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1. State two age-related changes to the swallowing system in the elderly.
2. State three symptoms of an esophageal phase Dysphagia.
3. Explain the clinical benefits of the MBS/VFSS study and the FEES examination.
4. List three readily available/public domain Dysphagia screening tools.
5. Describe a basic but essential oral care protocol.
6. Define three primary objectives in the management of xerostomia.
7. State three components of a clinical rationale supporting the initiation of a protocol for naturally thickened liquids.
8. List three risk factors to consider when assessing a tracheostomy patient for PO intake.

A Deeper Understanding of Dysphagia

• Swallowing misconceptions and pet peeves
• Anatomy and physiology of a swallow
• The effects of aging on the swallow
• Disorders associated with Dysphagia
• Medications that may induce Dysphagia
• Signs and symptoms
• Esophageal Dysphagia - our new frontier

Assessment and Screening Techniques

• Evaluation and Screening Tools
• The Modified Barium Swallow Study (MBSS)
• The Videofluoroscopic Swallowing Study (VFSS)
• Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
• The Esophagram/Barium Swallow
• Manometers

Treatment Strategies

• The phenomena of aspiration
• Oral care protocols
• Managing oral secretions
• The maneuvers
• Tracheostomy and extubation
• Disease specific dysphagias
• The National Dysphagia Diet
• Naturally thickened liquids

The Post Script

• Dysphagia competencies
• Patient and family education
• Managing non-compliance

Technology and Resources for Therapy

• Commercially available products
• Clinical resources (apps, websites, books, etc.)
• Supplemental handouts

Gina England, MA, CCC-SLP, has been a clinical speech pathologist in New Hampshire for over 30 years. During this time, she has worked in a variety of clinical settings across the medical continuum of care including acute care, acute inpatient rehab, skilled nursing, outpatient therapy and neurological day treatment programs. Gina's areas of interest and specialty have included cognitive rehabilitation, aphasia, motor speech, dysphagia and pediatric aquatic speech therapy. Since 2011, Gina has developed a private practice that focuses on the ongoing provision of direct clinical services and the participation in education and training workshops/ seminars across the United States.

Gina has presented at numerous state associations' annual conferences, including the New Hampshire and Vermont Brain Injury Associations and the New Hampshire Multiple Sclerosis Society. In addition to her role as a public speaker, she has also been a part time clinical supervisor in the Department of Communication Sciences and Disorders at the University of New Hampshire. She is also adjunct faculty at Granite State College and Nashua Community College, both of which are in New Hampshire.

Gina maintains a New Hampshire state license and ASHA certification in Speech Pathology. She also serves on the governing board for the New Hampshire Speech, Language and Hearing Association as the vice-president for Professional Development. Gina welcomes the opportunity to share her humorous and engaging style of presentation, which allows continuing education to be both fun and functional. Disclosures:

Financial: Gina England maintains a private practice. She is an adjunct faculty member at the Granite State College and Nashua Community College. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.

Nonfinancial: : Gina England has presented at numerous state associations’ annual conferences. She serves on the governing board for the New Hampshire Speech, Language and Hearing Association.

For U.S. and Canadian customers, a CE test is available for $9.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Registered Dietitians & Dietetic Technicians

PESI, Inc., PE001, is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) from July 1, 2019 through June 30, 2022. Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 6.0 continuing professional education units (CPEUs) for completion of this program/materials. Continuing Professional Education Provider Accreditation does not constitute endorsement by CDR of a provider, program, or materials. This self-study program/material is designated as LEVEL 2.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 10/23/2018
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Occupational Therapists & Occupational Therapy Assistant: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.3 continuing education credits.

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Physical Therapists & Physical Therapist Assistants
This self-study course consists of 6.25 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

California Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.25 continuing competency hours.

Illinois Physical Therapists & Physical Therapist Assistants: PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.6 contact hours.

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Speech-Language Pathologists & Audiologists
This course contains 6.0 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.

California Speech-Language Pathologists/Audiologists: PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 6.0 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.

Kansas Speech-Language Pathologists: Approved for 7.5 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.

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Social Workers
PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 6.25 Clinical Practice continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation.

Canadian Social Workers: PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 6.25 Clinical continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation. Canadian provinces may accept activities approved by the ASWB for ongoing professional development.

Illinois Social Workers: PESI, Inc. is an approved provider with the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 159-000154. Successful completion of this self-study activity qualifies for 6.0 contact hours.

Minnesota Social Workers: PESI, Inc. is an approved provider with the State of Minnesota, Board of Social Work. Provider #: CEP-140. This self-study course has been approved for 6.0 continuing education hours. A certificate will be issued upon successful completion of a post-test.

California Social Workers/ Counselors/Marriage & Family Therapists/Licensed Educational Psychologists: The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs. A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level activity consists of 6.0 clock hours of continuing education instruction.

Florida Social Workers, Marriage & Family Therapists, and Mental Health Counselors: PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 6.25 continuing education credits.

Ohio Social Workers, Counselors, and Marriage & Family Therapists: PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #: RCST071001. Successful completion of this self-study course meets the qualifications for 6.25 clock hours of continuing education credit.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Registered Dietitians & Dietetic Technicians, Nurses, Nursing Home Administrators, Occupational Therapists & Occupational Therapy Assistants, Pharmacists, Physical Therapists/Physical Therapist Assistants, Social Workers, Speech-Language Pathologists, and other Healthcare Professionals