Medical Speech Pathology

Curiosity, Dialogue, and Knowledge

The McNeill Dysphagia Therapy Program (MDTP)

Filling out the confidentiality and non-compete agreement at the beginning of the course dulled some of my enthusiasm. Initially, I felt a surge of irritation. If this treatment is so important, then why not share it? This thought was quickly leavened with the realization that all healthcare companies and device manufacturers operate under this legal umbrella of secrecy. Devices are patented because they make money. No one gets angry at GE because they don’t make new imaging technology free and available to all hospitals. We shouldn’t, then, get too upset when a new, research-based, program is also guarded. I would hope, however, that as this course spreads in popularity (I believe it will) that it will become available for purchase in different formats other than small lecture based presentations. A web-based video course with reviews could easily be set up, and people could pay a reasonable fee to access it.  It also wouldn’t hurt my feelings if more information was just shared freely, but I’ll try to temper my idealism. Given my constraints, I’ll make sure and talk about the McNeil Dysphagia Therapy Program (MDTP) in general terms, and I’ll try to comment specifically on the quality of the conference itself.

While I would have much preferred the next location this seminar was being conducted at (Europe) to Jackson, Mississippi, I was pleased with the conference room and all of the other administrative details of the conference. Also, ProCourse CEUs has a good point of contact with Cindy Barnett. She has always been easy to get in contact with, and was very helpful with the last CEU course I took on FEES through ProCourse CEUs. I know that I can expect to have the paperwork end taken care of without issue, and if there is a problem I know that Cindy can help me with figuring it all out.

As to the content of MDTP, I must be rather circumspect in what I say; so, I’ll lay out some bullet points to describe the therapy without going into too much detail:

  • It is definitely based on solid research (Randomized Clinical Trials).
  • It does not purport to be a panacea for all dysphagia patients.
  • It can work as a stand alone therapy or with other treatments (NMES, Biofeedback via sEMG, etc.).
  • It was much more than I expected, given the fact that it is largely based on exercise physiology, and I felt my knowledge base in this area was “pretty good”.
  • In my opinion, it is a true paradigm shift in terms of dysphagia treatment.
  • Even if I decided that this program wouldn’t work for many of my patients, I would still have learned a couple of really important clinical ideas (e.g.- reliability and validity are research terms that we all need to re-acquaint ourselves with due to their relationship to things like jobs and reimbursement, and it’s important to start identifying the clinical indicators that accompany aspiration during MBSS/FEES so we can note those during treatment).

The big question after any conference I’ve gone to is, “Was this worth the money and time?” In short, yes. I believe the information is solid and based on well thought out research. They manage to make connections to things that will challenge and delight you. The proof, as always, is in the pudding. I won’t really know for sure how well this works until I’ve used the therapy on a few of my own patients, but given the rigorous data supporting MDTP and the ease of access to its creators, (Dr. Giselle Carnaby and Dr. Michael Crary gladly gave me their email addresses for follow-up questions) I feel confident that I’ve stumbled across a new, exciting way of looking at how I approach the treatment of many of my patients with dysphagia.

5 comments on “The McNeill Dysphagia Therapy Program (MDTP)

  1. Jennifer Breen
    August 28, 2012

    Thanks Walt. I always enjoy keeping up with your insights. Can you elaborate on what specific types of info a receiving clinician would benefit from getting in a VFSS report. EPIC documentation has changed our write ups at YRMC but I always look to assure that the info clearly covers the deficits observed.

    • Admin
      August 28, 2012

      Hey Jen!

      In regard to this specific therapy approach (and likely in general as well) you want to be able to identify possible aspiration events while doing therapy. For example: coughing (do they cough when they aspirate/penetrate or do they cough excessively as a maladaptive bx), facial grimace with aspiration, throat clearing = aspiration with some patients, watery eyes may be a good measure of an aspiration event in others, but without data from the eval we will be left to simply guess. Also, I always appreciate knowing what’s really at the heart of the dysfunction (e.g.- weakness and where, dyscoordination, poor awareness, abnormal swallow pattern, etc.). I feel like I’m leaving important things out. If anyone else can think of other key features that they like to see in the report, chime in!


  2. Venus almonte
    December 11, 2012

    How to buy a device theraphy for throught

  3. Ashley
    May 20, 2014

    I was just curious if you had any updates. How do you think the program is working? have you been able to use it with many patients? Do you still feel it was worth the money?

    • Admin
      May 20, 2014

      I’ve been able to use it with a few, but every patient is not right for MDTP; as the authors of the method would agree. I can’t say that much about the details. I would say, however, it’s well worth the exposure to its unique perspectives on dysphagia therapy.

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