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NOMS Rating Scale

NOMS Dysphagia Rating Scale

LevelTermDefinition
Level 6 Minimal Dysphagia Swallowing is safe; the individual eats and drinks independently and may rarely req. minimal cueing. Patient usually self-cues when difficulty occurs. May need to avoid specific food items (e.g. popcorn and nuts) or req. add'l time (due to dysphagia).
Level 5 Mild Dysphagia Swallowing is safe w/ minimal diet restriction and/or occassionally requires minimal cueing to use compensatory strategies. Patient may occasionally self-cue. All nutrition and hydration needs are met by mouth at mealtime.
Level 4 Mild-Moderate Dysphagia Swallowing is safe, but usually requires moderate cues to use compensatory strategies, and/or the patient has moderate diet restrictions, and/or still requires tube feeding and/or oral supplements.
Level 3 Moderate Dysphagia Alternative method of feeding required as patient takes less than 50% of nutrition and hydration by mouth, and/or swallowing is safe with consistent use of moderate cues to use compensatory strategies, and/or requires maximum diet restriction.
Level 2 Moderate-Severe Dysphagia Patient is not able to swallow safely by mouth for nutrition and hydration, but may take some consistency with consistent maximal cues in therapy only. Alternative method of feeding required.
Level 1 Severe Dysphagia Patient is not able to swallow anything safely by mouth. All nutrition and hydration is received through non-oral means (e.g. nasogastric tube, PEG).
Level 7 Fxnal Swallow Patient's ability to eat independently is not ltd by swallow fxn. Compensatory strategies are effectively used when needed.
Created by: katieb67
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