Right Column

Electrical Stimulation

LEGAL GUIDANCE ON SPEECH-LANGUAGE PATHOLOGISTS
USING ELECTRICAL STIMULATION TO TREAT
SWALLOWING DISORDERS

Electrical Stimulation for Swallowing:
In early 2004, speech-language pathologists, the California Physical Therapy Association, and manufacturers of electrical, stimulating devices asked about the licensing authority for speech-language pathologists to use electrical stimulation applied to the surface of the anterior neck to treat swallowing disorders. The Board discussed the issue at its public meetings during which device manufactures provided background on the specific devices cleared by the Federal Drug Administration. Licensees also discussed their therapy successes in applying electrical stimulation to the skin of a patient with swallowing disorders. Further, the Board consulted with otolaryngologists about the research and application of this new therapy, and sought the advice of legal counsel whether existing scope of practice laws and regulations permit licensed practitioners to use an electrical instrument as a therapeutic intervention to treat swallowing disorders.

Although legal counsel concluded that the law does provide the authority for speech-language pathology licensees to use electrical stimulation to treat swallowing disorders, counsel concluded that such authority does not imply that all licensed practitioners are competent to provide it. Concurrent provisions relating to the professional conduct of a licensees enforces that "incompetence in the practice of speech-language pathology which has endangered or is likely to endanger the health, welfare, or safety of the public" constitutes unprofessional conduct and is grounds for formal discipline. As such, licensed professionals should not engage in providing electrical stimulation therapy for swallowing unless they are adequately trained and competent in its application, are aware of the potential risks, and are able to respond to any adverse reaction that may occur.

Finally, the Board also expressed concern regarding the deficiency of peer-reviewed research to support the efficacy of using electrical stimulation to treat swallowing disorders. Even though electrical stimulation may be within the scope of practice of a speech-language pathologist, the Board is unclear whether it is a beneficial therapy that provides significant, sustained relief to affected members of the public.