By: Hannah Carey, Madison McDaniel, Haley Conner, Kaitlin Weaver, Maggie Westfall

Introduction:
 
“Imagine what life would be like needing to take 20 minutes away from whatever it is your doing just to take a sip of water… I can’t imagine.”
 
This is the reality for individuals suffering from a disorder known as dysphagia. Dysphagia occurs when there is a disruption in the processes involved in feeding and/or swallowing. Without appropriate intervention, dysphagia can greatly impact an individual's overall quality of life.
 
What are pediatric feeding and swallowing disorders?
 
Feeding disorders are formally defined by the American Speech-Language Hearing Association [ASHA] as, “problems with a range of eating activities that may or may not include problems with swallowing” (ASHA, 2018). This includes problems with actions such as, sucking from a bottle, being fed with a spoon, chewing, and moving the food or drink back toward the throat for swallowing. Swallowing disorders occur when there is a disruption in the “process during which saliva, liquids, and foods are transported from the mouth into the stomach while keeping the airway protected” (ASHA, 2018). Implications of both feeding and swallowing disorders include aversion to different foods, malnutrition, gastrointestinal issues, behavioral issues, social implications, etc. In order to eliminate or minimize the effects of dysphagia, it is imperative that children receive appropriate intervention/therapy.
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What does swallowing intervention look like and SLPs role in treating the patient?
 
Swallowing therapy can be used to restore a person’s normal function, modify behavior without totally restoring function (compensatory strategies), or a combination of either of these. Patients who need swallowing therapy include those who have suffered damage from traumatic brain injuries, multiple muscle-weakening diseases, and many other causes. The amount of treatment necessary is dependent upon the severity of the problems experienced by the person. The role of the speech-language pathologist is dependent upon the specific patient’s needs. First, the SLP will be responsible for giving an assessment and diagnosis of the swallowing or feeding disorder. Once an issue or disorder has been determined, the SLP will then carryout treatment using a variety of techniques: biofeedback (where the patient can see the swallow), diet modifications (making food and liquids a desired consistency), and oral-motor therapy and exercises (asha.org).  
 
 
Why do services for this population matter?
During childhood, the body is growing at a rapid rate. The vitamins and minerals from food helps support the growth and development during this time. The nutrition from food allows the bones, muscles, tendons, joints and organs to develop and work as they should (Seidenberg). Along with the skeletal growth during these stages, good nutrition is needed for brain development. A study done by the CDC found that children who are not receiving the right amount of vitamins and minerals are receiving lower grades than the children that do. According to Dr. Reynaldo Martorell, when a child is receiving a poor diet without the proper nutrients required for growth, it can lead to learning disorders, attentional issues and behavioral/social problems (Brinkman, 2017).
 
What can we change?
Given the prevalence of swallowing disorders, and effects of feeding and swallowing disorders on children, it is critical that insurance companies cover therapy sessions for people with these disorders. Sessions should not be capped, as the focus of the treatment should be on the needs of the child and not on financial costs.
 
Advocate for the number of session they should get. Number of visits should be based on patient’s needs.
 
Every therapy session is going to be different, just like the number of therapy sessions is going to different based on the person and their needs. For instance, a person who has had surgery for a torn ACL is going to have more physical therapy sessions versus someone who is receiving physical therapy who has a sprained ankle. The same effect applies to those receiving swallowing services from the speech-language pathologist. The maximum number of therapy sessions insurances will cover is approximately 20 per year, which is a fairly small number. That being said, it is important to take into consideration the extent and severity of each case, and allow the recommended number of sessions based on what the professional thinks, rather than having insurance companies dictating the amount of sessions they believe a person should receive.
 
References:
 
Seidenberg, Casey. (n.d.). Why it’s so important to feed kids well during growth spurts. https://www.washingtonpost.com/lifestyle/wellness/why-its-so-important-to-feed-teens-well-during-growth-spurts/2018/04/03/c8d2cf98-2c7c-11e8-b0b0-f706877db618_story.html?noredirect=on&utm_term=.cc5c7bf6f31c
 
Brinkman, J. (2017). Why is healthy diet important for child development. https://www.livestrong.com/article/355822-why-is-a-healthy-diet-important-for-child-development/
 
https://www.feedingmatters.org
 
https://pedsfeeds.com
 
https://youtu.be/buwFUkOFipE
 
https://www.youtube.com/watch?v=MrbEUDO6S5U
 
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934965&section=Treatment
 
https://leader.pubs.asha.org/article.aspx?articleid=2289526
 
https://www.asha.org/Practice-Portal/Clinical-Topics/Pediatric-Dysphagia/

By: Chloe Adkins, Kaitlyn Adams, Skyler Brumfield, & Morgan Merritt

The Impacts of Social Communication Disorders: Why Insurance Reimbursement is Critical for Social Communication Treatment
 
