, Volume 27, Issue 1, pp 46–52 | Cite as

The Dysphagia Handicap Index: Development and Validation

  • Alice K. SilbergleitEmail author
  • Lonni Schultz
  • Barbara H. Jacobson
  • Tausha Beardsley
  • Alex F. Johnson
Original Article


Quality-of-life indicators for dysphagia provide invaluable information to the treating clinician regarding the success or failure of swallowing therapy. The purpose of this study was to develop a clinically efficient, statistically robust patient-reported outcomes tool that measures the handicapping effect of dysphagia on emotional, functional, and physical aspects of individual’s lives. 60 statements describing the handicapping effect of dysphagia were collected from patient reports and divided into subscales of physical, emotional, and functional problems. The statements were presented to 77 individuals with dysphagia. Respondents replied never, sometimes, or always to each statement and rated their self-perceived dysphagia severity on a 7-point equal-appearing interval scale. Cronbach’s α was performed to assess the internal consistency validation of the items within the questionnaire. The final questionnaire was reduced to 25 items and administered to 214 individuals with dysphagia and 74 controls. Test–retest was performed on 63 individuals with dysphagia. Cronbach’s α for the initial and final versions was strong at r = 0.96 and r = 0.94, respectively. Significant differences occurred between the dysphagia and control groups. Test–retest reliability was strong. We present a new, easy-to-complete, statistically robust, patient-reported outcomes measure for assessing the handicapping effect of dysphagia.


Dysphagia Handicap Quality of life Patient-reported outcomes Deglutition Deglutition disorders 



The authors gratefully acknowledge the staff of the Division of Speech-Language Sciences and Disorders, Department of Neurology, Henry Ford Hospitals and Health Network for their assistance in data collection for this study.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alice K. Silbergleit
    • 1
    Email author
  • Lonni Schultz
    • 2
  • Barbara H. Jacobson
    • 3
  • Tausha Beardsley
    • 1
  • Alex F. Johnson
    • 4
  1. 1.Division of Speech-Language Sciences and Disorders, Department of NeurologyHenry Ford Hospitals and Health NetworkDetroitUSA
  2. 2.Department of Biostatistics and Research EpidemiologyHenry Ford Hospitals and Health NetworkDetroitUSA
  3. 3.Voice CenterVanderbilt UniversityNashvilleUSA
  4. 4.Communication Sciences and DisordersMGH Institute of Health ProfessionsBostonUSA

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