Table 1.

Guideline for Functional Oral Intake (FOIS) scoring based on a comprehensive swallow evaluation

	Safe swallowing possible for
FOIS level	semisolids	liquids	solids	Quantity of oral intake	Supportive findings
Level 7	Yes	Yes	Yes	Normal portion	• 50 mL water swallow test negative • Any 2 < 2 • PHAD > 90 • GUSS = 20 • FEDSS = 1
Level 6	Yes	Yes	Yes	Normal portion	• 50 mL water swallow test negative • Any 2 < 2 • PHAD ≤ 90 • GUSS 15 to 19 • FEDSS = 2
	Avoid challenging consistencies (e.g., mixed consistencies, crumby food)
Level 5	At least two consistencies can be swallowed securely			Normal portion
Level 4	Yes	No	No	Normal portion	• 50 mL water swallow test positive • Any 2 ≥ 2 • PHAD ≤ 80 • GUSS 10 to 14 • FEDSS 3–4
Level 3	Yes	No	No	≤50% of normal portion
Level 2	Yes	No	No	Only few spoons or sips per mouth
Level 1	No	No	No	Nothing by mouth	• 50 mL water swallow test positive • Any 2 ≥ 2 • PHAD ≤ 80 • GUSS ≤ 9 • FEDSS ≥ 4

“Safe swallowing” corresponds to consistencies that can be safely swallowed by a subject based on the results of the clinical/instrumental swallowing evaluation. “Portion” corresponds to the percent of required intake that is safely consumed by mouth.

Any 2, Any 2 scale [Daniels et al., 1997]; PHAD, Parramatta Hospitals Assessment of Dysphagia [Broadley et al., 2005]; GUSS, Gugging Swallowing Screen [Trapl et al., 2007]; FEDSS, Fiberoptic Endoscopic Dysphagia Severity Scale [Warnecke et al., 2009].