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The future of hearing technology

Listen to this podcast episode of The Current with Matt Galloway on CBC Radio that aired on November 13, 2023 regarding the future of hearing technology.

Hearing aids are expensive and make everything sound louder, not just the things you want to hear. But technology is changing, and some researchers are turning to artificial intelligence for a solution. Galloway speaks with Ian Bruce, a professor in the McMaster School of Biomedical Engineering; and Richard Plummer, executive director of the Canadian Hard of Hearing Association.

This is the hearing test all Quebec newborns will soon undergo

📺Watch the report from CBC News.

Four-day-old Victoria gets a quick hearing test at LaSalle Hospital, one of the latest facilities to start using a screening program for hearing impairments among newborns. QASLPA President and SAC member Paul-Andre Gallant commented on the process of screening 90% of infants born in Quebec for hearing loss as part of the Universal Hearing Program.

Introducing Defy Dementia – The podcast for anyone with a brain, by Baycrest

Defy Dementia is an empowering new podcast by Baycrest dedicated to helping you reduce your dementia risk. Join them on a captivating exploration of key dementia risk factors as we interview experts, hear inspiring stories from persons with lived experience, and share practical advice to help optimize your ageing journey. Tune in and subscribe at or anywhere you get your podcasts and unlock the power to age fearlessly and defy dementia.

Each episode will be complemented by a short video, infographic, and related resources to help you take control of your brain health.

Defy Dementia is hosted by Jay Ingram (Canadian author and broadcaster) and Dr. Allison Sekuler (President and Chief Scientist, Baycrest Academy for Research and Education, and the Centre for Aging + Brain Health Innovation). The Public Health Agency of Canada generously funds the podcast.

Saskatchewan Continues to Invest in Health Care Opportunities as Students Head Back to School

SAC is pleased that the Saskatchewan Provincial Government recognizes the need for additional post-secondary seats, but we continue to advocate for an in-province S-LP and audiology program.

This article originally appeared on the Saskatchewan website on August 3, 2023.

The Government of Saskatchewan continues to incentivize health care training opportunities for Saskatchewan students and graduates as a main pillar of the four-point Health Human Resources (HHR) Action Plan.

The 2023-24 academic year will increase access to educational opportunities for students interested in a healthcare career by providing approximately 550 new training seats in 18 high-demand health occupations, an expansion announced earlier this year. This initiative builds upon the addition of 150 nursing seats announced in 2022.

“Saskatchewan is a great place to train and build a career in health care,” Health Minister Paul Merriman said. “As we prepare for the upcoming school year, our government continues to prioritize enhancing opportunities to train more healthcare professionals here at home and help them succeed.”

New training opportunities are being offered to Indigenous students including a Phlebotomy (blood collection) Program and an Indigenous Birth Support Worker Program now available at Gabriel Dumont Institute. Further, the Saskatchewan Indian Institute of Technologies is offering more seats in 2023 for the Health Care Aid Program in Prince Albert.

The College of Medicine at the University of Saskatchewan recently announced expanding the upcoming fall 2023 intake of medical students to the undergraduate program by four seats. This will increase the total number of seats from 100 to 104, with further plans to reach 108 seats next year.

Financial supports are available to domestic students and graduates pursuing a career in health care, including forgivable loans, bursaries and recruitment incentives to stay in Saskatchewan following graduation.

The Final Clinical Placement Bursary program available to students in eligible health disciplines has seen a high uptake, with 100 bursaries approved since April. Applications are open until September 30, 2023.

Training bursaries were recently announced for students and new graduates of paramedic programs who commit to joining Emergency Medical Services (EMS) in Saskatchewan.

Additional educational opportunities include seats secured through interprovincial training agreements. Saskatchewan students will be able to access 15 seats at the University of Alberta in the Speech-Language Pathology program and four seats secured at the British Columbia Institute of Technology in the Environmental Public Health program.

Work is ongoing on multiple initiatives of Saskatchewan’s HHR Action Plan to recruit, train, incentivize and retain more healthcare workers with progress being made in key areas.

