Odd Couple? Or Dynamic Duo? Collaborative practice between athletic training and speech-language pathology leads to interprofessional education at Ithaca College. Academic Edge
Free
Academic Edge  |   June 01, 2016

Aspen Photo / Shutterstock.com

Odd Couple? Or Dynamic Duo?
Author Notes
  • Mary Pitti, MS, CCC-SLP, is a clinical assistant professor of speech-language pathology at Ithaca College and clinic program director of Ithaca’s Sir Alexander Ewing Speech and Hearing Clinic. mpitti@ithaca.edu
    Mary Pitti, MS, CCC-SLP, is a clinical assistant professor of speech-language pathology at Ithaca College and clinic program director of Ithaca’s Sir Alexander Ewing Speech and Hearing Clinic. mpitti@ithaca.edu×
  • Michael Matheny, MS, ATC, clinical associate professor and head athletic trainer at Ithaca College, also contributed to this article.
    Michael Matheny, MS, ATC, clinical associate professor and head athletic trainer at Ithaca College, also contributed to this article.×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Professional Issues & Training / Academic Edge
Academic Edge   |   June 01, 2016
Odd Couple? Or Dynamic Duo?
The ASHA Leader, June 2016, Vol. 21, 38-39. doi:10.1044/leader.AE.21062016.38
The ASHA Leader, June 2016, Vol. 21, 38-39. doi:10.1044/leader.AE.21062016.38
Why on earth, my colleague in athletic training wanted to know, would a team physician refer an athlete who had collapsed on the soccer field after an episode of shortness of breath to me—a speech-language pathologist—for an evaluation at our college speech clinic?
Yet, as it turned out, that 2013 phone call from Michael Matheny—head of athletic training—prompted the creation of a partnership at Ithaca College. It’s a partnership that may seem like the “Odd Couple” but has proven to be the “Dynamic Duo” for athletes with vocal cord dysfunction (VCD).
VCD is best described as a type of respiratory disorder that interrupts the normal breathing cycle. The primary clinical feature is respiratory insufficiency presenting with shortness of breath, known as dyspnea.
Many athletic trainers (ATs) work with athletes who, at one time or another, experience shortness of breath. Part of the challenge for the AT is determining the appropriate and necessary course of action when an athlete experiences breathing distress. Removing the athlete from intense exercise and monitoring his or her progress, referral to the team physician, or immediate activation of emergency medical services are all possible options, depending on the suspected cause.
Often the cause is asthma or lack of fitness, but a third cause should also be included in the differential diagnosis: VCD, also referred to as exercise-induced laryngeal obstruction when the primary trigger is intense exercise.
An accurate diagnosis is critical to successful treatment of an athlete who experiences shortness of breath. Asthma is typically treated by a physician with prescribed asthma medication, including a rescue inhaler. Athletes who are out of shape need to work with a coach or personal trainer to improve their fitness level. VCD, however, warrants a team approach with input from relevant physicians, an AT and an SLP.
Three years ago, there was a fair amount of research and information on VCD in the speech-language pathology literature—but not in the literature for ATs and other sports health care professionals. Since then, we at Ithaca College have been raising awareness of this condition and how ATs and other sports health care professionals can work with SLPs to benefit athletes affected by the condition.

Athletes who generalize the clinical skills they learn in the speech clinic to the field, track, court or gym have the most success.

Case-based learning
To prepare our students to treat VCD, Matheny and I entered the collaborative teaming arena with a learning session based on the case that prompted that first phone call. We included AT students and graduate speech-language pathology student clinicians. AT faculty led the training, carefully scripting the case presentation to reveal particular key elements in a systematic manner. As each key element was revealed, AT students were asked to use clinical reasoning to determine the best AT practice for differential diagnosis, appropriate referral, treatment options and follow-up care. The goal of this interprofessional education was to have students learn in a situation that simulated the work setting.
This clinical problem-solving experience allowed the AT students to:
  • Recognize the clinical features of VCD.

  • Understand the SLP’s role in cases of VCD.

  • Gain knowledge beyond their own scope of practice to better care for the athletes they serve.

This approach also benefited the graduate speech-language pathology students who were treating this athlete. They gained experience providing education to future colleagues on the roles of an SLP in evaluating and treating athletes in cases of VCD and also learned about the role of an AT in sports health care.
Extending the reach
Since this initial case-based learning session, we have encouraged our future SLPs and ATs to collaborate in theory and in practice. They engaged in research by presenting collaborative cases at the Ithaca College Whalen Symposium, a student-based conference that showcases student research, scholarship and creativity. These presentations further highlight the need to promote collaboration between the disciplines on cases of VCD.
Student SLPs treating cases of VCD in our speech clinic now seek the feedback and expertise of the AT who works directly with the athlete receiving services. Athletes who generalize the clinical skills they learn in the speech clinic to the field, track, court or gym have the most success. Therefore, we encourage all student clinicians involved in VCD cases to communicate and collaborate with the athlete’s AT and other health care professionals to promote generalization.
Since that first soccer-player case, we have collaborated on cases involving athletes from soccer, track and field, basketball, swimming and crew. We have presented a regional speech-language conference and published a series of case narratives that highlight collaboration in the International Journal of Athletic Therapy and Training.
We have seen an increased awareness among our athletic training and speech-language pathology students who have learned through this interprofessional collaboration. These soon-to-be professionals will be more experienced with interprofessional collaboration and prepared with the best practice models in their respective fields.
What Student Clinicians Need to Know

Students in athletic training and speech-language pathology who treat athletes with vocal cord dysfunction/exercise-induced laryngeal obstruction (VCD-EILO) should know that:

  • VCD-EILO is thought to affect 2 to 3 percent of the adult athletic population.

  • Common symptoms include shortness of breath, tightness in the throat, quick onset with intense exercise, and a high-pitched, abnormal breath sound known as stridor.

  • Stridor is often misdiagnosed as asthma-associated wheezing.

  • Misdiagnosis can delay proper treatment and can affect athletic performance.

  • SLPs are trained to teach relaxation and breathing exercises that are clinically effective in reducing symptoms.

0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
June 2016
Volume 21, Issue 6