Semin Speech Lang 2023; 44(01): 042-056
DOI: 10.1055/s-0042-1759641
Review Article

Knowledge and Perceptions of Speech-Language Pathology Students Participating in a Feeding Training Program: A Pilot Study

Elizabeth Viccaro Sitler
1   Department of Linguistics and Communication Disorders, Queens College, Queens, New York
Carolyn Springer
2   Derner School of Psychology, Adelphi University, Garden City, New York
› Author Affiliations


This study examined the knowledge and perceptions of speech-language pathology students working with older adults before and after their participation in a feeding training program. A secondary objective evaluated the feeding training program in terms of improving students' knowledge and skills. A repeated measures design was used to assess changes in perceptions and knowledge over time of students participating in a feeding training program assisting older adults at a skilled nursing facility. Twenty-four students in the communication sciences and disorders department from a university were recruited. Data were collected on the perceptions of working with older adults, knowledge of feeding and swallowing, and the evaluation of the program. Participants reported feeling less fearful of assisting older adults with feeding issues and appeared to acquire a higher level of knowledge in certain areas post-training. Analysis of the evaluation forms revealed that students were positive about their experience. The findings provide additional support that perceptions become more favorable following early exposure to older adults through participation in service-learning experiences. This study supplements the literature about the knowledge and perceptions of speech-language pathology students working with older adults. This information may be used to improve the quality of care for older adults in various settings.

