Final answer:
ASHA defines the indications for an instrumental examination in cases where detailed assessment of the swallowing mechanism is necessary beyond what can be observed in a regular clinical exam of the oral cavity and pharynx.
Step-by-step explanation:
The ASHA document Clinical Indicators of Instrumental Assessment of Dysphagia specifies when an instrumental examination is indicated for making a diagnosis and/or planning effective management and treatment of dysphagia. An instrumental examination is typically indicated when there is a need to visually assess the structure and function of the swallowing mechanism in more detail than what can be observed during a basic oral exam. Such an assessment is beyond the inspection of the oral cavity and pharynx that is commonly performed during a medical exam using a tongue depressor to look for signs of infection or to test cranial nerve function. Instead, instrumental assessments such as videofluoroscopy or fiberoptic endoscopic evaluation of swallowing (FEES) are used to obtain a dynamic, real-time visualization of the swallowing process, revealing issues that may not be detectable through a standard clinical examination.