Mann Assessment of Swallowing Ability (MASA) Scoring Sheet
2 5 8 10 Alertness no response to difficult to rouse fluctuates alert speech 2 5 8 10 Cooperation no cooperation reluctant fluctuating cooperation cooperative 6 8 2 4 follows simple follows ordinary 10 Auditory comprehension no response to occasional motor response if cued conversation with conversation with NAD speech repetition little difficulty 2 4 8 6 10 Respiration chest infection coarse basal crepitations fine basal crepitations sputum upper airway chest clear suctioning chest physiotherapy other condition 1 3 5 Respiratory rate (for swallow) no independent some control/uncoordinated able to control breath rate for swallow control 2 3 4 1 5 Dysphasia unable to assess no functional speech expresses self in limited manner mild difficulty finding NAD sounds/single words short phrases/words words or expressing ideas 4 2 3 1 speech accurate after trial 5 Dyspraxia unable to assess groping/inaccurate/partial speech crude/defective in and error, minor searching NAD or irrelevant responses accuracy or speed on command movements 3 4 1 2 5 Dysarthria unable to assess speech unintelligible speech intelligible but slow with occasional NAD obviously defective hesitation or slurring 1 2 3 4 5 Saliva gross drool some drool consistently drooling at times frothy/expectorated NAD 1 3 4 2 5 Lip seal no closure incomplete seal unilaterally weak mild impairment NAD unable to assess poor maintenance occasional leakage 2 4 6 8 10 Tongue movement no movement minimal movement incomplete movement mild impairment in range full ROM 2 5 8 10 Tongue strength gross weakness unilateral weakness minimal weakness NAD 2 5 8 10 Tongue coordination no movement gross incoordination mild incoordination NAD unable to assess 4 6 8 2 10 Oral preparation unable to examine no bolus formation minimal chew thrust lip or tongue seal NAD no attempt gravity assisted bolus escape 5 1 2 3 4 Gag no gag absent unilaterally diminished unilaterally diminished bilaterally hyperreflexive NAD 2 4 8 6 slight asymmetry 10 Palate no spread or minimal movement unilaterally weak NAD elevation nasal regurgitation/air escape mobile 8 2 5 10 Bolus clearance no clearance some clearance/residue significant clearance/ fully cleared minimal residue 2 4 6 8 10 Oral transit no movement delay > 10 sec delay > 5 sec delay > 1 sec NAD observed 1 3 5 Cough reflex none observed/unable to assess weak reflexive cough NAD 2 5 8 10 Voluntary cough no attempt/ attempt inadequate attempt bovine NAD unable to assess 2 8 aphonic 4 6 10 Voice wet/gurgling hoarse mild impairment NAD unable to assess slight huskiness 1 5 10 Trache trache/cuffed trache/fenestrated no trache 8 2 5 laryngeal elevation 10 Pharyngeal phase no swallow pooling/gurgling mildly restricted immediate laryngeal elevation unable to assess laryngeal elevation incomplete slow initiation clearance of material incomplete clearance 1 5 10 Pharyngeal response not coping/gurgling cough before/during/after swallow NAD NBM thick vitamized oddslot diet Diet recommendations risk too great modified soft soft normal