15 Years of Industry Experience

SLP Role with FEES

It is the official position of American Speech and Hearing Association (ASHA) that flexible endoscopy is an imaging procedure that SLPs may use to evaluate swallowing function. Flexible endoscopy may also be used as a therapeutic aid and biofeedback tool during the course of swallowing treatment.
The assessment and management of dysphagia fall within the scope of practice of speech-language pathology. SLPs with expertise in dysphagia and specialized training in flexible endoscopy are qualified to use this procedure independently to assess swallowing function and related functions of structures within the upper aerodigestive tract.

FEES Competency

Learning FEES requires training from a well-organized formal course, usually over 15 hours, covering anatomy, physiology, medical issues, equipment, infection control requirements, endoscope handling, FEES protocol and procedures, FEES analysis scoring, and FEES analyses and applications. Hands-on, consistent, and concentrated training by an experienced and competent SLP instructor during the training course produces the best training results. On-the-job training rarely prepares the training SLP adequately. Formal training courses should also actively teach scoring and analysis procedures with supervised practice exercises.
Beyond basic FEES instruction and beginning proficiency training, FEES competency requires additional supervised training. To ensure safety, efficiency, and completeness, all supervised procedures (not passes) must be critiqued and repeated, as needed. This may be 5 or 50 supervised procedures. Obtaining the “magical” 25 “passes” does not equate to FEES proficiency or competency. Twenty-five “passes” mean nothing by themselves!! Competency means satisfactorily demonstrating an independent proficiency, as judged by a competent supervisor, in every aspect of FEES assessment–scope handling, FEES procedure administration using a predetermined protocol, management of study and patient problems, equipment use and infection control procedures, video/audio capturing a good study, analyzing all of the results, interpreting the biomechanical components, and finally writing a concise and informative report reflecting the science of the swallowing study. No specific number of procedures defines competency.

Flexible Endoscopy

The procedure is not intended to replace the fiberoptic examination performed by the otolaryngologist to assess the integrity of the laryngeal and pharyngeal structures. Physicians use endoscopy for functional evaluation of swallowing and/or assess the integrity of the laryngeal and pharyngeal structures to render a medical diagnosis.
Within interdisciplinary settings, these medical diagnoses and swallowing function assessment procedures can be accomplished through the combined efforts of these related professionals. Care should be taken in performing this examination. It should be done only in settings where medical personnel are available to ensure patient safety. Contact us today to learn more.