What is the Swallowing Rating Scale for dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Recovery from dysphagia is associated with increased pharyngeal representation in the brain, suggesting brain reorganization in recovery.

Several scales have been suggested to determine patients' functional outcomes. [66, 67, 68] One of them is the Swallowing Rating Scale (recommended by the American Speech-Language-Hearing Association [ASHA]), the categories of which are as follows:

  • level 0: The patient cannot be tested

  • level 1: Swallowing is not functional

  • level 2: Inconsistent and/or delayed swallowing, which hinders eating and therefore prevents the patient from meeting nutritional needs; however, some swallowing is possible

  • level 3: The swallowing disorder prevents eating for a portion of nutritional needs, and supervision is required for eating

  • level 4: The swallowing disorder does not prevent eating to meet nutritional needs, although general supervision is required to ensure the use of compensatory techniques

  • level 5: Swallowing is functional enough to meet nutritional needs, although self-monitoring and compensatory techniques are used; the patient may need occasional cueing, feeding with special techniques, and modifications

  • level 6: Swallowing is functional for most eating activity, although mild difficulty may periodically occur; additional time may be necessary for eating

  • level 7: Swallowing is normal in all situations

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