Pediatric Videofluoroscopic Swallow Studies: A Professional Manual with Caregiver Guidelines (1998). By Joan C. Arvedson and Maureen A. Lefton-Greif. Communication Skill Builders, 555 Academic Court, San Antonio, TX 78204-2498. $69. Reviewed by Janet P. Patterson, Central Michigan University, Mount Pleasant.

Two compatible parts comprise this manual that describes the use of videofluoroscopy (VFSS) in dysphagia diagnosis in the pediatric population. Part one is a six-chapter manual written for speech-language pathologists that presents the rationale and procedure for using VFSS with children. The first chapter in this part reviews instrumental assessment tools for dysphagia diagnosis. The second chapter describes the anatomy, physiology, and development of the swallow in children. The remaining chapters contain substantive information used in determining patient readiness for VFSS, conducting a VFSS evaluation, interpreting findings, and planning patient management. The section concludes with several illustrative case studies. Tables and figures are used liberally throughout to highlight points in the text. Three appendices and a thorough reference list complement the text.

Part two is titled "Caregiver Guidelines." The seven sections in this part provide tools to bridge the gap between the dysphagia team's recommendations and the caregiver's understanding of dysphagia, based on the premise that team recommendations may at times seem, "abstract, complex, or unreasonable to those caring for a child with dysphagia." These sections present sample letters and reproducible documentation forms to use prior to and following the VFSS; general information about feeding and swallowing, including issues surrounding tube feeding; suggested actions to ensure pediatric clients and caregivers are properly prepared for the VFSS evaluation; anatomical illustrations to aid interpretation of findings to caregivers; and a comprehensive glossary.

The authors bill this text as a "comprehensive description of the VFSS procedure with pediatric patients" presented "in the context of a comprehensive pediatric feeding and swallowing evaluation." The text lives up to its billing by providing valuable information to experienced speech-language pathologists who work as part of a pediatric dysphagia team. The authors incorporate theoretical and empirical support throughout the manual, despite their acknowledgment that objective data in the area of pediatric dysphagia are limited. The title of the second part is misleading, however, suggesting that the information contained in this section might be used directly by caregivers. It is more likely that the dysphagia team will use the information as its members interact with caregivers of pediatric patients.

The authors have integrated a substantial amount of information on pediatric dysphagia into a comprehensive, easily readable resource manual. Despite its expense, it should prove to be a valuable resource for professionals working in pediatric dysphagia.