This White Paper by the European Society for Swallowing Disorders (ESSD) reports on the current state of screening and non-instrumental assessment for dysphagia in adults. An overview is provided on the measures that are available, and how to select screening tools and assessments. Emphasis is placed on different types of screening, patient-reported measures, assessment of anatomy and physiology of the swallowing act, and clinical swallowing evaluation. Many screening and non-instrumental assessments are available for evaluating dysphagia in adults; however, their use may not be warranted due to poor diagnostic performance or lacking robust psychometric properties. This white paper provides recommendations on how to select best evidence-based screening tools and non-instrumental assessments for use in clinical practice targeting different constructs, target populations and respondents, based on criteria for diagnostic performance, psychometric properties (reliability, validity, and responsiveness), and feasibility. In addition, gaps in research that need to be addressed in future studies are discussed. The following recommendations are made: (1) discontinue the use of non-validated dysphagia screening tools and assessments; (2) implement screening using tools that have optimal diagnostic performance in selected populations that are at risk of dysphagia, such as stroke patients, frail older persons, patients with progressive neurological diseases, persons with cerebral palsy, and patients with head and neck cancer; (3) implement measures that demonstrate robust psychometric properties; and (4) provide quality training in dysphagia screening and assessment to all clinicians involved in the care and management of persons with dysphagia.

Background: The psychosocial impact of acquired dysarthria on the speaker is well recognized. To date, speech‐and‐language therapists have no instrument available to measure this construct. This has implications for outcome measurement and for planning intervention. This paper describes the Dysarthria Impact Profile (DIP), an instrument that has the potential to meet this need in clinical practice.Aims: To describe the development of the DIP, which was devised as part of a larger study to measure psychosocial impact of acquired dysarthria from the speaker's perspective.Methods & Procedures: The current psychometric properties of the DIP are examined. The scale was administered to 31 participants with acquired dysarthria. The internal consistency of the scale items and their intra‐rater reliability were investigated. Concurrent validity was assessed for the portion of the scale (Section A) assessing impact of acquired dysarthria on self‐perception, self‐concept and self‐esteem by comparing the results with changes in self‐concept as determined by the Head Injury Semantic Differential Scale (HISD II).Outcomes & Results: The DIP shows good internal consistency and strong intra‐rater reliability overall. There was a strong, statistically significant, correlation between results on Section A of the DIP and the results of the HISD II suggesting convergent validity for this portion of the scale. There are some limitations to the scale in its current format and these are highlighted.Conclusions & Implications: The scale is now ready for further refinement and development. Once validated, it should act as a robust outcome measure for clinicians.

Purpose. To explore the speaker's experience of living with acquired chronic dysarthria. Method. Ten people with dysarthria and progressive neurological illness and one person with dysarthria following stroke were interviewed in depth about their experience of living with dysarthria. They covered a range of ages, time post-onset and dysarthria severity levels. Interviews were transcribed and analysed using Framework Method of Analysis. Results. Acquired dysarthria can negatively impact on speakers' lives. Findings here suggest that the experience of living with dysarthria is highly individual. There were some common perspectives. Six key themes emerged from interviews: ‘dysarthria as only part of the picture’, ‘communication has changed’, ‘people treat me differently’, ‘dysarthria resulting in negative emotions’, ‘barriers to communication’ and ‘life is different now. The impact of co-existing physical disability and the need to consider dysarthria in context was emphasised by all participants. Conclusion. Findings re-emphasise the need to consider the individual experience in clinical practice. The findings provide direction for assessment and intervention in the area.

(1) Background: The volume-viscosity swallow test (V-VST) is a clinical tool for screening and diagnosis of oropharyngeal dysphagia (OD). Our aims were to examine the clinical utility of the V-VST against videofluoroscopy (VFS) or fiberoptic endoscopic evaluation of swallow (FEES) and to map the V-VST usage with patients at risk of OD across the years since it was described for the first time, carrying a systematic and a scoping review. (2) Methods: We performed both a systematic review (SR) including studies that look at the diagnostic test accuracy, and a scoping review (ScR) with articles published from September 2008 to May 2020. Searches were done in different databases, including PubMed and EMBASE from September 2008 until May 2020, and no language restrictions were applied. A meta-analysis was done in the SR to assess the psychometric properties of the V-VST. Quality of studies was assessed by Dutch Cochrane, QUADAS, GRADE (SR), and STROBE (ScR) criteria. The SR protocol was registered on PROSPERO (registration: CRD42020136252). (3) Results: For the diagnostic accuracy SR: four studies were included. V-VST had a diagnostic sensitivity for OD of 93.17%, 81.39% specificity, and an inter-rater reliability Kappa = 0.77. Likelihood ratios (LHR) for OD were 0.08 (LHR–) and 5.01 (LHR+), and the diagnostic odds ratio for OD was 51.18. Quality of studies in SR was graded as high with low risk of bias. In the ScR: 34 studies were retrieved. They indicated that V-VST has been used internationally to assess OD’s prevalence and complications. (4) Conclusions: The V-VST has strong psychometric properties and valid endpoints for OD in different phenotypes of patients. Our results support its utility in the screening and clinical diagnosis and management of OD.