Presenter: James L. Coyle, PhD, CCC-SLP, BCS-S, ASHA Fellow
"I like that this course went through how the PAS was created and reason for it. We use PAS in our MBSS notes, but no one has had any further education on it, so I wasn't sure if we were even using it correctly!"
– M.G., prior course participant
The penetration-aspiration scale was published more than 25 years ago and has been in widespread use in both clinical and research settings. It was designed to limit the seemingly infinite ways of describing airway compromise events on MBS/VFSS videos into a comprehensive and manageable set of descriptors, to provide an ordinal method of rating severity of airway protection impairment, and to help establish the answer to "what is normal airway protection" for healthy individuals.
This course presents the motivation and rationale behind development of the PA Scale. It overviews anatomic landmarks denoting separation between critical airway subdivisions of the pharynx, larynx and trachea, and provides examples of each PAS score in MBS/VFS images. Learn which PAS scores are typically occurring, especially for older individuals. Common judgment errors and methods of resolving uncertainties in score selection will be discussed, along with a handy decision-making algorithm for using the PAS. Course focus is the adult population.
Course is offered for 0.2 ASHA CEUs – 2 contact hours.
Course Overview – Run Time 02:11:13
Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.
"I feel after watching this course that I can immediately apply it in therapy today. Can easily bridge the research-to-clinical practice gap with this knowledge."
– H.H., prior course participant
The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.
Video PowerPoint presentation with author narration & downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.
"Well organized course. Discussing the pros and cons of the PAS scale was beneficial." D.P. (Nov. 2023)
"Discussing how to use and interpret PAS scores in conjunction with the narrative description was helpful. I enjoyed the important information given in several contexts, repeated, shown in charts, diagrams, etc." G.S. (Nov. 2023)
"I liked the speaker's ability to keep it interesting and realistic. The rationale re: the scale and appropriate applications/use was beneficial." M.G. (Nov. 2023)
"The description of each level of the scale was beneficial. I enjoyed the inclusion of video with anatomical drawing." C.G. (Nov. 2023)
"Very clear content. Landmarks and real video examples were helpful. The quiz was also helpful in the way it was phrased to help consolidate learning." M.B. (Nov. 2023)
"The anatomy review was beneficial." M.T. (Nov. 2023)
"The sections about how NOT to use the PAS were helpful. This course clarified a lot of my points of confusion regarding the purpose and administration of this scale." N.A. (Nov. 2023)
"I liked the clinical relevance. And discussion of the appropriate use of the PAS." J.R. (Oct. 2023)
"The presenter was very knowledgeable & used many visuals with detailed explanations and landmarks." A.H. (Oct. 2023)
"Learning how to correctly score each swallow was beneficial. I liked the discussion of the limitations of scores and the importance of describing the pattern." C.B. (Oct. 2023)
"I liked the images of MBS with multiple arrows showing anatomical differences in structure. Review of anatomy was beneficial." N.C. (Oct. 2023)
"Good examples and review of application of scale in clinical practice." N.A. (Oct. 2023)
"I liked the examples of each score. It was beneficial to understand the severity of scores." K.S. (Oct. 2023)
"The practical application of the PAS and how to document the results using the PAS to judge treatment efficacy was beneficial. I liked the flexibility to watch this course at anytime and anywhere. Easy to stop and repeat so I could avoid misunderstanding." B.A. (Sep. 2023)
"Easy to follow course that kept my attention. The test was adequate to recall knowledge. I liked the ease of use." C.O. (Sep. 2023)
"Loved watching the MBS examples. Anatomy review was fantastic. Really appreciated how speaker continued to address/review/point out anatomy throughout multiple examples." C.L. (Sep. 2023)
"Anything Dr. Coyle presents is extremely useful! Discussing how to "tell a story" in narrative form on reports and surrogate anatomical landmarks was helpful." L.G. (Sep. 2023)
"PAS scoring criteria was beneficial. I liked the speaker." K.K. (Aug. 2023)
"All of it was great. Very valuable in practice." V.W. (Aug. 2023)
"I liked the sample videos for each score. It was beneficial to learn how to describe what I see, penetration & aspiration, and to what degree." M.D. (Jul. 2023)
"This course was current, thorough, and very well done! I LOVED the explanations with diagrams of the anatomy." W.H. (Jul. 2023)
"Great course, very useful. I've been using the PA scale for years, and this course provided some great additional information and clarification on how it should be used. I liked everything." A.L. (Jul. 2023)
