Use of NMES for Swallowing Habilitation in Neonatal Intensive Care Units: A Survey of Clinical Practice

Abstract

Purpose: The purpose of this investigation was to identify clinical practice patterns of speech language pathologists who use NMES with the neonate and young infant population, specifically, the modality treatment parameters and physiological rationale. Method: An online survey was disseminated to query use of NMES by licensed speech language pathologists who routinely address swallowing habilitation in neonatal intensive care units (NICUs). Results: Eleven of the forty practicing speech language pathologists who completed the survey indicated they have used NMES on neonates and infants in the NICU, indicating that most speech language pathologists do not use this modality with infants. Of the speech language pathologists who used this modality, primary reliance on clinical judgement for determination of NMES dose, frequency of treatments, electrode placement, and discharge determination was identified. While SLPs acknowledged that little empirical evidence is available, those who used this modality indicated that ASHA should support this modality in infants. Conclusions: Reliance on clinical judgement, as indicated by SLPs who use NMES on neonates and young infants, is not consistent with the evidence-based practice triad which encourages the use of high-quality peer reviewed published evidence to inform clinical decision-making. Additional basic and applied research is needed to support use of NMES as a therapeutic modality in infants.