Mann Assessment of Swallowing Ability (MASA) Scoring SheetAlertness

2no response to

speech

5difficult to rouse

8fluctuates

10alert

Cooperation 2no cooperation

5reluctant

8fluctuating cooperation

10cooperative

Auditory comprehension2

no response to speech

4occasional motor response if cued

6follows simple

conversation withrepetition

8follows ordinary

conversation with little difficulty

10NAD

Respiration2

chest infectionsuctioning

4coarse basal crepitations

chest physiotherapy

6fine basal crepitations

8sputum upper airway

other condition

10chest clear

Respiratory rate (for swallow)1

no independentcontrol

3some control/uncoordinated

5able to control breath rate for swallow

Dysphasia 1unable to assess

2no functional speechsounds/single words

3expresses self in limited manner

short phrases/words

4mild difficulty finding

words or expressing ideas

5NAD

Dyspraxia 1unable to assess

2groping/inaccurate/partial

or irrelevant responses

3speech crude/defective in

accuracy or speed on command

4speech accurate after trial

and error, minor searchingmovements

5NAD

Dysarthria 1unable to assess

2speech unintelligible

3speech intelligible but

obviously defective

4slow with occasional hesitation or slurring

5NAD

Saliva 1gross drool

2some drool consistently

3drooling at times

4frothy/expectorated

5NAD

Lip seal1

no closureunable to assess

2incomplete seal

3unilaterally weak poor maintenance

4mild impairment occasional leakage

5NAD

Tongue movement 2no movement

4minimal movement

6incomplete movement

8mild impairment in range

10full ROM

Tongue strength 2gross weakness

5unilateral weakness

8minimal weakness

10NAD

Tongue coordination2

no movement unable to assess

5gross incoordination

8mild incoordination

10NAD

Oral preparation 2unable to examine

4no bolus formation

no attempt

6minimal chew thrust

gravity assisted

8lip or tongue seal

bolus escape

10NAD

Gag 1no gag

2absent unilaterally

3diminished unilaterally

4diminished bilaterally

5hyperreflexive

NAD

Palate2

no spread or elevation

4minimal movement

nasal regurgitation/air escape

6unilaterally weak

8slight asymmetry

mobile

10NAD

Bolus clearance 2no clearance

5some clearance/residue

8significant clearance/

minimal residue

10fully cleared

Oral transit2

no movementobserved

4delay > 10 sec

6delay > 5 sec

8delay > 1 sec

10NAD

Cough reflex 1none observed/unable to assess

3weak reflexive cough

5NAD

Voluntary cough2

no attempt/ unable to assess

5attempt inadequate

8attempt bovine

10NAD

Voice2

aphonicunable to assess

4wet/gurgling

6hoarse

8mild impairmentslight huskiness

10NAD

Trache 1trache/cuffed

5trache/fenestrated

10no trache

Pharyngeal phase2

no swallow unable to assess

5pooling/gurgling

laryngeal elevation incomplete

8laryngeal elevation mildly restricted slow initiation

incomplete clearance

10immediate laryngeal elevation

clearance of material

Pharyngeal response 1not coping/gurgling

5cough before/during/after swallow

10NAD

Diet recommendations NBMrisk too great thick vitamized diet modified soft soft normal

Fluid recommendation NBM thick fluid (batter) thick (honey) thick (nectar) normal

Swallow integrityDysphagiaAspiration

definite

dysphagia

aspiration

probable

dysphagia

aspiration

possible

dysphagia

aspiration

unlikely

dysphagia

aspiration

Total = � � �

Additional Problems:Summary:Recommendations:Diagnosis:Date: Signature:

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