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7 International Dysphagia Diet 7 International Dysphagia Diet Standardisation Initiative Updates Difficulty Swallowing

By: Get News

Did you know that over 50 nations around the world have started to implement the International Dysphagia Diet Standardisation Initiative (IDDSI). This has been a global consensus on foods and drinks that are ordered and prepared for people with difficulty swallowing (dysphagia). The vision is for improved patient safety (aka, risk mitigation) for all ages, all cultures/languages, and in all care settings (including people at home). We will all be using the same terminology for the different solid food levels and drink levels (see framework on and in image below). Imagine, no more guesswork by the skilled nursing facility when selecting a diet for your loved one. The diet texture will be already identified based on the person’s swallow study and labeled by the hospital (e.g., Soft & Bite-Sized, Level 6 and Mildly thick liquid, Level 2) who will communicate with the same diet terminology as the nursing facility down the street.

Nations around the world have been forming work groups (aka, reference groups) to foster IDDSI implementation. It is inspiring to have global IDDSI meetings with large nations like Brazil, Mexico, Canada, and China, as well as smaller nations such as Iceland, Myanmar, Azerbaijan, Portugal, and the United Arab Emirates. It truly is a global wave of standardization of food and liquid textures (aka, dysphagia diets).

The American Speech-Language and Hearing Association (ASHA) along with the Academy of Nutrition and Dietetics (AND) declared May 1, 2019 as the official launch date for IDDSI in the USA. Then COVID-19 hit! Many facilities that were deep in the middle of IDDSI implementation were derailed. In the United States, the United States IDDSI Reference Group (USIRG) formed in early 2021 to support implementation across the nation with a large group of active volunteers who are generating resources and answering questions.

I am on the USIRG’s Communication & Advocacy and Resources & Best Practice work groups. We have been busy! Regarding resource development, we are curating and creating resources that are US-specific. We have been trying to gather resources that facilities have already created. We hope that organizations/facilities around the nation are keeping up with IDDSI updates and sharing with other facilities. It would be nice to not have everyone re-invent the wheel. However, some proprietary regulations in some healthcare organizations have prevented faster dissemination of those resources and handouts. If you are able to share with others around the nation, please contact You can also contact to ask questions and provide ideas on what resources need to be developed.


by Karen Sheffler, MS, CCC-SLP, BCS-S of

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Company Name: Karen Sheffler, MS, CCC-SLP, BCS-S
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Country: United States

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