Clinical Assessment of Swallowing and Prediction of Dysphagia Severity Dysphagia with aspiration is prevalent in acute stroke; however, noninvasive clinical screening assessments to identify patients at risk of developing aspiration are limited. This study was undertaken to determine whether risk factors detected in the clinical examination approximated the videofluoroscopic swallow study (VSS) in identification of dysphagia severity. Six clinical ... Research Article
Research Article  |   November 01, 1997
Clinical Assessment of Swallowing and Prediction of Dysphagia Severity
 
Author Affiliations & Notes
  • Stephanie K. Daniels
    Department of Veteran Affairs Medical Center and Tulane University School of Medicine, New Orleans
  • Colleen P. McAdam
    Alton Ochsner Medical Foundation, New Orleans
  • Kevin Brailey
    Department of Veteran Affairs Medical Center and Tulane University School of Medicine, New Orleans
  • Anne L. Foundas
    Department of Veteran Affairs Medical Center and Tulane University School of Medicine, New Orleans
  • Contact author: Stephanie K. Daniels, MS, Speech Pathology, Department of Veteran Affairs Medical Center, 1601 Perdido Street, New Orleans, LA 70146, Email: daniels.stephanie_k@new-orleans.med.va.gov
Article Information
Swallowing, Dysphagia & Feeding Disorders / Research Articles
Research Article   |   November 01, 1997
Clinical Assessment of Swallowing and Prediction of Dysphagia Severity
American Journal of Speech-Language Pathology, November 1997, Vol. 6, 17-24. doi:10.1044/1058-0360.0604.17
History: Received July 7, 1997 , Accepted September 4, 1997
 
American Journal of Speech-Language Pathology, November 1997, Vol. 6, 17-24. doi:10.1044/1058-0360.0604.17
History: Received July 7, 1997; Accepted September 4, 1997

Dysphagia with aspiration is prevalent in acute stroke; however, noninvasive clinical screening assessments to identify patients at risk of developing aspiration are limited. This study was undertaken to determine whether risk factors detected in the clinical examination approximated the videofluoroscopic swallow study (VSS) in identification of dysphagia severity. Six clinical features—dysphonia, dysarthria, abnormal volitional cough, abnormal gag reflex, cough after swallow, and voice change after swallow—were assessed by means of an oropharyngeal evaluation and a clinical swallowing examination. Clinical assessments and VSS were completed on consecutive stroke patients (n=59) within 5 days of hospital admission. The VSS was scored on a scale of 0 to 4 (0=normal, 1=mild, 2=moderate, 3=moderate-severe, 4=severe dysphagia). Results showed that the presence of at least 2 of the 6 clinical features consistently distinguished patients with moderate to severe dysphagia from patients with mild dysphagia/normal swallowing. These data demonstrate that this clinical dysphagia screening tool can provide objective criteria for the need for VSS in acute stroke patients.

Author Note
The authors gratefully acknowledge the Research Service of VAMC, New Orleans, and the constructive comments of Donald A. Robin and Thomas W. Powell.
Order a Subscription
Pay Per View
Entire American Journal of Speech-Language Pathology content & archive
24-hour access
This Article
24-hour access