Research informs the development of national resources to improve the management of dysphagia in people with learning disabilities
Research carried out by the Community Learning Disability teams
at Central Manchester University Hospitals NHS Foundation
Trust (CMFT) has informed the development of new resources
published by Public
Health England, to improve the management of dysphagia in
people with learning disabilities.
Dysphagia is difficultly eating, drinking or swallowing and
affects oral, pharyngeal and/or oesophageal stages of the swallow.
It can lead to serious health problems including aspiration
pneumonia, asphyxia, dehydration and poor nutritional status.
Around 1 in 10 people with learning disabilities have the
The series of interlinked studies explored the prevalence of
dysphagia in adults with learning disabilities; the characteristics
and conditions associated with dysphagia and carer knowledge of and
adherence to dysphagia management strategies.
Jane Jolliffe, Health Service Manager, Professional Lead Speech
and Language Therapy and Clinical Effectiveness Coordinator for the
Learning Disability Service at CMFT carried out the research
Juliet Goldbart, Associate Dean and Research Institute
Director, Manchester Metropolitan University (MMU) and Dr
Darren Chadwick, Reader in Applied Psychology, University of
Wolverhampton (formerly Research Fellow at MMU).
Jane said: "We were aware that many people with
learning disabilities supported by the Community Learning
Disability teams had dysphagia. Service users were often describes
as having 'eating and drinking difficulties' rather than the
medical condition 'dysphagia' and this appeared to affect the way
the condition was treated. However there was limited evidence
to inform practice.
"We wanted to document the range and severity of dysphagia in
adults with learning disabilities and to improve their quality of
life. We also wanted to understand carers' perspectives about
the condition and evaluate the advice and support given by speech
and language therapists."
Through the studies, support for people with learning
disabilities has improved and now includes a detailed observational
assessment leading to a person-centred risk assessment and
management plan alongside health education, for clients and carers
around specific risk reduction strategies (for example, altered
consistency, better positioning and changes in utensils).
Jane added: "Anecdotally, we and our physiotherapy colleagues
feel that hospital admissions due to dysphagia related conditions
have reduced and the research has raised professionals' and
clients' awareness of dysphagia in adults with learning
disabilities. The research has provided evidence for the need
to expand dysphagia support for people with learning disabilities
and has helped us design our dysphagia programme of care."
More widely, the research has informed the development of new
resources to improve the management of dysphagia in people with
learning disabilities published by Public Health
the website to see the factsheets, review of evidence and
examples of reasonable adjustments that can be made by