A decision-algorithm defining the rehabilitation approach: ‘Facial oral tract therapy’®

Abstract

Aim. The aim of this study was to describe and define the rehabilitation approach: ‘Facial Oral Tract Therapy’ (F.O.T.T.)®.

Method. We defined the content and process of the rehabilitation approach (F.O.T.T.)® in a decision-algorithm supported by a manual with supplementary material. The algorithm was developed by a research occupational therapist and an F.O.T.T.® senior instructor. We used an inductive approach combining existing knowledge from: F.O.T.T.® instructors, therapists trained in using the F.O.T.T.® approach, and existing literature. A group of F.O.T.T.® instructors and the originator of the treatment approach Mrs. Kay Coombes has given comments to and approved the algorithm.

Result. The algorithm consist of five flowcharts: ‘one assessment’ chart guiding the therapist in the examination of the patient and four ‘treatment charts’, one for each of the four areas of F.O.T.T.®: swallowing and eating; oral hygiene; breathing, voice, and speech articulation; facial expression, giving guidance on interventions. The algorithm outlines all important components in the treatment that the therapist should decide to use or not to use in the intervention. The algorithm is supported by a manual with criteria of when to use which components.

Conclusion. This algorithm is designed to be a practical guideline to therapists using F.O.T.T.® in clinical practice and in educational settings. The use of this algorithm may support standardization of F.O.T.T.® and thereby promote and maintain the quality in the treatment. This in turn will facilitate research that addresses F.O.T.T.® and outcomes.

Keywords:

• Rehabilitation research
• therapeutic methods
• practice guideline

Acknowledgments

The authors thank John Whyte, MD, PhD, for inspiration and discussion during the development of this algorithm. The authors are very grateful to the FOrmaTT group for their constructive comments on the algorithm, as well as the occupational therapists at our Department, and to Ingrid Poulsen Med dr. for critical reading of this article. The authors are also very pleased that Ms. Kay Coombes, the originator of F.O.T.T.®, has been very supportive of their work and they thank her for critical reading of this article together with Margaret Walker.