Dysphagia Self-Test - American Dysphagia Network

American Dysphagia Network	A network for the prevention, diagnosis & treatment of swallowing disorders.

Self-Test for Swallowing Disorders (Dysphagia)

Below are some general questions related to swallowing.

Please read each question and click on the "Yes" or "No" box next to each question.
When you have finished answering ALL of the questions, click on the "Submit My Test Now" button.

Your results will come back to you immediately.

Yes No	Does food sometimes go down the wrong pipe?
Yes No	Does your voice sometimes sound "gurgly" or wet when you eat?
Yes No	Is eating sometimes less enjoyable than it used to be?
Yes No	Do you sometimes have trouble clearing food from your mouth in one swallow?
Yes No	Do you sometimes get the feeling that food is stuck in your throat?
Yes No	Have you had repeated pneumonia or other respiratory illnesses?
Yes No	Have you ever lost weight without trying?
Yes No	Do you often have trouble swallowing medications?
Yes No	Do you often choke or cough when you eat solid foods or swallow liquids?
Yes No	Do you often have difficulty swallowing a specific food or liquid?
Your age:

The self-test is also available in the following languages in PDF form:

Reference: UniHealth Foundation. (2008, February). Dysphagia Care Among Seniors in Los Angeles County: Planning and Pilot Study. (Grant 912). Los Angeles, CA: Logemann, J.A., Stewart, C., Hurd, J., Aschmann, D., Matthews, N. & Reimer, T., Calahan, S., Taylor, S., & Burton, W.