Publication History

Article published online:
17 January 2023

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  • References

  • 1 Federal Interagency Forum on Aging-Related Statistic. Older Americans 2020: Key Indicators of Well-Being. Washington, DC: US Government Printing Office; 2020 : Accessed November 14, 2022 at:
  • 2 Jin K, Simpkins JW, Ji X, Leis M, Stambler I. The critical need to promote research of aging and aging-related diseases to improve health and longevity of the elderly population. Aging Dis 2014; 6 (01) 1-5
  • 3 U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Speech-Language Pathologists. Washington, DC: U.S. Department of Labor; 2021 . Accessed November 14, 2022 at:
  • 4 Thiyagalingam S, Kulinski AE, Thorsteinsdottir B, Shindelar KL, Takahashi PY. Dysphagia in older adults. Mayo Clin Proc 2021; 96 (02) 488-497
  • 5 Engh MCN, Speyer R. Management of dysphagia in nursing homes: a national survey. Dysphagia 2022; 37 (02) 266-276
  • 6 Adkins C, Takakura W, Spiegel BMR. et al. Prevalence and characteristics of dysphagia based on a population-based survey. Clin Gastroenterol Hepatol 2020; 18 (09) 1970-1979.e2
  • 7 Namasivayam-MacDonald AM, Riquelme LF. Presbyphagia to dysphagia: multiple perspectives and strategies for quality care of older adults. Semin Speech Lang 2019; 40 (03) 227-242
  • 8 Namasivayam AM, Steele CM. Malnutrition and dysphagia in long-term care: a systematic review. J Nutr Gerontol Geriatr 2015; 34 (01) 1-21
  • 9 Kulvanich S, Ito K, Takei E. et al. Impact of oral and swallowing function on the feeding status of older adults in nursing homes. Gerontology 2021; 67 (02) 168-176
  • 10 Batchelor-Murphy MK, Steinberg FM, Young HM. Dietary and feeding modifications for older adults. Am J Nurs 2019; 119 (12) 49-57
  • 11 Chiang C-K, Hwu Y-J. Feeding experiences of nursing aides for residents with dysphagia. Geriatr Nurs 2018; 39 (04) 436-442
  • 12 Liu W, Cheon J, Thomas SA. Interventions on mealtime difficulties in older adults with dementia: a systematic review. Int J Nurs Stud 2014; 51 (01) 14-27
  • 13 Wright L, Cotter D, Hickson M. The effectiveness of targeted feeding assistance to improve the nutritional intake of elderly dysphagic patients in hospital. J Hum Nutr Diet 2008; 21 (06) 555-562 , quiz 564–565
  • 14 Keller H, Beck AM, Namasivayam A. International-Dining in Nursing home Experts (I-DINE) Consortium. Improving food and fluid intake for older adults living in long-term care: a research agenda. J Am Med Dir Assoc 2015; 16 (02) 93-100
  • 15 Simmons SF, Hollingsworth EK, Long EA. et al. Training nonnursing staff to assist with nutritional care delivery in nursing homes: a cost-effectiveness analysis. J Am Geriatr Soc 2017; 65 (02) 313-322
  • 16 Nogueira D, Reis E. Swallowing disorders in nursing home residents: How can the problem be explained?. Clin Interv Aging 2013; 8: 221-227
  • 17 Federal Register.. Medicare and Medicaid Programs; Requirements for Paid Feeding Assistants in Long Term Care Facilities. A Rule by the Centers for Medicare & Medicaid Services. 2013 ;68(187):55528–55539. Accessed November 14, 2022 at:−24362
  • 18 Howson FFA, Robinson SM, Lin SX. et al. Can trained volunteers improve the mealtime care of older hospital patients? An implementation study in one English hospital. BMJ Open 2018; 8 (08) e022285
  • 19 Simmons SF, Bertrand R, Shier V. et al. A preliminary evaluation of the paid feeding assistant regulation: impact on feeding assistance care process quality in nursing homes. Gerontologist 2007; 47 (02) 184-192
  • 20 Roberts HC, De Wet S, Porter K. et al. The feasibility and acceptability of training volunteer mealtime assistants to help older acute hospital inpatients: the Southampton Mealtime Assistance Study. J Clin Nurs 2014; 23 (21-22): 3240-3249
  • 21 American Speech-Language-Hearing Association. Speech-Language Pathologists (SLPs) as the Preferred Providers for Dysphagia Services. ( n.d. ). Accessed November 14, 2022 at:
  • 22 Riquelme LF. Managing dysphagia in long-term care settings: clinical considerations. Perspectives on Swallowing and Swallowing Disorders 2013; 22 (03) 107-117
  • 23 Darling RM. Knowledge of aging and attitudes toward older people by communication sciences and disorders students. Contemp Issues Commun Sci Disord 2016; 43: 50-63
  • 24 McCoy YM, Desai RV. Presbyphagia versus dysphagia: Identifying age-related changes in swallow function. Perspectives of the ASHA Special Interest Groups SIG 2018; 15: 15-21
  • 25 Caesar LG, Kitila M. Speech-language pathologists' perceptions of their preparation and confidence for providing dysphagia services. SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 2020 5. 1666-1682
  • 26 Adkins DM, Mayhew SL, Gavaza P, Rahman S. Pharmacy students' attitudes toward geriatric nursing home patients. Am J Pharm Educ 2012; 76 (05) 81
  • 27 Allan LJ, Johnson JA. Undergraduate attitudes toward the elderly: the role of knowledge, contact and aging anxiety. Educ Gerontol 2008; 35 (01) 1-14
  • 28 Chang C-C, Lin L-C. Effects of a feeding skills training programme on nursing assistants and dementia patients. J Clin Nurs 2005; 14 (10) 1185-1192
  • 29 Faronbi JO, Adebowale O, Faronbi GO, Musa OO, Ayamolowo SJ. Perception, knowledge and attitude of nursing students towards the care of older patients. Int J Afr Nurs Sci 2017; 7: 37-42
  • 30 Fitzgerald JT, Wray LA, Halter JB, Williams BC, Supiano MA. Relating medical students' knowledge, attitudes, and experience to an interest in geriatric medicine. Gerontologist 2003; 43 (06) 849-855
  • 31 Gonzales E, Morrow-Howell N, Gilbert P. Changing medical students' attitudes toward older adults. Gerontol Geriatr Educ 2010; 31 (03) 220-234
  • 32 King BJ, Roberts TJ, Bowers BJ. Nursing student attitudes toward and preferences for working with older adults. Gerontol Geriatr Educ 2013; 34 (03) 272-291
  • 33 Neville C. A cross-sectional view of Australian undergraduate nurses' perceptions of working with older people. Australian College of Nursing 2015; 23: 285-292
  • 34 Gabel RM, Searl J, Fulks SJ. Communication disorders students' attitudes toward aging and the elderly. Contemp Issues Commun Sci Disord 2003; 30: 32-40
  • 35 Heape A, Causey B, Lloyd T, Jeter S. Ageism among graduate students in communication sciences and disorders: a longitudinal analysis. Perspect ASHA Spec Interest Groups 2020; 5: 1306-1312
  • 36 Blackwood J, Sweet C. The influence of ageism, experience, and relationships with older adults on physical therapy students' perception of geriatrics. Gerontol Geriatr Educ 2017; 38 (02) 219-231
  • 37 Kaf WA, Barboa LS, Fisher BJ, Snavely LA. Effect of interdisciplinary service learning experience for audiology and speech-language pathology students working with adults with dementia. Am J Audiol 2011; 20 (02) S241-S249
  • 38 Lea E, Mason R, Eccleston C, Robinson A. Aspects of nursing student placements associated with perceived likelihood of working in residential aged care. J Clin Nurs 2016; 25 (5-6): 715-724
  • 39 Milutinović D, Simin D, Kacavendić J, Turkulov V. Knowledge and attitudes of health care science students toward older people. Med Pregl 2015; 68 (11-12): 382-386
  • 40 Seaman K, Saunders R, Williams E, Harrup-Gregory J, Loffler H, Lake F. An examination of students' perceptions of their interprofessional placements in residential aged care. J Interprof Care 2017; 31 (02) 147-153
  • 41 Watson JB, Drulia T, Lynch Z. Enhancing SLP students' perceptions of older persons and collaborative practice through geriatric interprofessional teamwork. Perspect ASHA Spec Interest Groups 2021; 6: 941-954
  • 42 Kuh GD. Report from the Association of American Colleges and Universities. High-Impact Educational Practices: What They Are, Who Has Access to Them, and Why They Matter. Washington, DC: 2008
  • 43 Nolan MR, Brown J, Davies S, Nolan J, Keady J. The Senses Framework: Improving Care for Older People Through a Relationship-Centered Approach. Getting Research Into Practice (GRiP) Report No 2. 2006 . Accessed November 14, 2022 at:
  • 44 Pan IJ, Edwards H, Chang A. Taiwanese nursing students' attitudes toward older people. J Gerontol Nurs 2009; 35: 1-6
  • 45 Parsons K, MacDonald S, Hajek A, Moody J. Increasing attitudes and interest in caring for older adults in first year nursing students using innovative teaching and learning strategies. J Nurs Educ Pract 2015; 5: 63-71
  • 46 Fannin DK, Mandulak KC. Introduction to the forum: increasing diversity in the Communication Sciences and Disorders workforce, part 1. Am J Speech Lang Pathol 2021; 30 (05) 1913-1915