Unit 4 - Food preparation

4.3. Levels, descriptors and measurement methods in dysphagia oriented products

4.3.1. Levels, descriptors and methods for liquid food

Description/Characteristics

  • Flows like water

  • Fast flow

  • Can drink through any type of teat/nipple, cup or straw as appropriate for age and skills.


Physiological rationale for this level of thickness

  • Functional ability to safely manage liquids of all types


Testing method

IDDSI Flow Test: Less than 1 mL remaining in the 10 mL slip tip syringe after 10 seconds of flow


(Source: https://www.iddsi.org)

Description/Characteristics

  • Thicker than water

  • Requires a little more effort to drink than thin liquids

  • Flows through a straw, syringe, teat/nipple

  • Similar to the thickness of most commercially available ‘Anti-regurgitation’ (AR) infant formulas

Physiological rationale for this level of thickness

  • Often used in the pediatric population as a thickened drink that reduces speed of flow yet is still able to flow through an infant teat/nipple. Consideration to flow through a teat/nipple should be determined on a case-by-case basis.

  • Also used in adult populations where thin drinks flow too fast to be controlled safely. These slightly thick liquids will flow at a slightly slower rate.


Testing method

IDDSI Flow Test: Test liquid flows through a 10 mL slip tip syringe# leaving 1-4 mL in the syringe after 10 seconds


(Source: https://www.iddsi.org)

Description/Characteristics

  • Flows off a spoon

  • Shippable, pours quickly from a spoon, but slower than thin drinks

  • Mild effort is required to drink this thickness through standard bore straw (standard bore straw = 0.209 inch or 5.3 mm diameter)


Physiological rationale for this level of thickness

  • If thin drinks flow too fast to be controlled safely, these Mildly Thick liquids will flow at a slightly slower rate

  • May be suitable if tongue control is slightly reduced.


Testing method

IDDSI Flow Test: Test liquid flows through a 10 mL slip tip syringe leaving 4 to 8 mL in the syringe after 10 seconds


(Source: https://www.iddsi.org)



Description/Characteristics

  • Can be drunk from a cup

  • Moderate effort is required to suck through a standard bore or wide bore straw (wide bore straw = 0.275 inch or 6.9 mm)

  • Cannot be piped, layered or molded on a plate because it will not retain its shape

  • Cannot be eaten with a fork because it drips slowly in dollops through the prongs

  • Can be eaten with a spoon

  • No oral processing or chewing required – can be swallowed directly

  • Smooth texture with no ‘bits’ (lumps, fibers, bits of shell or skin, husk, particles of gristle or bone)


Physiological rationale for this level of thickness

  • If tongue control is insufficient to manage Mildly Thick drinks (Level 2), this Liquidized/Moderately thick level may be suitable

  • Allows more time for oral control

  • Needs some tongue propulsion effort

  • Pain on swallowing


Testing method

(Source: https://www.iddsi.org)

Fork Drip Test

(Source: https://www.iddsi.org)