Answers to common questions...
Q: I am planning to publish an article, do you have a graphic of the IDDSI framework I can use and do I need permission?
Yes – you're welcome to use our downloadable framework You can find it
. and No, you do not need to seek permission from IDDSI as long as you cite the CreativeCommons BY-SA 4.0 license as follows:
The International Dysphagia Diet Standardisation Initiative 2016 @http://iddsi.org/framework/.Attribution is NOT PERMITTED for derivative works incorporating any alterations to the IDDSI Framework that extend beyond language translation.
Modification of the diagrams or descriptors within the IDDSI Framework is DISCOURAGED and NOT RECOMMENDED. Alterations to elements of the IDDSI framework may lead to confusion and errors in diet texture or drink selection for patients with dysphagia. Such errors have previously been associated with adverse events including choking and death.
Q: Do I need to recommend both food and drinks need to be a Level 3 or Level 4 when my patient is requiring either food or drinks at this level?
IDDSI level 4 (Pureed Foods and Extremely Thick Drinks), IDDSI level 3 (Liquidised Foods and Moderately Thick Drinks) are presented on the IDDSI framework as connected because of their flow property and behaviour is similar. It does not mean that they need to be prescribed together. Clinicians need to assess the patient’s ability to manage foods and drinks independently.
your patient may require liquids thickened to Level 3 due to poor oral control but can manage minced and moist foods Level 5. In this case, they would be prescribed Level 5 Minced & Moist, Level 3 Moderately Thick.
Q: Does IDDSI have some lists of foods that meet the criteria for different levels?
Due the overwhelming number of foods globally and variation in preparation methods, it is not possible to outline lists of foods under each Level.
For example: A piece of fruit that is very ripe and passes the IDDSI Fork or Spoon pressure test and is cut into the appropriate IDDSI specified size for and adult or child
meets the criteria for Level 6 soft and bite sized. Another piece of the same variety of fruit which is unripe, that does not pass the IDDSI fork/spoon pressure test, even when cut into the appropriate size, would NOT meet the criteria for Level 6 Soft & Bite sized. Consider the behaviour of a ripe banana vs. a green banana.