HHR Progress Update Highlights

  • The Saskatchewan Health Authority has had great success connecting with nursing students and recent graduates to promote employment opportunities. Since December 2022, the SHA has hired more than 560 new graduates from the province and across Canada.
  • Almost 170 positions are now filled of the 250 new and enhanced permanent full-time positions targeted to stabilize staffing in rural and remote areas of the province.
  • The Rural and Remote Recruitment Incentive of up to $50,000 available to new employees in nine high-priority classifications in 53 rural and remote areas continues to see much interest, with nearly 140 incentives conditionally approved to date.
  • In late August, Saskatchewan will begin implementing an accelerated, streamlined pathway for internationally-educated nurses that shortens licensure timeframes from months to 14 weeks.
  • Nurse recruits from abroad will be supported through the process, from recruitment to their work placements and settlement in a new community.
  • The first 10 of the 400 Registered Nurses (RNs) with conditional offers from the Philippines arrived in Saskatchewan in July and are participating in clinical training. Once clinical training is complete these RNs will be eligible for licensure and ready to begin working in Saskatchewan’s health system.
  • Nineteen Continuing Care Assistants (CCAs) and two Medical Laboratory Assistants (MLAs) from the Philippines arrived earlier in 2023 and are working in communities across the province, particularly rural and remote locations.

Details on health care opportunities, how to access them and more information on the province’s HHR Action Plan are available at

Hearing aids, counselling may slow cognitive decline for some seniors, new study finds

This article originally appeared in CBC News on July 19, 2023.

Seniors at risk of dementia who were given hearing aids and counselling had less cognitive decline over a three-year period, a randomized trial finds.

Research published Monday in The Lancet medical journal found that at-risk seniors saw their rate of cognitive decline nearly cut in half over three years if they wore hearing aids, compared to seniors who just received an education.

While past research has shown a link between hearing loss and cognitive decline, experts say this study supports the need for seniors to use devices to mitigate the risk.

In Canada, audiologists estimate that around three million people have some hearing loss that could be improved with hearing aids, yet 80 per cent don’t wear them.

“It’s a testament that hearing intervention, it’s not just improving your hearing; there are a lot of cascading effects that we see now,” said the study’s co-principal investigator Dr. Frank Lin.

Lin, a professor at Johns Hopkins University’s School of Medicine and Bloomberg School of Public Health, says the study shows that good hearing “decreases loneliness, improves your social engagement, you become more active [and] it might take a load off your brain.”

The randomized control trial involved 977 participants, who were about 77 years old on average.

Some people were considered healthy, while others had underlying conditions like high blood pressure and diabetes, which put them at a greater risk for cognitive decline.

Participants were randomly divided into two groups: one that got hearing aids with additional counselling and another that only took part in a successful aging health education class.

Over three years, researchers measured the level of cognitive decline between the two groups.

There was no significant difference in cognition between the two groups overall, nor was there a notable difference for the healthy participants across both groups.

But when researchers looked at the results for just the participants who were at higher risk of dementia, those who got hearing aids slowed their cognitive decline by 48 per cent over the study period.

How is hearing tied to dementia?

According to Lin, researchers suspect that hearing loss can impact the brain in three significant ways.

The first, he said, is related to cognitive load, which means that there’s excessive work being done by the brain to compensate for poor hearing.

“Your brain is constantly getting a much more garbled signal from the ear,” he said. “And we understand now that likely takes a toll on the brain.”

The brain is constantly reallocating resources to handle hearing as a result, and that might “come at the expense” of our thinking and memory, Lin said.

A second reason is that if the brain isn’t getting enough auditory input, that can cause parts of it to shrink, said Lin.

And lastly, hearing loss can cause someone to withdraw and not be as socially engaged. This is also thought to contribute to brain atrophy.

“The thing with hearing intervention [is that] it likely targets all those pathways: it reduces load on the brain, provides more stimulation to the brain, [and] at the same time, it helps you be more engaged with your life,” said Lin

Study limits confounding factors

While these study results aren’t surprising to those in the industry, the methods used provide more robust support for the idea that hearing loss is tied to cognitive function.

There’s been a lot of research recently that shows hearing loss can be an early warning sign for potential decline, said Kathy Pichora-Fuller, a professor emeritus in psychology at the University of Toronto not involved in the study.

But what stands out to the gerontologist and audiologist is that there weren’t as many confounding factors due to the fact that participants were randomly assigned to either group.

This would mean that lifestyle factors were relatively the same between the control and intervention groups.

