PROGNOSIS FOR SWALLOWING FUNCTION RECOVERY FOLLOWING CVA

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One-hundred patients with new-onset unifocal CVA and swallowing disorders will be classified into CVA subtypes by neuroanatomic site, vasoular territory, and clinical signs and symptoms. Clinical dyaphagia evaluation and videofluoroseopy with modified barium swallow (VF/MBS) will be performed 3, 6, 12, and 26 weeks following CVA to determine the presence and severity of oropharyngeal swallowing disorders. Clinical language evaluations will be performed coneurrently to determine the presence and severity of speech-language and neurobehavioral deficits. Individual diets will be assigned according to VF/MBS results. Each patient will receive dysphagia therapy, lappropriate to the identified swallowing disorders, from a trained speech pathologist or family member trained by a speech pathologist. This five-year study proposes to qualitatively and quantitatively examine types of swallowing disorders found in specific CVA subtypes and changes in swallowing function across CVA subtypes over a 26-week period following stroke onset. The effects of speech-language and neurobehavioral deficits on the ability to increase oral intake during the process of dysphagia therapy also will be studied.