Establishing a public school dysphagia program: a model for administration and service provision.

PURPOSE Many school-based speech-language pathologists (SLPs) are hampered in participating in managing children with dysphagia by their school systems' lack of supportive policies and procedures. A need exists to better define the dysphagia-trained SLP's role and clarify the district's responsibility. The purpose of this article is to address the critical administrative issues and administrative components surrounding dysphagia in the schools and to offer the SLP some solutions to these problems. METHOD A narrative review of the relevant literature addresses the following questions that are important for administrative planning and implementation of programs for students with dysphagia in the schools: (a) Should school systems assume responsibility for working with students with dysphagia? (b) Why is a system-supported procedure recommended? (c) What service delivery models can a system use to serve students with dysphagia? (d) What components should be included in a dysphagia procedure? CONCLUSION SLPs should be proactive in providing dysphagia services to students in the schools. A procedure that is adopted by a school system for all of its employees to follow will offer direction and guidance. This system-supported procedure may provide assurance that dysphagia services are being provided in a professionally acceptable manner. Ongoing staff development and training is essential. A system can implement dysphagia services using existing staff, when possible, and policies and procedures that have been approved by the system.