dysphagia Who Require Mealtime Assistance: A Survey of Speech and Language Therapists' Clinical Practice
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  Data: <searchLink fieldCode="AR" term="%22Sally+Morgan%22">Sally Morgan</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-7573-4290">0000-0002-7573-4290</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kathleen+Mulligan%22">Kathleen Mulligan</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6003-3029">0000-0002-6003-3029</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kelly+A%2E+Weir%22">Kelly A. Weir</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5042-1925">0000-0002-5042-1925</externalLink>)<br /><searchLink fieldCode="AR" term="%22Katerina+Hilari%22">Katerina Hilari</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-2091-4849">0000-0003-2091-4849</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2026 61(3).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: <searchLink fieldCode="DE" term="%22Students+with+Disabilities%22">Students with Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Disabilities%22">Physical Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+Reactions%22">Motor Reactions</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Language+Pathology%22">Speech Language Pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Occupations%22">Allied Health Occupations</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Neurological+Impairments%22">Neurological Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Counseling+Techniques%22">Counseling Techniques</searchLink><br /><searchLink fieldCode="DE" term="%22Child+Caregivers%22">Child Caregivers</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink>
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  Data: 10.1111/1460-6984.70254
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
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  Data: Background: School-aged children with neurodisability and oropharyngeal dysphagia who need mealtime assistance have an increased risk of premature death. Speech & Language Therapists (SLTs) provide assessment and recommendations to optimise mealtime nutrition and hydration, but little is known about current clinical practice including mealtime recommendation provision and carer adherence support strategies. Before developing any intervention, the context needs to be known. Aims: This survey aimed to explore the practice of UK SLTs working with school-aged children with neurodisability and oropharyngeal dysphagia that require mealtime assistance. This included describing workforce and service delivery; assessment practices; mealtime recommendations targeted for example, carer use certain pace, specific utensil; current approaches used to provide mealtime recommendations including the people worked with, delivery modality and adherence support techniques. Methods and Procedures: An online ethically approved survey was developed using research literature, with SLT stakeholder consultation and piloted prior to dissemination. The survey comprised 36 questions focusing on demographic and caseload information, typical assessment and intervention practice. Questions were multiple choice and free text responses with an upload option for intervention implementation documents. The survey was disseminated using professional networks and social media (summer 2021). Descriptive statistics were used with qualitative analysis for free text and submitted documents. Outcomes and Results: SLT participants consented and completed demographic and assessment practice questions (n = 139) with 102 continuing to the final question. Participants worked across all UK regions, with different employers (NHS, education, independent) and in acute, school and community settings and frequently shared care. Some SLTs had no access to instrumental assessment; videofluoroscopy (n = 5, 4%) or FEES (n = 88, 63%), and there was limited published assessment use. Participants (n = 122) commonly used 17 different mealtime recommendations, most frequently targeting carers to change pace, environment, food consistency (n = 120-121, 98%-99%, sometimes-often). Qualitative analysis identified two practice styles: 'collaborative creation' or 'informative prescription'. 37 SLTs provided 59 intervention documents, (n = 39, 66%) were accessible information mealtime mats. There were 28 unique mat templates with 19 different names. Formats and recommendation target frequency differed for example, drink texture (n = 27, 96%), pace (n = 14, 50%). Conclusions and Implications: This work provides contextual information on UK SLT practice with school-aged children with neurodisability and oropharyngeal dysphagia who require mealtime assistance. Further work is required to support research into practice implementation (e.g., assessments), alongside exploration and evaluation of meal mat use and potential SLT consultation styles. These findings contribute to a project creating a resource to improve SLT-family-carer working.
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      – SubjectFull: Motor Reactions
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