What is IDDSI?

By Elyse Matson, MA CCC-SLP, SLP Therapy Resource

IDDSI stands for International Dysphagia Diet Standardization Initiative. The purpose of the initiative was to create standards across all environments so that the foods and liquids have the same texture or viscosity.

For example, when a patient arrives to your facility on nectar liquids, how do we determine if the hospital’s version of nectar is the same as ours?

The IDDSI framework consists of a continuum of 8 levels (0-7), where drinks are measured from Levels 0–4, while foods are measured from Levels 3–7.

There are specific testing methods to determine the levels, including a flow test with use of a 10 ml syringe and a fork test to determine food particle size and food softness.


So should you implement IDDSI at your facility? There are several factors to consider. The first is, who is your menu vendor? The vendor supplies the menus to the kitchen and provides instructions/wording on which diets your facility uses and how to prepare the meals. It is up to this vendor to adopt IDDSI and provide the new language/instructions to the kitchen.

The next question is whether your local hospitals/referral sources are adopting IDDSI. This may create a need to address the diets sooner rather than later. We have created a conversion chart below to provide to your admitting nurses so they can convert the IDDSI diets back to your current diets.

Finally, you will need to work closely with your SLP, Dietary Department and IDT to determine if your facility is ready for this change. For further questions, please go to www.iddsi.org or reach out to Elyse Matson, SLP Resource (ematson@ensignservices.net).