, Volume 18, Issue 2, pp 101–113 | Cite as

McGill Ingestive Skills Assessment (MISA): Development and First Field Test of an Evaluation of Functional Ingestive Skills of Elderly Persons

  • Heather C. Lambert
  • Erika G. Gisel
  • Michael E. Groher
  • Sharon Wood–Dauphinee


There is a lack of reliable and valid clinical assessment tools for individuals with loss of ingestive skills. The McGill Ingestive Skills Assessment (MISA) was developed to facilitate the reliable and valid bedside assessment of elderly persons with feeding difficulties. Items were generated by a literature review and selected with the collaboration of a multidisciplinary team. The first version of the MISA comprised 190 items in 7 scales, covering the domains of medical history, mealtime environment, physical characteristics of the patient, food textures consumed, solid ingestion, liquid ingestion, and behaviors related to self-feeding. The first field test for item selection included 50 individuals, aged 60 years and older, living in the community, supervised housing, and long-term care centers. After field testing, 134 items were eliminated due to poor face validity, redundancy, or poor psychometric performance. The remaining 56 items were provided with 4 response categories and were reorganized into 5 scales. The revised version was field tested to determine its preliminary psychometric properties on 33 individuals, 60 years of age and older, residing in a long-term care center. Six items were eliminated due to redundancy after the second field test. Analyses of the revised version resulted in the elimination of another 6 items that were redundant or that demonstrated poor reliability. Internal consistency of all scales is ≥0.86 and interrater agreement is ≥0.92. These analyses suggest that the psychometric properties of the MISA are adequate for diagnosis and treatment planning. This supports its readiness for clinical use following further reliability and validity testing with a larger sample


Dysphagia Clinical Feeding Neurologic impairment Psychometric properties Deglutition Deglutition disorders 



The authors wish to acknowledge the assistance of Dr. M. Abrahamowicz in the development of the project, data analysis, and in the preparation of this manuscript. This study was funded in part by a Health Canada NHRDP Fellowship, a REPAR Fellowship, a doctoral bursary from the Fonds de la Recherche en Santé du Quebec, and a Canadian Occupational Therapy Foundation–Royal Canadian Legion Fellowship in Gerontology to H.L.


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Copyright information

© Springer-Verlag New York Inc. 2003

Authors and Affiliations

  • Heather C. Lambert
    • 1
  • Erika G. Gisel
    • 1
  • Michael E. Groher
    • 2
  • Sharon Wood–Dauphinee
    • 2
  1. 1.School of Physical and Occupational TherapyMcGill University, Montreal, QuebecCanada
  2. 2.College of Health ProfessionsUniversity of Florida, Gainesville, FloridaUSA

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