EAT-10 Questionnaire | Eating Assessment Tool (EAT-10)

EAT-10:
A Swallowing Screening Tool

Last Name First Name Sex Age Date
OBJECTIVE:

EAT-10 helps to measure swallowing difficulties.
It may be important for you to talk with your physician about treatment options for symptoms.

A. INSTRUCTIONS:

Answer each question by choosing the number that best describes your condition.
To what extent do you experience the following problems?

1 My swallowing problem has caused me to lose weight.
 0 = No problem
 1
 2
 3
 4 = Severe problem
2 My swallowing problem interferes with my ability to go out for meals.
 0 = No problem
 1
 2
 3
 4 = Severe problem
3Swallowing liquids takes extra effort.
 0 = No problem
 1
 2
 3
 4 = Severe problem
4Swallowing solids takes extra effort.
 0 = No problem
 1
 2
 3
 4 = Severe problem
5Swallowing pills takes extra effort.
 0 = No problem
 1
 2
 3
 4 = Severe problem
6Swallowing is painful.
 0 = No problem
 1
 2
 3
 4 = Severe problem
7 The pleasure of eating is affected by my swallowing.
 0 = No problem
 1
 2
 3
 4 = Severe problem
8When I swallow food sticks in my throat.
 0 = No problem
 1
 2
 3
 4 = Severe problem
9I cough when I eat.
 0 = No problem
 1
 2
 3
 4 = Severe problem
10Swallowing is stressful.
 0 = No problem
 1
 2
 3
 4 = Severe problem
B. SCORING:

Add up the number of points and write your total score in the boxes.
Total score (max. 40 points)

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C. WHAT TO DO NEXT:
If the EAT-10 score is 3 or higher, you may have problems swallowing efficiently and safely. We recommend discussing the EAT-10 results with a physician.

References: The validity and reliability of EAT-10 has been determined.
Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and Reliability of the Eating Assessment Tool (EAT-10). Annals of Otology Rhinology & Laryngology 2008;117(12):919-924.

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