As a speech pathologist, a part of our role is to assess safe swallowing in children and adults. There are many reasons why people may have a swallowing difficulty (known as dysphagia), including delayed achievement of oral milestones as a child, neurological conditions or following medical events such as strokes, surgeries or injuries to the head or neck. The general process of ageing can also impact a person’s swallow. 

Along with supporting a person to eat in a safer mealtime environment (e.g. supporting their posture and reducing distractions during meals), a speech pathologist may recommend a texture modified diet. But what are some of the different textures that can be recommended? And why are they recommended in the first place?

An ultimate goal of a speech pathologist working with people who have swallowing difficulties, is to ensure mealtimes are safe and enjoyable experiences. For those with dysphagia, the risk of choking or having food or drinks ‘go down the wrong way’ is increased. This can lead to some very serious, and even fatal consequences. This is where a speech pathologist can make some recommendations to help! By changing the texture of meals to suit an individuals need, people with swallow difficulties can safely enjoy their meals, avoiding complications and get the nutrients they need.

Diet recommendations are made in accordance with The International Dysphagia Diet Standardisation Initiative (IDDSI) guidelines. These guidelines provide a useful and consistent way to view texture modified diets. Levels 3–7 outline different food textures. These are liquidised, pureed, minced and moist, soft and bite sized and regular foods. 

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People with dysphagia may have significant difficulty chewing their food. They may have difficulty coordinating movements of the tongue, cheeks and jaw for moving food around their mouth, and moving food the back of their mouth, to then swallow. A pureed, minced and moist or soft, cut up diet may be recommended to alleviate the load on the muscles, and ensure the person can still get enough to eat.

As another example, a soft and bite sized diet may be recommended for people who are prone to fatiguing during meals. By recommending softer foods, which requires less strenuous chewing, people can eat more of their meals. 

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Overall, a speech pathologist may recommend texture modified diets based on the individual’s presentation and specific needs. You can chat with your speech pathologist to find out why you, or a family member, may be recommended a modified diet. 

For more information about different food textures, and examples of food suitable for each texture, go to https://iddsi.org/framework/ or ask your speech pathologist.