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$129.00 USD


Brand new course


0.45  ASHA CEUs

Dysphagia Intervention for the Esophageal Zone (DIEZ): A Therapeutic Respiratory Technique for Non-Pathologic Esophageal Stasis and Globus #e314


Presenter: Roxann Diez Gross, PhD, CCC-SLP, ASHA Fellow

This course demonstrates the effects of the respiratory cycle on esophageal transport and the successful application of the DIEZ technique.


DIEZ Esophageal Therapy


"This is a fascinating topic and can't wait to try on my patients specifically during outpt mbs - majority are patients with c/o globus."

– L.E., prior course participant

Read more comments about this course!

The Dysphagia Intervention for the Esophageal Zone (DIEZ) is based upon the inverse relationship between intraluminal esophageal pressures and the respiratory cycle. DIEZ is a respiratory-based therapeutic technique for improving esophageal clearance thus helping to eliminate the sensation of food sticking, regurgitation of undigested food, and non-pathologic globus sensation.

This course will fully describe how to determine who is appropriate for this therapy, how to evaluate these patients, provide instructions in how to teach the DIEZ technique to adults and children, and offer tips for making the technique habitual. Supplemental material such as patient and physician handouts are also included.

Basic esophageal and respiratory anatomy and physiology are reviewed. The manner in which the two systems functionally interact for bolus transport will be fully explained. VFSS and case studies are shown that demonstrate the effects of the respiratory cycle on esophageal transport and the successful application of the DIEZ technique. High resolution manometry with impedance is also explained and demonstrated so that learners can better understand the relative amounts and locations of esophageal pressures in relation to the respiratory cycle. The evidence presented in this course makes the case for using high lung volumes and prolonged exhalation when swallowing to address esophageal stasis and globus. This knowledge can also help to expand communication with gastroenterologists and physicians. Content is appropriate for both pediatric and adult clients.

Course is offered for 0.45 ASHA CEUs – 4.5 Contact Hours.

Course Overview – Run Time: 4:36:28

  1. Introduction.
  2. Esophageal Basics.
  3. Effects of Respiratory Cycle on Esophageal Pressures.
  4. Dysphagia Intervention for the Esophageal Zone (DIEZ).
  5. Esophageal Pathology and Medical Evaluation of the Esophagus.
  6. SLP Assessment, Treatment and Goals.
  7. Case Studies.

Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.

DIEZ Esophageal Therapy

The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.

Course Format

Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.

Reviews

"I have many people who complain of Globus. I appreciate the explicit instructions about the technique and the extensive review of the research/evidence; this might be another option or "tool" in my toolbox for how to go about helping patients with symptom mgmt." R.Z. (Jun. 2024)

"This is a fascinating topic and can't wait to try on my patients specifically during outpt mbs - majority are patients with c/o globus. I liked the case studies." L.E. (Jun. 2024)

"I like that this is a new horizon in dysphagia management and something possible that we can offer to the appropriate patient to potentially provide them some relief from their symptoms." K.F. (Jun. 2024)

"It was beneficial to discuss how respiration affects esophageal clearance. The course was easy to follow." M.W. (Jun. 2024)

"Excellent offering in a new technique/strategy to help clients manage their issues." K.W. (May 2024)

Course Objectives

  1. Describe the pressure relationships between the esophagus and the respiratory cycle.

  2. Identify peristalsis and bolus clearance on high resolution manometry images.

  3. Demonstrate how to instruct patients in the DIEZ therapeutic technique.

  4. Identify who is appropriate for evaluation and treatment.

  5. Describe the instrumental and non-instrumental methods for pre and post treatment assessments.

Presenter & Disclosures

Roxann Diez Gross, PhD, CCC-SLP, ASHA Fellow, is a leading expert, accomplished researcher, and frequently invited national and international lecturer. Her areas of expertise include swallowing function, esophageal dysphagia, and management of patients with tracheostomy tubes and speaking valves.

Currently, Dr. Gross is a consultant and clinical specialist for Swallowing Diagnostics, Inc., Parkland, FL. She was the Director of Research at The Children's Institute in Pittsburgh, PA., and prior to this position, she was Director of the Swallowing Disorders Center at the University of Pittsburgh Medical Center and Assistant Professor of Otolaryngology in the School of Medicine.

Dr. Gross has published several scientific papers and clinical book chapters. Most recently, she was the primary editor of a case study textbook that focuses on tracheostomy and ventilator dependence in adults and children. Her primary area of research examines interactions between breathing and swallowing in neurologic and respiratory disease. Over the past 10 years, she has expanded her clinical work and research to include non-pathologic forms of esophageal dysphagia.

Speaker Disclosures:

Financial — Roxann Diez Gross is presenter of online CE courses by Northern Speech Services; receives royalties.

Nonfinancial — Roxann Diez Gross has no relevant nonfinancial relationships to disclose.

Intended Audience / Accreditation

asha ce approved provider

This program is offered for 0.45 ASHA CEUs (Intermediate Level; Professional Area).

Intended Audience

  • Speech-Language Pathologists

ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.

ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:

  • Current ASHA Member
  • ASHA Certificate of Clinical Competence (CCC) Holder
  • Licensed by a state or provincial regulatory agency to practice speech-language pathology (SLP) or audiology
  • Credentialed by a state regulatory agency to practice SLP or audiology
  • Credentialed by a national regulatory agency to practice SLP or audiology
  • Engaged in a Clinical Fellowship under the supervision of an individual with their ASHA CCC
  • Currently enrolled in a master's or doctoral program in SLP or audiology

If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.

Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.

Additional accrediting agencies by which Northern Speech is an approved CE provider:

  • California: NSS is approved as a provider of continuing education by the California Speech-Language Pathology & Audiology Board. Provider #PDP4. Online CEU limits may apply; please contact SLPAHADB for current online CEU acceptance policies.
  • Iowa: NSS is approved as a provider of continuing education by the Iowa Board of Speech Pathology and Audiology Examiners. Provider #169.
  • Kansas: NSS is approved as a provider of continuing education by the Kansas Department of Health and Environment. Provider #LTS-S0005.

Frequently Asked Questions

Customer Support: Please phone 888.337.3866 or email info@northernspeech.com.

Course Completion Timeframe:

You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.

However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.

Content Access:

Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.

Certificate of Completion:

On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.

ASHA CE Registry Submission:

During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.

Purchase Orders:

Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at info@northernspeech.com or fax to 888-696-9655.

What is an Online Course?

Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.

Receiving CEUs:

Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.

Registering for an online course:

You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.

Accessing your purchased course or returning to a purchased course:

You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.

Testing requirements:

Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.

Number of CEUs offered:

We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.

State licensing boards and online CEUs:

NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.

Course formats:

Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.

Course handouts:

Most of our online courses provide a link to download the accompanying handout as a PDF file. 

Group discounts:

Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.

Computer requirements:

For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.

Course Cancellation Policy:

A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded. 

Special Needs:

Please click here for any special needs requests, and we will do our best to accommodate them. 

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