The use of sensory and chemesthetic stimuli in the treatment of oropharyngeal dysphagia: scoping practice in Ireland and the UK

Taste affects thresholds of swallow elicitations implying that swallowing functions may be sensitive to sensory qualities of boli. There is some evidence to suggest that sensory and chemesthetic stimuli may provoke changes in dysphagia population’s response to oral feeding and swallowing. The purpose of this study is to investigate clinical practice behaviours with regard to sensory and chemesthetic stimuli by speech and language therapists (SLTs) in the Republic of Ireland, Northern Ireland, England, Scotland and Wales. A survey containing 15 questions was developed and disseminated via an electronic survey tool (www.surveymonkey.com) to gatekeepers of Dysphagia special interest groups across these five countries. A total of 84 were received. The results showed that a high portion of respondents currently use sensory and chemesthetic stimuli in practice, with 60% of stimuli being used in assessment and 63% of stimuli being used in treatment. Such stimuli were used more by respondents working with adult than paediatric caseloads (85% versus. 16%). Sour (79.1%), carbonation (69.8%) and sweet (69.2%) tastes were found to be the most employed tastes while metallic, chalky, kokumi and fatty tastes were not used in clinical practice by any of the 84 participants. This study effectively determined the range of sensory and chemesthetic stimuli in practice in Ireland and the UK and the frequency at which they are being used. More research trials on a wider variety of client group’s specific to the use of these eighteen stimuli will be required to establish an evidence base, as this study was limited with respect to its number of client groups. This will not only guide SLTs as to what to do in practice, but also provide these clients with effective therapies and positive outcomes and thus avoid variability amongst dysphagia practices and maintain a high standard of care.