Typically in studies done with hearing aids, Pichora-Fuller said they compare people who have them with those who don’t.

But Pichora-Fuller says people who already own hearing aids are often different: they may be more motivated, socially engaged, wealthier or have a higher education. All of these factors could be what help preserve their mental state as they age.

“Now we can compare apples to apples,” she said about the new study.

She says it’s also important to know that the participants in this study were not only given hearing aids but also engaged in continuous audio rehabilitation with an expert.

Barriers to getting hearing aids

Even though the benefits of hearing aids have been clear for some time, those who work in the industry say patients are still reluctant to get them.

“Hearing aids do have a stigma associated with them and it’s very long-standing,” said Marilyn Reed, an audiology practice advisor at Baycrest Centre in Toronto.

“The way to overcome stigma is to really talk about the problem.”

This starts with family doctors, Reed said. Regular screening in people 50 and older in primary care, she said, can reduce shame, educate people and allow for earlier intervention.

Another barrier is cost, said Reed: The most basic hearing aids available in Canada start at around $2,000 a pair.

Most recently, the U.S. approved over-the-counter hearing aids, which has dramatically reduced the price. Many expect Canada will soon follow suit.

As for the next steps with this research, Lin says they are going to continue to follow the people who started off healthy to track if they eventually see any benefit from the hearing aids.

He says they also plan to do more research on whether there are long-term cognitive benefits with hearing aids and their ability to reduce rates of dementia.

Congratulations to the 2023 SAC Awards Recipients

Speech-Language & Audiology Canada (SAC) is proud to announce the winners of the 2023 Awards and Recognition Program! SAC would like to thank the recipients this year for their immense contribution to their professions and communities.

Eve Kassirer Award for Lifetime Achievement

Kim Lawlor
Kim Lawlor, S-LP

Kim Lawlor is Registered Speech-Language Pathologist in Newfoundland and Labrador with an interest in oral language development and stuttering. Kim has focused on collaborative partnerships with educators, government agencies and community organizations during her 30 years working in the education system. She currently works as a Program Specialist for the Newfoundland and Labrador English School District where she is the provincial team lead for Speech-Language Pathology.

André Lafargue Mentorship Award

Sandrine Umunoza
Sandrine Umunoza, S-LP

Sandrine Umunoza is a bilingual speech therapist of Rwandan origin with her own successful multidisciplinary private practice called the Cabinet d’orthophonie l’Envol. With three offices in Gatineau (QC), Sandrine’s practice continues to grow year after year. She has been collaborating with indigenous communities for over 10 years in the North Shore of Quebec to better serve their communication, language, and learning needs.

CJSLPA Editor's Award

Normative Indicators of Language Development in Québec French at 54, 60, and 66 Months of Age: Results of the ELLAN Study

The team of Audette Sylvestre, Mélissa Di Sante, Catherine Julien, Caroline Bouchard, Vincent Martel-Sauvageau, and Jean Leblond are the recipients of the 2023 CJSLPA Editor’s Award for the French article titled in translation Normative Indicators of Language Development in Québec French at 54, 60, and 66 Months of Age: Results of the ELLAN Study.

Federal Funding to Transform Primary Care Training in Canada

SAC is proud to play a role in Team Primary Care by developing Curricula to benefit patients with communication disorders in comprehensive interprofessional primary care (CIPC).
This article originally appeared on on June 8, 2023

The Team Primary Care initiative will transform the training of current and future generations of primary care practitioners, enhancing their ability to work in interprofessional teams.

MISSISSAUGA — June 8, 2023 — Today, the Honourable Jean-Yves Duclos, Minister of Health, on behalf of the Honourable Carla Qualtrough, Minister of Employment, Workforce Development and Disability Inclusion, announced a federal investment of $45.3 million in grant funding from Employment and Social Development Canada to the Foundation for Advancing Family Medicine. These funds will spearhead Team Primary Care: Training for Transformation, an initiative designed to build the capacity of interprofessional, comprehensive primary care practitioners working in teams through improved training, retention and planning tools.

The funding was awarded under the Sectoral Workforce Solutions Program’s solicited call for proposals. At its core, Team Primary Care aims to enhance the readiness of a supported primary care workforce to deliver more team-based comprehensive services with greater continuity and coordination of care with a whole person orientation. This initiative includes dedicated funding to support the optimization of existing primary care teams through the integration of new team members.

