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The Swallowing Clinical Assessment Score in Parkinson's Disease (SCAS-PD)
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Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
The Swallowing Clinical Assessment in PD (SCAS-PD) aims to identify the occurrence of specific alterations of each phase of swallowing (oral, pharyngeal, and laryngotracheal) giving the patient 3 different consistencies of food: 20 ml liquid (water), 10 ml paste (liquid with pudding consistency), and one unit solid (salt cracker).
Comments/Special Instructions
The SCAS-PD is not a patient-completed scale, but rather a clinical assessment. It consists of 12 items, evaluating aspects of the oral stage of swallowing (prehension of food, labial discharge, oral transit time, and presence of residue), the pharyngeal stage of swallowing (multiple deglutition, laryngeal elevation, and cervical auscultation), and the signs of laryngotracheal penetration/aspiration (throat clearing, cough, change in vocal quality, choking, and respiratory impairment).
The SCAS-PD is designed to be administered by a trained speech pathologist capable of identifying the clinical signs of laryngotracheal penetration/aspiration that are a component of the tool.
Scoring and Psychometric Properties
Scoring: The SCAS-PD consists of 12 items that assess 3 phases:
  1. Oral phase - Max score 18 after the 3 evaluated swallows.
  2. Pharyngeal phase - Max score of 66.
  3. Signs of laryngotracheal aspiration - Max score 270. Range 0 to 354 points. Requires cervical auscultation. Levels of severity: normal =2, functional swallowing >2 =15, mild dysphagia >15 =35, moderate dysphagia >35 =60, severe dysphagia >60.
Psychometric Properties: Limited clinimetric data are available. In the initial report, SCAS-PD internal consistency was a= 0.91 for the total score, 0.73 for the oral phase, 0.86 for the pharyngeal phase, and 0.95 for signs of penetration/aspiration. Severity of dysphagia (at any level) displayed a sensitivity of 100% with a specificity of 87.5%; for moderate-severe dysphagia the sensitivity was 100% and specificity was 87%. No test-retest information was available.
Strengths: The SCAS-PD demonstrates good concordance with the videofluoroscopic swallowing study (VFSS) and can be considered a relatively simple, low-cost, diagnostic tool and substitute for the VFSS.
Weaknesses: The SCAS-PD is not a simple, patient-completed questionnaire, but rather a formal assessment that should be applied by a trained speech pathologist capable of identifying the clinical signs of laryngotracheal penetration/aspiration. Therefore, it is not a routine screening tool for clinical office use or clinical trials.
Key References:
Loureiro F, Nobrega AC, Sampaio M, Argolo N, Dalbem A, Melo A, Gomes I. A Swallowing Clinical Assessment Score (SCAS) to evaluate outpatients with Parkinson's disease. PAJAR - Pan American Journal of Aging Research. 2013;1(1),16-19.
Branco LL, Trentin S, Augustin Schwanke CH, Gomes I, Loureiro F. The Swallowing Clinical Assessment Score in Parkinson's Disease (SCAS-PD) Is a Valid and Low-Cost Tool for Evaluation of Dysphagia: A Gold-Standard Comparison Study. J Aging Res. 2019 Mar 13;2019:7984635.
Document last updated August 2022