January 2023 Pediatrics Newsletter
“Be at war with your vices, at peace with your neighbors, and let every new year find you a better man.” – Benjamin Franklin
About me: My name is Ashley Stone! I have worked primarily in pediatric hospitals for more than 8 years treating patients & completing MBSS. I graduated from Baylor University (Sic ‘Em) with my Bachelor of Science and from the University of Texas at Dallas with my Master of Science in Communication Disorders.
New Beginnings: Our outpatient clinic is now open every Friday for pediatric patients of all ages! We have supported seating devices for those that are in need.
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What should parents expect: Their child’s appointment will be approximately 1 hour from arrival to departure. They will leave with a written handout of their child’s recommended diet, instructions on how to achieve that diet, and specifications on any required specialized feeding utensils, bottles, cups, etc. The referring physician and the child’s speech-language pathologist, if applicable, will receive a copy of the full report by the next business day.
My goal is for each family to leave their appointment feeling confident to feed their child from the moment they leave our clinic.
MBSS vs FEES: These are both instrumental tools for assessing a swallow. However, there are some key differences between the two that, I believe, make the MBSS the superior method. FEES is invasive to the patient, as a flexible endoscope must be passed through the nares. This can be problematic for children that won’t sit still. Yes, they must sit still during a MBSS as well, but they are generally more comfortable without a foreign object through their nose.
| MBSS - All Structure Visible at One Time | FEES - Only One Surface Structure Visible at a Time |
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| Biomechanics & Swallow Patterns Observed | MBSS | FEES |
| Bolus Preparation/Mastication | Yes | |
| Bolus Transport/Lingual Motion | Yes | |
| Oral Residue | Yes | |
| Nasopharyngeal Reflux | Yes | |
| Acute Pharyngeal Swallow | Yes | White Out |
| Vocal Cord Movement (in A-P view) | Yes | Yes |
| Laryngeal Elevation | Yes | |
| Anterior Hyoid Excursion | Yes | |
| Epiglottic Movement | Yes | Limited |
| Pharyngoesophageal Segment Opening During Swallow | Yes | |
| Bolus Movement before/after swallow | Yes | Yes |
| Bolus Movement during the swallow | Yes | |
| Pharyngeal Residuals | Yes | Yes |
| Tongue Base Retraction | Yes | |
| Aspiration before or after the swallow | Yes | Yes |
| Aspiration during the swallow | Yes | |
| Esophageal Motility & any Reflux (A-P View) | Yes | |
| Noninvasive | Yes |
*In pediatrics, there may be some aspects of the swallow that are more difficult to view due to immature anatomy and a smaller viewing plane.
Referrals: When you are ready to make a referral, please call our office at 817.514.6271. You can locate all of required paperwork on our website at www.dysphagiadiagnostex.com. We can also email or fax the required paperwork, if necessary. We are always available Monday-Friday, 8:00am-4:30pm, to answer any questions you may have! If you are unsure if a patient is appropriate, please email me directly at ashley@diagnostex.us or info@diagnostex.us, and we will be more than happy to answer any and all questions!
I, and the rest of the DiagnosTEX staff, look forward to helping you serve your patients and ensure a safe diet for ALL children.
Keep an eye out for a newsletter each month!