“Many living in Canada currently do not have access to comprehensive primary care. This reality, compounded by the health workforce shortage, makes team-based care a valuable model for the delivery of comprehensive primary care,” said Claudia Zuccato Ria, Executive Director of the Foundation for Advancing Family Medicine. “By reimagining training for both current and future generations of primary care practitioners, we are launching a foundational component of broader primary care reform, bringing us closer to connecting everyone in Canada to interprofessional teams providing comprehensive continuing primary care.”

Team Primary Care is co-led by the College of Family Physicians of Canada and the Canadian Health Workforce Network, in partnership with over 100 health professional and educational organizations across Canada.

“The combination of funding for education, infrastructure change and enabling collaboration between the health practitioner community are essential to build a primary care workforce that’s ready to deliver team-based care in Canada.” said Dr. Ivy Oandasan, Co-Lead of Team Primary Care and Director of Education at the College of Family Physicians of Canada. “The Team Primary Care initiative is based on this premise and is an important first step in the right direction.”

Team Primary Care is now collaborating with over 100 partners to develop over 40 practitioner-specific, primary care team training projects, with further projects anticipated to enhance, align, and increase readiness for practicing in this collaborative care delivery approach. Team Primary Care will also create and adapt interprofessional training approaches across health professions including support for the full participation of Indigenous and internationally educated practitioners, maximizing their integration.

“Team Primary Care is a unique and timely initiative that brings together the full range of primary care practitioners to train and learn how to work together,” said Ivy Lynn Bourgeault, Co-Lead of Team Primary Care and Lead of the Canadian Health Workforce Network and Professor, University of Ottawa. “Our initiative will increase the recognition of how each practitioner group can contribute to addressing the challenges individuals in Canada face in accessing primary care.”


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About the Foundation for Advancing Family Medicine

The Foundation for Advancing Family Medicine (FAFM; formerly known as the Research and Education Foundation) was established in 1994 to better serve the future of family medicine. The FAFM is dedicated to advancing the discipline of family medicine through research and education initiatives. The FAFM offers numerous awards, grants, and scholarships, as well as initiatives to support the training and continuing professional development of medical students, family medicine residents, and family physicians at every stage of their careers.

About the College of Family Physicians of Canada

The College of Family Physicians of Canada (CFPC) is a professional organization representing more than 42,000 members nationwide. The College establishes the standards for and accredits postgraduate family medicine training in Canada’s 17 medical schools. It reviews and certifies continuing professional development programs and materials that enable family physicians to meet certification and licensing requirements. The CFPC provides high-quality services, supports family medicine teaching and research, and advocates on behalf of the speciality of family medicine, family physicians, and the patients they serve.

About the Canadian Health Workforce Network

The Canadian Health Workforce Network is a knowledge exchange network of researchers, decision-makers, and other knowledge users with expertise in health workforce planning, policy and management. Its internationally recognized, interdisciplinary and intersectoral health workforce research expertise provides an excellent foundation to lead large, multi-stakeholder projects to address complex health workforce challenges while building capacity in both official languages.

‘Hearing shouldn’t be for the privileged’: Family fights for cochlear implant coverage

This article originally appeared on Global News on May 24, 2023.

Erica Hall knew her son couldn’t hear the day he was born. Doctors believed it may have been fluid in his ear that caused the newborn to fail his hearing screening, but Hall said she knew through his “startled” movement that it was more than that. Four months later, doctors told Hall and her husband, who live in Mississauga, Ont., that their son Greyson had profound hearing loss due to genetics that the parents unknowingly carried. But with the help of cochlear implants in both ears, Greyson was given the gift of sound. He is now 18 months old and able to listen and dance to music.

Cochlear implants are surgically inserted medical devices designed to improve hearing for people with significant hearing loss. Unlike hearing aids, which amplify existing hearing abilities, implants act as a substitute for non-functional or damaged inner ear structures, directly stimulating the auditory nerve, according to the Canadian Hard of Hearing Society. The surgery, which is performed under general anaesthesia, usually lasts a few hours, and patients can typically be discharged from the hospital on the same day.

