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The What, Who, When, Why and How of Transitional Foods….
Transitional foods may be familiar to many people, as these types of foods are often given to young children as they begin to develop chewing skills. So, what exactly are transitional foods as outlined in the IDDSI Framework and how can they be used for people with dysphagia?
WHAT: Transitional foods are described in the IDDSI descriptors as:
Foods that start as one texture (e.g. firm solid) and change to another texture when:
• moisture is applied (e.g. saliva, water)
• there is a change in temperature ( e.g. heating)
Some common examples include solids such as ice cream (frozen form), small chips of ice (typically used for assessment or rehabilitation), some types of wafers and biscuits, some types of potato or other crisps, snack puffs, various type of infant/child biscuits/puffs.
WHO:
Although transitional types of foods are often used with young children, these types of foods can be used with all ages and are useful when working with individuals with dysphagia. It is also important to be aware that some transitional foods will change to a consistency that may not be suitable for some individuals with dysphagia (e.g. Ice cream that melts to a liquid consistency may be deemed unsafe for someone who cannot manage a more liquid consistency).
WHEN and WHY:
Dysphagia clinicians might use Transitional Foods to:
- Teach children chewing skills (e.g. developmental chewing, developmental disability population
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Rehabilitate chewing skills (e.g. after stroke) as these can be helpful to increase chewing skill and strength. Over time, this might mean the person can safely manage more food textures.
- To assist in the assessment and treatment of dysphagia -specifically ice chips or in Japan, special dysphagia jelly may be used.
It is important to note that Transitional foods are not a Level on the IDDSI Framework but rather depicted as a grey bar that runs alongside L7 Regular through to L5 minced and moist. Transitional foods can therefore be included along with those particular IDDSI food levels that include chewing skills. Transitional foods don’t have their own IDDSI level because there is not enough nutrition in these types of foods for a functional diet.
HOW:
As with all foods and liquids being offered, it is essential to TEST a transitional food to determine if it is appropriate to use for an individual with dysphagia. The fork pressure test is utilized for this purpose as outlined below:
- Use a sample the size of a thumb nail (1.5 x 1.5 cm)
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Place 1 mL of water on the sample
- Wait 1 minute
- Perform the IDDSI Fork Pressure Test
The food is a Transitional Food texture if the sample:
- has been squashed and disintegrated and no longer looks like its original state
OR
- has melted significantly and no longer looks like its original state
The dysphagia clinician should determine the appropriateness of recommending a Transitional food for an individual with dysphagia.
Check on the New Zealand Global Update video link below where a recipe for a transitional type of food in showcased. Don’t forget to perform IDDSI Testing if you try out the recipe!!
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