1. What does the name MannaQure mean and how do you pronounce it?
"Manna"-Found in the book of Exodus, the food that was miraculously provided for the Israelites in the wilderness during their flight from Egypt. "Manna"-Mentioned in the bible, spiritual nourishment of divine origin. MannaQure is pronounced Manna.

2. Why does the monolingual SLP need MannaQure?
The US Census Bureau 2012 data estimates 12-14% of the population in the states of CA and TX will be Spanish-speaking only, which is equitable to a combined total of over six million people in those states alone, not to mention NM, AZ, NV, FL, NY, NJ, IL and CO. Patients with dysphagia, per ASHAs 2008 special populations reached 22% for those fifty years of age and older with an estimated ten million Americans evaluated by SLPs each year. In an attempt to meet these demands placed on the monolingual SLP, MannaQure provides accurate translation of medical terms, includes a Functional Pronunciation Guide and aids SLPs in seeking life-long learning to develop those knowledge and skills required to provide culturally and linguistically appropriate services per ASHAs Principle of Ethics II, rules B and C, 2013. The results of the standardization research indicated that any SLP, regardless of their level of Spanish-speaking ability, may administer and interpret the assessment items to aid in the development patient's deficits.

3. How would a bilingual SLP benefit from MannaQure?
The bilingual SLP will also benefit from the use of the MannaQure assessment given the variations in regional dialects, cultural differences, and accents that may exist among speakers and may therefore alter outcomes. MannaQure provides professional medical terminology pertaining to the disorders of dysphagia and dysarthria in a manner that is appropriate and that the patients are able to comprehend. Fifty-percent of the clinicians who participated in the research development, varying in levels of Spanish-speaking fluency with four of the six described as native or near-native levels of proficiency, provided feedback and 100% agreed or strongly agreed that the tool is effective in the identification of their patient's deficits.

4. What was the rationale for MannaQure test-development?
Review of the "Demographic Profile of American Speech-Language Hearing Association Members Providing Bilingual Services August 2012" reveals that of the 150,241 individuals represented by ASHA, 7039 (5%) indicated they met the ASHA definition of a bilingual service provider. While ASHA does not offer bilingual certification, the organization did request on the 2012 dues notice that ASHA members self identify as being bilingual based on ASHA's policy. Clearly, the demand being placed on the monolingual clinician exceeds the supply of bilingual SLPs; this fact, coupled with the lack of materials currently available for SLPs in today's market, necessitated the development of MannaQure.

5. Why did the developers of the MannaQure Comprehensive English to Spanish Assessment of Dysphagia and Dysarthria create a Functional Pronunciation Guide vs providing traditional phonetic transcription of the test items?
The research and development phase of MannaQure revealed that consistent consonants and vowels across both languages necessary for phonetic transcription to aid in pronunciation critical for accurate administration do not exist. The Functional Pronunciation Guide was also included with sensitivity toward the SLPs who do speak Spanish however may not be familiar or comfortable with transcription of the Spanish phonetic alphabet.

6. How was the Functional Pronunciation Guide developed?
The Functional Pronunciation Guide was developed in the clinical setting to aid the SLP in adequate articulation of test items and was developed with sensitivity toward the clinician's level of fluency and the need to ensure the examinee's comprehension-level of instruction.

7. Why did the MannaQure Team include Cognitive-Communication test items in an assessment of dysphagia and dysarthria disorders?
An assessment of receptive/expressive language along with cognitive-communication test items was included to enable the SLP to assess the patient's ability to comprehend and answer yes/no questions, follow one and two-step directives, answer WH-questions, requires the examinee to produce automatic sequences and state self-biographical information with increasing length and complexity, all of which may be necessary for active and functional participation in a traditional treatment program. Immediate memory, temporal orientation, and recall of general information items require responses from recent and remote memory in additional to organizational skills are included per the Center for Medicare and Medicaid's (CMS) ability to learn and retain new information guideline for skilled ST intervention.

8. Why would an SLP administer the Patient/Caregiver Informant Questionnaire if he/she intends to administer the assessment?
The Patient/Informant Awareness of Dysphagia and Dysarthria Questionnaire allows for keen insight to the scope and duration of deficits as perceived by the patient and their respective caregivers. Social workers, intake coordinators, case managers or admission personnel gathering patient history upon admission or during the care-plan meeting may benefit from utilization of this tool in preparation for an evaluation by the SLP.

9. What information is the SLP to glean from the Oral-Facial Stimulability Probe?
This probe of the Oral Mechanism Function Evaluation is intended to be administered to patients for whom the level of alertness/impairment is deemed to be profound per their inability to produce three consecutive functional responses to prior subset test items. Information regarding the intact function of Cranial Nerve I/Olfactory Nerve, Cranial Nerve II/Optic Nerve, Cranial Nerve III/Oculomotor Nerve, Cranial Nerve IV/Trochlear Nerve, Cranial Nerve V/Trigeminal Nerve, Cranial Nerve VI/Abducent Nerve, and Cranial Nerve IX/Glossopharyngeal Nerve is examined to determine whether or not the patient is stimulable for treatment necessary for the expectation of improvement.

10. How do I treat my Spanish-speaking patients who are unable to follow one-step commands, imitate oral-facial musculature movements or exercises typically expected for participation in a traditional skilled ST treatment program?
Treat speakers of other languages just as you would any other: The presence of behaviors and/or responses observed, along with information from the administration of the Oral-Facial Stimulability Probe, should alert and subsequently guide the clinician in determining whether or not the patient is capable of making gains facilitative toward an enhanced quality of life through treatment. Possible positive responses to stimulation, which should be included in an effective treatment program, may include behaviors such as flaring of nares, oral-facial movement or grimace, localization to sound or stimulation, ocular or head movements, and swallow initiation evidenced by laryngeal movement; all of which may be targeted as goals for improvement in a trial treatment regimen.

11. I've administered the MannaQure Assessment; what do I do now?
The results of the developmental research indicate that the clinicians who participated were able to administer and interpret the assessment items to aid in the development of their patient's treatment of dysphagia and/or dysarthria type deficits through repetition, adaptation and utilization of the subset test items throughout the course therapy. Any SLP, regardless of their level of Spanish-speaking ability, may modify the directives used in the assessment to enhance their treatment program. The developers of the MannaQure assessment intend to create and further develop a comprehensive treatment protocol for each corresponding subset soon to be released.