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NOMS Rating Scale
NOMS Dysphagia Rating Scale
| Level | Term | Definition |
|---|---|---|
| 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. |