Speech and swallowing intervention following oral cancer treatment: A survey of speech-language pathologists in Australia and New Zealand

Abstract

Purpose Treatment for oral cancer has debilitating effects on speech and swallowing, however, little is known about current speech-language pathology practice. Method An online survey of speech-language pathologists (SLPs) was disseminated via emails to speech pathology departments, social media platforms, and professional online forums. Survey questions captured demographics, service delivery, type and timing of speech and swallowing interventions, and influences and barriers to practice. Result Forty-three SLPs working in Australia (n = 41) and New Zealand (n = 2) completed the survey. SLPs recommended speech and swallowing compensatory strategies significantly more frequently than active intervention. Swallowing outcomes measures were either instrumental (n = 31, 94%) or performance ratings (n = 25, 76%), whereas speech was measured informally with judgements of intelligibility (n = 30, 91%). SLPs used a range of supports for their decision making, particularly expert opinion (n = 81, 38.2%). They reported time and staffing limitations (n = 55, 55%) and a lack of relevant evidence (n = 35, 35%) as the largest barriers to evidence-based service delivery. Conclusion There is variability amongst SLPs in Australia and New Zealand regarding rehabilitation of speech and swallowing for people with oral cancer. This study highlights the need for evidence-based guidelines outlining best practice for screening processes, active rehabilitation protocols, and valid outcome measures with this population.