What is social communication?
Social communication refers to the use of appropriate social skills during interactions with others. Some of these skills include:
Conversational skills Asking for, giving, and responding to information Turn taking Eye contact Introducing and maintaining topics Asking questions or for clarification Avoiding repetitive information Adjusting language based on situation Using humor Using appropriate strategies for gaining attention and interrupting Offering/responding to expressions of affection appropriately Facial expression Body language Personal space  
Why is social communication important?
Social skills are necessary for various everyday interactions that occur in educational, occupational/professional, and casual settings. For example, children in preschool need to be able to take turns while playing alongside their peers. The transition into school-age and adolescence may include interaction with peers and teachers in group settings (e.g., in-class group projects and extracurricular activities). As children get older, the use of social skills becomes more demanding, considering children/adolescents are “expected” to behave and communicate appropriately in various situations. A lack of proper social skills can make even the most simple tasks difficult (e.g., asking to borrow a pencil, ordering coffee). It can even lead to the devastating issue of bullying. Throughout adulthood, effective social skills are also important in the workplace and in personal life.
 
Lack of these skills can lead to difficulties in the following environments:
School
Interactions with peers (e.g., building relationships/friendships) Interactions with teachers (e.g., communicating needs/wants) Grades (due to lack of participation) Bullying It is important for children and adolescents to be able to appropriately interact with peers and teachers. These social interactions can occur during meetings with teachers, group projects, lunchtime, recess, and/or extracurricular activities. In free social situations such as recess, children do not have adults to “supervise” conversations. Lack of guidance and structure can lead to unacceptable behavior such as bullying by peers. Challenges with social skills can leave a bullied child unable to respond appropriately to a bad situation. The child may be unable to defend themselves or talk to an authority figure about the situation, allowing the bullying to get worse.
 
Workplace
Relationships with co-workers Communicating with authority figures Appropriate and professional behavior and language Social skills are important in ensuring effective communication and productivity in the workplace. Employees must be able to form relationships with co-workers and bosses, as this is essential to working as a team. It is also important for employees to display appropriate manners, body language, and compassion during all interactions in the workplace
(especially with clients) to demonstrate professionalism.
 
Personal Life
Dating/relationships Family Friendships Effective communication in emergency situations Within a person’s social life, they encounter many situations in which they have to know how to appropriately communicate with others. As members of society, we have the ability and choice to form relationships of varying degrees with those we come into contact with. Therefore, it is vital to have the skills needed to facilitate and build new relationships. It is also important to be able to interact with others in emergency situations, as those can be time sensitive. Being able to interact with others in adverse situations (e.g., car accidents, robberies, fires) is vital in ensuring the safety of everyone involved. Lacking appropriate social skills in the aforementioned situations does not only affect the individual, but potentially those around them, too. This speaks to the importance of the presence of social skills in every person’s life.
 
Why is reimbursement of professional social skill intervention important?
Social communication is a functional aspect of everyday life. People should not have to settle for less than adequate social skills, considering there are professional services available for improving these challenges. For example, speech-language pathologists are health professionals with the ability to help those who need a boost in social skills. Basic insurance policies do not always cover the amount of speech therapy needed for an individual to be successful. As social skills are needed throughout the lifespan, it is important for people to be willing to contact their insurance companies and advocacte for needed services.
 
What can you do?
Advocating for reimbursement is as easy as…
Contacting your insurance company to disucss the importance of these services. Furthering your own education regarding social communication. Sharing this blog post with family and friends to expand knowledge about the importance of social skills.  
 
References
 
Abdoola, F., Flack, P. S., & Karrim, S. B. (2017). Facilitating pragmatic skills through role-play in learners with language learning disability. South African Journal of Communication Disorders, 64(1), 1–12. https://doi-org.marshall.idm.oclc.org/10.4102/sajcd.v64i1.187
 
Adams, C., Lockton, E., Freed, J., Gaile, J., Earl, G., McBean, K., … Law, J. (2012). The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. International Journal of Language & Communication Disorders, 47(3), 233–244. https://doi-org.marshall.idm.oclc.org/10.1111/j.1460-6984.2011.00146.x
 
Pietro, S. (2017). Social communication disorder basics. Retrieved from https://childmind.org/guide/social-communication-disorder/
 
Social communication disorders: Overview. (n.d.). Retrieved from https://www.asha.org/Practice-Portal/Clinical-Topics/Social-Communication-Disorder/
 
Team, U. (n.d.). Understanding social communication disorder. Retrieved from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder