1. STAFF TRAINING GUIDE
Getting IDDSI Ready
What HCPs need to know

2. What is IDDSI?
IDDSI stands for the International Dysphagia Diet Standardisation Initiative. IDDSI is a group of volunteers working together to develop international standardized terminology and definitions for texture modified foods and thickened liquids for people with dysphagia.
The IDDSI came together in 2013 to create these standards, resulting in the International Dysphagia Diet Framework, to meet the needs of individuals with dysphagia across age span, all care settings and all cultures. The framework includes food and drink descriptors along with instructions for easy, reliable and accessible methods to test different foods and drinks.
Source: (c) The International Dysphagia Diet Standardisation Initiative

3. The History IDDSI Replaces the National Dysphagia Diet
In the past, the National Dysphagia Diet (NDD) was the only standardized diet tool in the United States, and it was a great beginning. NDD was published in 2002 by the American Dietetic Association (ADA), now known as the Academy of Nutrition and Dietetics. It was created as an official project of the ADA, but the NDD was not officially supported by American Speech-Language Hearing Association (ASHA). However, the NDD was the result of consensus among dietitians, Speech-Language Pathologists, and food scientists. This tool listed diets that were appropriate for patients with swallowing disorders.
The use of food science and the science of rheology have helped us create diets not only to avoid diet-label confusions, but also to provide for the safest textures for the patient’s particular type of dysphagia.
Source:
Source: (c) The International Dysphagia Diet Standardisation Initiative

4. The Thick-It® Commitment
At Thick-It®, we are committed to research, innovation and education. These are the pillars of our organization as we work to find reliable dysphagia nutrition solutions for people with swallowing difficulties and their caregivers.
We know that in order to find the best solutions for the more than 580 million people worldwide living with dysphagia, we must work collaboratively with experts in healthcare, food science and technology, and patient safety. Along with the new framework, IDDSI has defined food and drink descriptors and instructions to improve the safety and care for the population affected with dysphagia (estimated to be 8%).
We are proud to partner as gold sponsors with IDDSI, to support a global effort to promote a set of standardized, common language terminology and definitions developed for texture modified foods and thickened liquids.
Source: (c) The International Dysphagia Diet Standardisation Initiative

5. The Benefits of IDDSI Dysphagia Patients
Healthcare Providers & Caregivers
Standardized thickness levels are objective and predictable
IDDSI labeling is designed to be easily understood by everyone, vs. potentially confusing or unfamiliar terms like “nectar” and “honey”
IDDSI labeling is also designed to be clearly marked and each level is distinct.
The IDDSI framework includes tests to determine where foods or drinks fall on the scale
As more brands adopt IDDSI standards, it will be easier for caregivers and facilities to compare products
The IDDSI initiative is led by volunteers worldwide and is supported by a number of industry leaders (such as ASHA and the National Foundation of Swallowing Disorders). IDDSI’s goal is to develop standardized terminology for texture modified foods and thickened liquids for people with dysphagia, under the objective and unbiased recommendation of this diverse group.
Source: (c) The International Dysphagia Diet Standardisation Initiative

6. The IDDSI Framework
The framework has eight levels (0–7). Each level has detailed descriptors that would best meet the needs of an individual with dysphagia (for more information on the descriptors, please visit
Source: (c) The International Dysphagia Diet Standardisation Initiative

7. The IDDSI Food & Drinks Classification and Testing
Source: (c) The International Dysphagia Diet Standardisation Initiative

8. Flow Test HOW TO USE THE IDDSI STANDARDS
The IDDSI flow test classifies IDDSI Levels 0-3 based on their rate of flow. Use a syringe (following syringe dimensions as per image below) for correct results:
For example videos visit
Source: (c) The International Dysphagia Diet Standardisation Initiative

9. Flow Test HOW TO USE THE IDDSI STANDARDS
What specific syringe should I use?
These may not be the only syringes that are appropriate. Just make sure the syringe measures 61.5 mm from the 0 to the 10 mm lines.
Source: (c) The International Dysphagia Diet Standardisation Initiative

10. Flow Test Instructions
HOW TO USE THE IDDSI STANDARDS
Flow Test Instructions
Videos of IDDSI flow test can be found here:
or in the IDDSI App, available in the Apple App Store and Google Play Store.
Turn over to check IDDSI level
Source: (c) The International Dysphagia Diet Standardisation Initiative

11. Fork Drip Test HOW TO USE THE IDDSI STANDARDS
Thick drinks and fluid foods (LEVELS 3 and 4) can be tested by assessing whether they flow through the slots/prongs of a fork and comparing against the detailed descriptions of each level.
Source: (c) The International Dysphagia Diet Standardisation Initiative

12. Spoon Tilt Test HOW TO USE THE IDDSI STANDARDS
Extremely thick drinks and purée foods (LEVELS 4 & 5) can be tested by using this method. Food and drinks at this level should be smooth and not require any biting or chewing. Food must pass Fork Drip and Spoon Tilt tests. See videos of the Level 5 IDDSI Fork Drip Test and IDDSI Spoon Tilt Test at:
Source: (c) The International Dysphagia Diet Standardisation Initiative

13. The IDDSI Food & Drinks Classification and Testing
Recap
Source: (c) The International Dysphagia Diet Standardisation Initiative

14. IDDSI Label Changes to Thick-It® Products
IDDSI & THICK-IT®
IDDSI Label Changes to Thick-It® Products
What is changing?
Updated recommended dosage to reflect the IDDSI framework. The package labels will be changing over the coming months, NOT the products trusted for over 30 years. Our products have been tested, and will continue to be tested, to ensure compliance with the new IDDSI framework and a consistent and safe experience for consumers.
What products will be affected?
Thick-It® Original, Thick-It® Original Foodservice, and Thick-It® Original Concentrated Food & Beverage Thickeners
Thick-It® Clear Advantage® Ready-to-Drink Beverages
Thick-It® Purées

15. IDDSI Framework & Thick-It®
IDDSI & THICK-IT®
IDDSI Framework & Thick-It®
Example Labeling
Dual Labeling New IDDSI levels will be shown alongside old (honey/nectar) terminology. Final label changes coming soon.
Source: (c) The International Dysphagia Diet Standardisation Initiative

16. Additional Resources
Further IDDSI resources available at
The IDDSI Framework and Descriptors are licensed under the Creative Commons Attribution Sharealike 4.0 International License March 4, 2017

17. Schedule a IDDSI Training with Thick-It
to help your staff better understand these new standards
thickit.com/iddsi-training or call