ASHA scope of practice specifically states SLPs have an inability to fully assess pharyngeal phase of swallowing at bedside and must use an instrumental in order to fully assess the pharyngeal phase.

This idea extends to the actions of changing diets at bedside without an instrumental – if you don’t know what’s wrong, how can you be sure you’re fixing “it” and not doing more harm to the patient?

We would balk at the idea of a physical therapist treating a hip fracture or a physician treating a stroke without first confirming diagnosis with the aid of imaging diagnostics and using that information to form an appropriate treatment plan.  Equally, SLPs should have access to objective imaging diagnostic information in order to identify dysphagia and treat effectively.