Original Research

The South African dysphagia screening tool (SADS): A screening tool for a developing context

Calli Ostrofsky, Jaishika Seedat
South African Journal of Communication Disorders | Vol 63, No 1 | a117 | DOI: https://doi.org/10.4102/sajcd.v63i1.117 | © 2016 Calli Ostrofsky, Jaishika Seedat | This work is licensed under CC Attribution 4.0
Submitted: 28 January 2015 | Published: 16 February 2016

About the author(s)

Calli Ostrofsky, Department of Speech and Hearing Therapy, University of Witwatersrand, South Africa
Jaishika Seedat, Department of Speech and Hearing Therapy, University of Witwatersrand, South Africa


Background: Notwithstanding its value, there are challenges and limitations to implementing a dysphagia screening tool from a developed contexts in a developing context. The need for a reliable and valid screening tool for dysphagia that considers context, systemic rules and resources was identified to prevent further medical compromise, optimise dysphagia prognosis and ultimately hasten patients’ return to home or work.

Methodology: To establish the validity and reliability of the South African dysphagia screening tool (SADS) for acute stroke patients accessing government hospital services. The study was a quantitative, non-experimental, correlational cross-sectional design with a retrospective component. Convenient sampling was used to recruit 18 speech-language therapists and 63 acute stroke patients from three South African government hospitals. The SADS consists of 20 test items and was administered by speech-language therapists. Screening was followed by a diagnostic dysphagia assessment. The administrator of the tool was not involved in completing the diagnostic assessment, to eliminate bias and prevent contamination of results from screener to diagnostic assessment. Sensitivity, validity and efficacy of the screening tool were evaluated against the results of the diagnostic dysphagia assessment. Cohen’s kappa measures determined inter-rater agreement between the results of the SADS and the diagnostic assessment.

Results and conclusion: The SADS was proven to be valid and reliable. Cohen’s kappa indicated a high inter-rater reliability and showed high sensitivity and adequate specificity in detecting dysphagia amongst acute stroke patients who were at risk for dysphagia. The SADS was characterised by concurrent, content and face validity. As a first step in establishing contextual appropriateness, the SADS is a valid and reliable screening tool that is sensitive in identifying stroke patients at risk for dysphagia within government hospitals in South Africa.


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Crossref Citations

1. Post-stroke dysphagia: An exploration of initial identification and management performed by nurses and doctors
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South African Journal of Communication Disorders  vol: 67  issue: 1  year: 2020  
doi: 10.4102/sajcd.v67i1.625