Effectiveness of dysphagia training for adult learning disabilities support workers

Abstract

Accessible summary• It is important to notice problems with eating, drinking and swallowing in people with a learning disability.• People who have problems with eating, drinking and swallowing need support from staff to help them stay healthy.• This study shows that training gives staff a better understanding and more confidence when identifying problems and supporting a person with eating, drinking and swallowing difficulties. SummaryThis study investigated the effectiveness of a 1-day dysphagia training package delivered to support workers who work with adults with a learning disability. Thirty-eight support staff took part in this study. Twenty-five support staff received training, and 13 did not receive training and therefore acted as a control group. Three questionnaires were completed by each participant: immediately before, immediately after and a month after the training delivery. Questionnaires measured both confidence and knowledge. Findings indicated that there was a significant increase in knowledge and confidence scores in the trained group. These increases were largely maintained over a 1-month period. There was no significant change in confidence or knowledge scores in the untrained group.

People with intellectual disabilities and dysphagia

“…None of these were RCTs and only two considered outcomes for people with intellectual disabilities, one using a single-subject multiple treatment design [45], and one prospective controlled non-randomised (quasiexperimental) trial [46]. Other intervention studies related to the outcomes of training for caregivers: one used a between-subjects experimental design with three training conditions and pre, post and 3-10 month follow-up [18]; one used a pre-post-design with no comparison group [47]; and one used repeated measures with a control group [48]. Other studies including information related to interventions were limited to audits, retrospective review of records and patient monitoring.…”

“…In a study on dysphagia training for support workers, the control group had a combination of high confidence scores and low knowledge scores, potentially putting clients at risk of choking, chest infections and aspiration pneumonia due to not recognising or underestimating problems and therefore mismanaging them [48]. In one study, carers demonstrated knowledge of the risks of aspiration and asphyxiation, but one-third demonstrated a lack of awareness of all of the relevant risks of non-compliance, in particular tending to overlook the risk of poor nutritional status, injury during mealtimes and dehydration [67].…”

“…One-day dysphagia training for support workers of adults with intellectual disabilities led to gains in knowledge and confidence (e.g. 13 of 25 participants' scores went from 1 'not confident' to 4 'very confident' in achieving recommended drink consistency) and this gain was maintained a month after having attended the training [48]. In a study on training support staff who had no prior experience of modifying fluid consistencies, the group trained using Thickness Indicator Model (TIM) tubes alongside typical training and written guidance were more accurate at modifying fluids at 3-10-month follow-up than those receiving written guidance alone or typical training with written guidance, being 41.8% more accurate than they were prior to training [18].…”

Simulation Instruction for Direct Support Professionals: A Pilot Study between a School of Nursing and Community Providers Supporting Persons with Intellectual and Developmental Disability

“…Tredinnick and Cocks [13,20] research findings on dysphagia training indicated that there was a significant increase in both knowledge and confidence in the group of DSPs who received training strategies that included lecture, activities, and discussion. Research results by Mackey & Dodd [21] suggested that most DSPs felt group activities and subsequent discussions were the most effective strategies during their DSP training.…”

“…Persons with ID/DD are often dependent on the DSP's skills, knowledge, and confidence, to properly manage their health [13]. In order to successfully oversee these health conditions, DSPs oftentimes rely on nursing personnel to help guide care including seizure management and monitoring of dysphagia.…”