"Learning about the landmarks used to make judgments on PAS scores was beneficial. I liked having the diagrams and VF images to illustrate the different PAS scores." N.H. (Jun. 2023)
"The guidelines for using PAS when reviewing MBSS images were beneficial. I liked the clarification for PAS use guidelines and the anatomical refresher." L.I. (Jun. 2023)
"Very informative course and great anatomy review. I liked the specific PAS scoring." K.V. (Jun. 2023)
"Discussion of whether or not to use PAS scores in reports was beneficial. I liked the tent analogy for VF's." A.J. (May 2023)
"This course went into depth of anatomy on the VFSS. The video examples of PAS were beneficial." T.P. (May 2023)
"I benefited from the review of the anatomical structures visible via MBS images. I liked the various examples of each PAS score." M.M. (May 2023)
"How to use the PAS in my evaluation and reports was beneficial. It's all about judgment and nuances." C.T. (May 2023)
"This was fantastic!! Defining the PAS and pairing it with the anatomy was great. Presenter's speaking manner was engaging and informative." L.D. (May 2023)
"Anatomy and landmarks were beneficial! I liked learning how to comprehensively use the PAS score." R.P. (Apr. 2023)
"I liked the anatomical examples, the descriptions of PA scores, format to describing these, and patterns in reports was useful. I liked the interaction from the presenter - highlighting/drawing on slides whilst talking. The visual elements were clear and useful - diagrams and anatomical images, etc." T.K. (Mar. 2023)
"It was beneficial to review anatomy on MBSS, so when reading reports or viewing the videofluoroscopy, I am more clear on what I am observing. I liked the videos and anatomy pictures as I am a visual learner." B.G. (Mar. 2023)
"The whole course was very informative and easy to follow along! It will help standardize how we rank scores during MBSS." K.V. (Mar. 2023)
"I always love learning from Dr. Coyle. I liked the penned-in examples he provided. Anatomical landmarks were beneficial." A.P. (Mar. 2023)
"I liked the expertise of the presenter, and the visual material was clear and helpful. Some anatomical notions and vocabulary that have been clarified in my mind were beneficial as well as the research results about what's normal in swallowing and how to judge PAS when the cough is NOT spontaneous." A.P. (Mar. 2023)
"Course was to the point. I liked the anatomy review and the understanding to not use the score as a descriptor number, but to use the number as a reference for myself to develop descriptions of the patient’s swallow." J.H. (Mar. 2023)
"Review of anatomy and practice videos were beneficial." J.V. (Mar. 2023)
"The presenter was thorough and clear. I enjoyed the presentation. The use of the PAS and the discussion about how it was developed was interesting. I also liked how the study gave us a perspective of the normal PAS scores." L.S. (Mar. 2023)
"I feel after watching this course that I can immediately apply it in therapy today. Can easily bridge the research-to-clinical practice gap with this knowledge." H.H. (Mar. 2023)
"Liked viewing VFSS and the application to report writing. Many examples and thorough explanations of landmarks." S.G. (Mar. 2023)
"All of this content is beneficial to my practice." L.M. (Mar. 2023)
"Learned ways to use PENASP scale in practice." R.M. (Feb. 2023)
"I liked the review of the anatomy with where to look for deep and shallow penetration." S.P. (Feb. 2023)
"Concise information. Using PAS scores to determine a pattern." M.K. (Feb. 2023)
"Scoring parameters and clinical judgment/reasoning of results were beneficial. The presentation used alternate references to anatomical structures facilitating greater comprehension." D.B. (Feb. 2023)
"I liked the presenter's clear presentation style and specificity of examples. Discussion about how to score the PAS and use descriptions, not necessarily scores." C.K. (Feb. 2023)
"Importance of identifying and describing patterns in airway invasion characterized by frequency, depth, residue, and patient response. Review of anatomical landmarks and limitation on x-ray." D.Z. (Feb. 2023)
"Further discussion of anatomy/physiology, explanations of valid ways to interpret the data. I thought the course was nicely paced and organized." E.W. (Feb. 2023)
"Anatomical boundaries for judgement of P/A scores. Discussion of identification and use of anatomical structures to aid PAS score decisions was beneficial." R.S. (Feb. 2023)
"Using anatomical landmarks to determine PAS score." T.L. (Feb. 2023)
"Highly relevant to my practice and will be utilized daily." J.W. (Feb. 2023)
"Good clarity and standardization. I liked the detailed identification of anatomical markers in identifying aspiration/penetration and the functional application to diagnosing and treating dysphagia. Many times other clinicians assume everyone is able to identify these things as they have been doing it for years, but when learning from several mentors at a time, it can become a gray area as to how things are interpreted." J.N. (Feb. 2023)