“Over the past almost year since he’s received his devices, it has been absolutely amazing,” Hall told Global News. “Upon diagnosis, I thought he would never experience music, he would never be able to dance to a beat, and I’ve seen it. And when I see it, I cry tears of complete joy. The best decision we’ve made for him was the surgery and to embrace cochlear implants.”

The cochlear implants, including surgery, cost around $100,000 and were covered by the province. However, the implants may need to be replaced or upgraded every five to 10 years (due to wear and tear or as parts become obsolete), and in Ontario, the second pair is only partially covered.

“The cochlear implants are very expensive,” Hall said. “Once that warranty is up at the age of five, we are responsible for paying for the replacement device and that cost is over $11,000 out of pocket. We just need help affording it because hearing shouldn’t be for the privileged, and that’s what I feel Ontario has made it to be.

And now they may have to pay double the price. Hall is pregnant with their second child, and after genetic testing, they were told their new baby boy (who is due in July) will also have profound hearing loss.

“I was absolutely devastated. A lot of parents of kids with hearing loss also feel this immense grieving period. You expect your child’s life to be one way, and it’s not,” Hall said. She said while she’s happy both boys are able to “go on this journey together,” she’s stressed about the financial strain on the family as they do not have private insurance.

Ontario has its Assistive Devices Program (ATP), which covers up to 75 per cent of assisted speech processors, like cochlear implants. However, there is a cap for replacement devices.

Bonnie Cooke is an audiologist and director of audiology at Speech Language and Audiology Canada. She said a single cochlear implant device (for one ear) costs on average between $11,000 and $15,000. With the cap, that means ATP will cover around $5,444 and the rest is usually out of the patient’s pocket for a replacement device, she said.

“It’s a huge cost, especially in many cases people will have two implants,” Cooke said. “The lifespan of a cochlear implant processor can be anywhere from five to 10 years at the most. So if your child is implanted with a set of cochlear implants by the age of one, you’re looking to sort of have to map out savings to ensure that they have new processors every five to 10 years.”

Cochlear implant coverage also varies across Canada, she said. For example, Saskatchewan has a co-pay program, which means families pay $840 per replacement device. In Nova Scotia, the government fully covers replacements.

“It’s unfortunate that it’s not the same. But one thing that is the same, is that the initial cochlear implant is funded the same across (all) provinces. And so that’s great,” Cooke said.

A 2019 survey by Statistics Canada found that at least 1.3 million Canadians aged 15 years and over have a hearing disability. Some 319,000 Canadians with a hearing disability do not use a hearing aid or cochlear implant, though they need them; of these, 66 per cent said it was because of the cost. Hearing loss is also on the rise across the country, according to Anne Marie Langlois, manager of programs and services accessibility and employment at the Canadian Hard of Hearing Association (CHHA).

She explained that hearing loss is not only a health issue but a social one as well, as there is a “sense of isolation” that comes with it.

“Individuals who struggle with communication, those individuals are impacted throughout their lives socially, at work and being able to maintain health and well-being,” Langlois said, adding that she believes it’s important that the government invests in hearing care to make sure the funding is available to all families.

Hall is hoping for this as well. Her family, and others, have been petitioning Ontario Health Insurance (OHIP) and ATP to extend coverage for cochlear implants.

“We’re asking for either OHIP to cover it or for the Assisted Devices Program to increase the coverage to match what Saskatchewan offers,” Hall said. “The banner headline of assisted devices (in Ontario) says 75 per cent coverage. But the fine print has a dollar cap, and that dollar cap is $5,444 per device. And my son has bi-lateral devices as will this baby as well.”

Congratulations to the 2022-2023 SAC Scholarship Recipients

Speech-Language & Audiology Canada (SAC) is proud to announce the winners of the 2022-2023 SAC Scholarships. A total of $31,750 was awarded to 27 students in speech-language pathology, audiology, and communication health assistants’ programs.

Student winners were selected based on their accomplishments in the areas of academic, community service, and leadership potential.

SAC’s scholarship program is the result of a collaboration between the Elks of Canada, KIDSPEECH, the Beach Family, and donations from our members. The scholarship program is our commitment to helping the next generation of speech-language pathologists, audiologists, and communication health assistants as they pursue their education and career.

“Supporting the future of our profession by helping students with their education elevates us all,” says Victoria McLeod, Aud (C), Chair of the Scholarship Committee. “The talent and creativity these students bring to their academic and clinical experience set them apart as true leaders.”

