IDDSI Flashcards
What does IDDSI stand for?
International Dysphagia Diet Standardisation Initiative
How many levels are in the IDDSI continuum?
8 levels (0-7)
What do levels 0-4 primarily describe?
Drinks
What do levels 3-7 primarily describe?
Foods
What are the key features of Level 0: Thin?
- Flows like water
- Fast flow
- Can drink through any type of teat, cup or straw
What is the IDDSI flow test result for Level 0: Thin?
Less than 1 mL remaining in the 10 mL slip tip syringe after 10 seconds of flow
What are the key features of Level 1: Slightly Thick?
- Thicker than water
- Requires more effort to drink
- Flows through straw, syringe, teat
What is the flow test result for Level 1: Slightly Thick?
Test liquid flows through a 10 mL slip tip syringe leaving 1-4 mL in the syringe after 10 seconds
What are the key features of Level 2: Mildly Thick?
- Flows off a spoon
- Sippable, pours quickly off spoon but slower than thin drinks
- Mild effort required to drink through straw
What is the flow test result for Level 2: Mildly Thick?
Test liquid flows through a 10 mL slip tip syringe leaving 4 to 8 ml in the syringe after 10 seconds
What are the key features of Level 3: Liquidised - Moderately Thick?
- Can be drunk from cup
- Moderate effort required to suck through straw
- Smooth with no bits
What is the flow test result for Level 3: Liquidised - Moderately Thick?
Test liquid flows through a 10 ml slip tip syringe leaving > 8 ml in the syringe after 10 seconds
What are the key features of Level 4: Pureed - Extremely Thick?
- Cannot be drunk from a cup
- Does not require chewing
- Shows some very slow movement under gravity but cannot be poured
- No lumps
- Liquid must not separate from solid
What is the fork pressure test result for Level 4: Pureed - Extremely Thick?
When a fork is pressed on the surface, the tines/prongs of a fork can make a clear pattern on the surface, and/or the food retains the indentation from the fork
What are the key features of Level 5: Minced and Moist?
- Can be eaten with a fork or spoon
- Soft and moist with no separate thin liquid
- Small lumps visible within the food
What are the lump size specifications for Level 5: Minced and Moist?
Adult: equal to or less than 4mm width and no longer than 15mm in length
What are the key features of Level 6: Soft and Bite-sized?
- Can be eaten with a fork, spoon or chopsticks, with no need for knife
- Soft, tender and moist throughout but with no separate thin liquid
- Chewing is required before swallowing
What is the fork pressure test result for Level 6: Soft and Bite-sized?
When a sample the size of a thumb nail (1.5x1.5 cm) is pressed with the tines of a fork to a pressure where the thumb nail blanches to white, the sample squashes, breaks apart, changes shape, and does not return to its original shape when the fork is removed.
What are the key features of Level 7: Easy to Chew?
- Normal, everyday foods of soft/tender textures
- Any method may be used to eat these foods
- Does not include: hard, tough, chewy, fibrous, stringy, crunchy, or crumbly bits, pips, seeds, fibrous parts of fruit, husks or bones
What is the spoon pressure test result for Level 7: Easy to Chew?
When a sample the size of a thumb nail (1.5x1.5cm) is pressed with the base of a spoon to a pressure where the thumb nail blanches to white, the sample squashes, breaks apart, changes shape and does not return to its original shape when the spoon is removed.
What are the key features of Level 7: Regular?
No texture restrictions
What are the physiological requirements for Level 7: Regular?
- Ability to bite hard or soft foods and chew them for long enough that they form a soft cohesive ball/bolus that is ‘swallow ready’
- An ability to chew all food textures without tiring easily
- An ability to remove bone or gristle that cannot be swallowed safely from the mouth
