The International Dysphagia Diet Standardization Initiative

The International Dysphagia Diet Standardization Initiative

Launched on May 1, 2019 in the United States, IDDSI- the International Dysphagia Diet Standardization Initiative (IDDSI) is a new initiative developed and endorsed by The Academy of Nutrition and Dietetics (AND) and the American Speech-Language-Hearing Association.
The premise of IDDSI is to: “Achieve global diet terminology, creating common terminology and common understanding across international borders, across the lifespan, across all professions, and across all stakeholders to help the care of people with difficulty swallowing (dysphagia).”

The idea is to eliminate confusion between diets that are listed as ground vs chopped and puree vs blender-ized. The incidence of Dysphagia has increased significantly and has rapidly become a significant issue for skilled nursing facilities to address. Dysphagia can lead to aspiration pneumonia which may lead to death and or costly hospitalization.

The IDDSI dysphagia diet framework consists of eight levels (0-7) and includes both foods and liquids on a single continuum. Seen below, it takes has an interesting visual model with two triangles one inverted to the other. The levels are identified by numbers, text labels, and color codes with drinks being measured from Levels 0-4, while foods are measured from Levels 3-7.

The IDDSI Model

The IDDSI model expand and separate out the liquids to offer more choices to increase freedom to patients when appropriate. Instead of Thin, Nectar, Honey and Pudding, the nectar is separated into two categories with slightly thick liquids including items such as drinkable supplements. Additionally, levels 3 and 4 include food and drink criteria with level 3 including moderately thick liquids and liquidized foods, and level 4 including extremely thick liquids and pureed foods.

As Speech Language Pathologists for Skilled Nursing Facilities, Language Fundamentals believes in providing speech therapy to help patients enjoy quality of life on the least restrictive diet possible. Effectively treating the symptoms of dysphagia is a critical responsibility of the speech language pathologist. Check out our blog for more information on IDDSI.

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