We would like to thank all the scholarship applicants, our donors, the Scholarship Committee, and the educators at the various schools for supporting their students. Congratulations to all the students – we look forward to seeing what you will accomplish next.

Elks and Purple Fund for Children Scholarships

Gordon Leslie Memorial Scholarship
Olivia Ellard
speech-language pathology
University of British Columbia
Quinlyn Johnson
speech-language pathology
University of Alberta
Lindsay Kroes
speech-language pathology
McMaster University
Héloïse Lessard-Dostie
University of Ottawa
Julia Montgomery
speech-language pathology
University of British Columbia
Olivia Musat
Dalhousie University
Chris Plimmer
Western University
Isabel Schneider
speech-language pathology
University of Toronto
Emma Van Lieshout
Western University
Mia Vardouniotis
speech-language pathology
University of Toronto
Susan Lane Scholarship
Leen Al-Fayez, speech-language pathology, University of Toronto
Deborah Kully Scholarship
Anusha Khepar, speech-language pathology, University of Alberta

KIDSPEECH Scholarships

Leadership Scholarship Karlee Appel, speech-language pathology
Western University
Doctoral Scholarship Christine Muscat, speech-language pathology
University of Toronto
Travelling Scholarship Hailey Brien, speech-language pathology
Dalhousie University

Beach Family Graduate Scholarships

Lauren Denusik, speech-language pathology
Western University
Alyssa DiMarco, speech-language pathology
McMaster University

SAC Scholarships

SAC logo
Isabel Richard Scholarships
Carole Hiew
speech-language pathology
University of Alberta
Maissie Hillman
speech-language pathology
University of Alberta
Emerald Schreier
speech-language pathology
University of Alberta
SAC Research Scholarships
Matthieu Martin
speech-language pathology
Dalhousie University
Simon Pawlowski
Dalhousie University
SAC Audiology Scholarship
Megan Moore
Western University
Grace Margaret Harris Scholarship
Kelsi Fry
Dalhousie University
Communication Health Assistant Student Scholarship
Rebecca De Santo
Georgian College
SAC Student Achievement Awards
Ashley Harvey
Georgian College
Chloe Korade
speech-language pathology
University of Alberta

Get a test for swallowing issues at Saskatchewan Swallowing Diagnostics

This article originally appeared in Saskatoon Star Phoenix.

Jennifer Cameron-Turley’s Fiberoptic Endoscopic Evaluation of Swallowing test is available at her Saskatoon clinic with or without a doctor’s referral.

Businesses and non-profit organizations regularly open and move in Saskatoon. Today the StarPhoenix talks to Jennifer Cameron-Turley, a licensed speech-language pathologist, who opened Saskatchewan Swallowing Diagnostics in downtown Saskatoon.

Cameron-Turley, a healthcare worker for almost 30 years, opened her new business at the beginning of May to conduct outpatient tests and provide direction for people with certain swallowing issues.

She says that she is not only the first business in Saskatchewan but actually, the first independent business in Canada to provide the FEES test (Fiberoptic Endoscopic Evaluation of Swallowing), which is an instrumental swallowing test with several unique advantages. FEES is available at her clinic with or without a doctor’s referral, and without having to arrange travel to an outpatient appointment at an acute care hospital.

Part of Cameron-Turley’s mission is to educate people because she has found a general lack of knowledge about what to do about swallowing issues. She is eventually hoping to offer on-site services to remote and rural areas throughout Saskatchewan. For now, she is open by appointment two days a week at Wall Street ENT Clinic.

Related: Saskatchewan seeing shortage of speech pathologists

How common are swallowing problems in Canada?

Swallowing problems are quite prevalent in people over the age of 50, but they can happen at any age. People also might have a neurological issue or an acute or chronic disease that affects their swallowing. I would say probably 10 per cent of people over 50 have dysphagia or swallowing disorder. And the vast majority of people over 80 in nursing homes, probably 70 per cent of them have a swallowing disorder of some kind.

What are some signs that someone may have a swallowing disorder?

