The purpose of this study was to describe the swallowing characteristics of elderly patients requiring mechanical ventilation with tracheostomy admitted to a long-term, acute-care hospital. The study was conducted through retrospective record review of patients on mechanical ventilation who had received a Modified Barium Swallow Study (MBSS) during their hospitalization. In a period from 1994 to 2002, 58 patients met the inclusion criteria. The study examined the results of both the clinical and the MBSS evaluations and compared the results and recommendations of the two examinations. Data were obtained from the MBSS records to describe the group in terms of dysphagia symptoms, frequency and occurrence of aspiration, respiratory status, and demographic variables. Parametric and nonparametric statistics were used to determine differences between the evaluations and any significant associations between aspiration and demographic variables, pharyngeal symptoms, and cognitive deficits. Significant differences were found between diet recommendations before and after the MBSS, and significant associations were found between aspiration and three pharyngeal symptoms. Although aspiration and especially silent aspiration occurred frequently in this group, most individuals were able to begin some level of oral intake after the MBSS evaluation. Due to the lack of reliable clinical evaluation measures, the MBSS is necessary for differential diagnosis of dysphagia and dietary recommendations for these individuals.

Semantic feature analysis (SFA) is a therapeutic technique that is used for the treatment of naming deficits occurring with aphasia. Aphasia commonly impairs a person's ability to retrieve words easily, and speechlanguage pathologists (SLPs) often struggle to determine an effective means of facilitating this skill. SFA has been shown to improve naming of targeted items with generalization to control stimuli. SFA also teaches the individual with aphasia a process for accessing semantic networks and for self-cueing. This project examined the use of SFA to address naming deficits and measured the impact of SFA on connected speech output with an individual with moderate aphasia with both expressive and receptive components. The study was conducted in two phases: The first stage examined improvements in naming skills, and the second stage assessed improvements in connected speech. This individual demonstrated improvements in naming for trained and untrained stimuli and also increased in measures of connected speech from baseline over a 17-month period. The usefulness of SFA for practicing SLPs in the current health care service delivery system is discussed.