"I liked the videos showing what each score would look like." L.D. (Jan. 2023)
"Course was extremely thorough and very well laid out. I liked the review of the anatomy to discuss the differences between deep laryngeal penetration and aspiration." A.R. (Jan. 2023)
"Dr. Coyle was very organized, had a nice calm presentation and with good examples." P.M. (Jan. 2023)
"I liked the anatomical structures (refresher) during MBSS. Appropriate use of PAS. Presented well." R.J. (Jan. 2023)
"Excellent speaker; enjoyable to listen to. Anatomical landmarks used in scoring the PAS were beneficial. I liked the pace of the presentation; speaker was very thorough." S.D. (Jan. 2023)
"I have been waiting for this course since I started doing videofluoroscopy!" A.S. (Jan. 2023)
"Loved the critical thinking and how to use PAS scale scores in clinical practice versus research. Anything that Dr. Coyle presents is wonderful. He is a talented speaker and makes complex information digestible." J.K. (Jan. 2023)
"Learning the development and functional use of the scale was beneficial. I find all of James Coyle's courses to be practical and applicable to daily practice and interventions." A.P. (Jan. 2023)
"Learning proper way to use the tool, nuances to ensure accuracy of scoring. Speaker was knowledgeable and engaging." K.S. (Dec. 2022)
"Anatomy review was beneficial. I liked the video examples and explanations." H.B. (Dec. 2022)
"The discussion of what the borders are to count the bolus as being penetrated or aspirated was beneficial. I liked the sample narrative to show how the scores should be summarized. I liked how specific course was and how immediately the information/methods could be utilized. I liked that it went into detail with all the anatomy which is absolutely necessary to accurately score for the PA scale." K.L. (Dec. 2022)
"Good clarity of information presented." D.D. (Dec. 2022)
"The whole thing: this was a very clear, well-organized course. We don't use the scale at my place of work, but it is occasionally used in hospital charts I have seen and this is an excellent explanation of the chart. I loved the video examples of each score, and "woahed" out loud to see the number 6 video example." C.K. (Dec. 2022)
"I liked the refresher on the anatomy portions! I like that this course went through how the PAS was created and reason for it. We use PAS in our MBSS notes, but no one has had any further education on it, so I wasn't sure if we were even using it correctly!" M.G. (Dec. 2022)
Financial — James Coyle is a presenter of CE seminars and online CE courses sponsored by Northern Speech Services; receives speaking fees and royalties.
Nonfinancial — James Coyle has no relevant nonfinancial relationships to disclose.
This program is offered for 0.2 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
Additional accrediting agencies by which Northern Speech is an approved CE provider:
Course Completion Timeframe:
You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.
However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.
Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.
Certificate of Completion:
On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.
ASHA CE Registry Submission:
During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
Purchase orders are currently not accepted for online orders, if you wish to submit a purchase order please do so at firstname.lastname@example.org or fax to 888-696-9655.
What is an Online Course?
Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.
Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.
Registering for an online course:
You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.
Accessing your purchased course or returning to a purchased course:
You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.
Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.
Number of CEUs offered:
We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.
State licensing boards and online CEUs:
NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.
Most of our online courses provide a link to download the accompanying handout as a PDF file.
Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.
For our online courses to function best, we recommend that you update your computer to include the newest version of your Internet browser (Safari, Chrome, Firefox, Edge, Internet Explorer, etc.) and newest version of your computer's operating system. Also a high-speed Internet connection is recommended (cable or DSL). Speakers or headphones will be required for many of our courses as many contain audio components.
Course Cancellation Policy:
A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded.
Please click here for any special needs requests, and we will do our best to accommodate them.
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