Big signs are persistent coughing and choking when you’re eating and drinking, or having food get stuck in your throat. This happens to everyone once in a while, but persistent difficulties are a red flag. Changes in your voice quality while eating or drinking can also be a sign of an issue. Sometimes it can feel like a persistent lump in the throat. When we do the FEES test we can sometimes see that people might be regurgitating some stomach acid or food into their throat.

If I can see what’s going on, I can refer people to different medical specialists who can help them out. Another thing is getting chest infections because you have food going down the wrong way. That can really put people at risk of ending up in the hospital if they end up with chest infections because they’re aspirating, or having food and liquid go into the lungs. Aspiration does not always lead to aspiration pneumonia, but it is certainly a risk factor, especially if you’re elderly, frail, your immune system is compromised, or you have pre-existing lung disease.

What steps can people take if they notice swallowing problems?

A lot of people don’t know where to go. Up to this point, you really did have to get a doctor’s referral to get an outpatient instrumental swallow test at an acute care hospital. But now with Saskatchewan Swallowing Diagnostics, outpatient instrumental assessments won’t need to be hospital-based and people can self-refer. It’s always a good idea to talk to your doctor anyway because there’s more than one cause of swallowing disorders. But with FEES people can certainly self-refer if they think they are having an issue, and then I can send the report to their physician once the examination is completed. If a person is unsure if this test is for them, I can certainly discuss the situation with them over the phone and see if this is appropriate for them, or tell them if I think a different test or a different medical specialist would be more appropriate.

How does the FEES test work that you conduct at Saskatchewan Swallowing Diagnostics?

FEES involves a slender nasal endoscope that goes into the nose and allows the speech-language pathologist to clearly view the patient’s pharynx (throat) and larynx (voice box) and oesophagal opening while the patient is eating and drinking to see exactly how the muscles are moving. That way we can see if there’s anything we can do in terms of manoeuvres or therapy that will make swallowing better over time. Or there might be diet recommendations for a person to alter their diet to make it safer and have them be less likely to aspirate or have things go down into the lungs.

The test typically takes around 15 to 20 minutes, then I would talk to the person about what I found. I’d make recommendations, introduce any therapeutic exercises and do any teaching that I need to do with them or the family. The visit would be about an hour.

Are other tests available to assess swallowing disorders?

Right now there are two “gold-standard” instrumental swallowing evaluations. One of those instrumental studies is FEES, and the other is a Modified Barium Swallow study (MBS), which is done in radiology in an acute care hospital. That test is excellent for diagnosing certain types of swallowing disorders but there are some disadvantages to it, too. The radiation dose of an MBS is relatively low — and speech-language pathologists and radiologists are always very careful to keep the doses as low as possible — but there are situations in which it’s best to minimize one’s exposure, especially if you have a history of head and neck cancer treatment with prior radiation, for example.

So I think my FEES service will really open things up to centres that do not have acute care hospitals, especially in rural and remote locations, and people in nursing homes and things like that where people might not be so mobile.

How does FEES compare to the other test?

It stands out very favourably. There are different indications and contraindications for each test but there are a lot of advantages to FEES for some patients. If you primarily have trouble chewing or moving food around in your mouth, or if your oesophagus or food tube is the cause of your swallowing problems, doing an MBS (Modified Barium Swallow) is the preferred test for you. There are some contraindications for FEES, such as a history of facial or nasal surgery or trauma, blocked nasal passages on both sides or a history of severe nosebleeds, or a history of vasovagal episodes or fainting.

What training have you had in conducting the FEES test?

Not many speech-language pathologists in Saskatchewan are trained to do FEES yet, but I hope to see the exam become more available over time. I went down to the United States to get trained in the technique and the interpretation. And then there was an ear, nose and throat doctor that oversaw my training in Canada for quite a few months and deemed me competent to scope and interpret results independently.

I’ve been doing FEES with in-patients in the hospital for a few years. I’ve done hundreds of them now but of course, there is always more to learn and I’m always trying to learn more to be a better clinician. There’s only one speech pathologist I know that’s doing this in an outpatient setting in Toronto. It’s certainly not common. But in the U.S., mobile FEES providers are getting increasingly common.

This interview has been edited and condensed.

Saskatchewan Swallowing Diagnostics

Owner: Jennifer Cameron-Turley
Address: 140 Wall Street (Wall Street ENT Clinic)
Hours: Mondays and Fridays, 9 a.m. to 5 p.m.
Check: Facebook