CDRE - IDDSI

Soft & bite-sized

• can be eaten with a fork, spoon or chopsticks
• can be mashed/broken down with pressure from fork, spoon or chopssticks
• a knife is not required to cut this food, but may be used to help load a fork or spoon
• soft, tender and moist thorughout but with no separate thin liquid
• chewing is required before swallowing
• 'bite-sized' pieces as appropriate for size and oral processing skills
  • paediatric, 8mm pieces (no larger than)
  • adults, 15mm pieces (no larger than)

Easy to chew

• normal, everyday foods of soft/tender textures
• any method that may be used to eat these foods
• sample size is not restricted at level 7, therefore, foods may be of a range of sizes
• does not include: hard, tough, chewy, fibrous, stringy, crunchy, or crumbly bits, pips, seeds, fibrous parts of fruit, husk or bones
• may include 'dual consistency' or 'mixed consistency' foods and liquids if also safe for level 0 and at clinician discretion.

In none: hard and crunchy foods are regular foods. IDDSI does categorize regular foods actually also into level 7, however the adapted IDDSI 7 is called easy to chew. 

As soon the person can eat hard, though, chewy, fibrous, stringy, dry, crispy, chunchy or crumbly bits usually no food restriction is required anymore (liquids still may do)

Foods that starts as one texture (e.g. firm solid) and changes into another texture specifically when moisture (e.g. water or saliva) is applied or when a change in temperature accurs.

IDDSI transitional foods may include and are not limited to:

• ice chips
• ice cream/sherbet
• Wafers (also includes religious communion wafer)
• waffle cones used to hold ice cream
• some biscuits/cookies/crackers
• some potato crisps - only ones made or formed from mashed potato (e.g Pringles)
• shortbread
• prawn crisps

It is a specific test for level 0,1,2,3. It tests how liquids flow through a syringe. 

We need a 10 mL syringe and a 10 second timer. 

To make sure that the syringe gives accurate results, the length of the 10 ml scale should be 61.5 mm. Alternativly we can also fill it with 10 mL of water. If the Syringe is empty in ~7 seconds.https://www.iddsi.org/videos/2-2-iddsi-flow-test-instructions

fill the 10 mL syringe with the liquid you want to text. After 10 seconds there still will be 1 to 4 ml of liquid in the syringe. 

Check out this video
1https://www.iddsi.org/videos/2-4-iddsi-flow-test-level-1

The 10 mL syringe will still contain 4-8 ml of liquid after 10 seconds of flow time.

https://www.iddsi.org/videos/2-5-iddsi-flow-test-level-2

If there is after 10 seconds of flow time, still 8-9.9 mL inside the syringe, it indicates that it is a moderately thick liquid.

We can also use the fork test: with the fork we try to get some of the liquid out of a cup. the liquid drips slowly or in dollops/strands though the slots of a fork. (usually if we test food if it reaches the 'liquidised' state.https://www.iddsi.org/videos/2-6-iddsi-tests-level-3-moderately-thick

In the flow test, level 4 is not leaving the syringe because it is too thick - usually only used when we over thicken a liquid and see that the 'extremely thick' liquid is not getting out of the syringe anymore. 

there are 4 other tests for level 4, pureed food: 

• fork pressure test: smooth, no lumps, minimal granulation. When fork is pressed on food, the tines/prongs ican make a clear pattern on the surface, and the food tetains the indentation from the fork
• fork drip test: sample sits in a mound/pile above the fork, a small amount may flow through and form a short tail below fork tines, but it does NOT flow or drip CONTINOUSLY through the prongs of a fork
• spoon tilt test: holds shape on spoon. A full spoonful must plop off the spoon if it is tilted. a very gentle flick may be necessary to dislodge the sample from spoon. A thin film remaining on the spoon after the tilt test is acceptable, however, you should still be able to see the spoon through the thin film. if it does not fall off, then it is too sticky/thick
• finger test (if no spoon or fork available): just possible to hold a sample in fingers. The testure slides smoothly and easily between fingers and leaves noticeable coating.https://www.iddsi.org/videos/2-8-iddsi-spoon-tilt-test-level-4-extremely-thick

There are 5 tests available for the minced & moiste consistency:

• fork pressure test: when pressed with fork the paricles should easily be separated between and come though the tines of a fork. can be easily mashed with little pressure from a fork - the pressure should NOT make the thumb nail blanch to white
• fork drip test: wen a sample is scooped, it sits in a pile or can mound on the fork and does not easily flow/fall through the tines of a fork. 
• spoon tilt test: cohesive enough to hold shape on spoon. A full spoonful must fall of the spoon if the spoon is tilted or turned sideways or shaken lightly. Sample should NOT be sticky
• Chopstick test: chopsticks can be used to scoop or hold this texture if the sample is moist and cohesive and the person has very good hand control to use chopssticks
• finger test: it is possible to easily holf a sample using fingers; small, soft, smooth, rounded particles can be easily separated using fingers. the material feel moist and leave fingers wet

https://www.iddsi.org/videos/2-9-iddsi-tests-level-5-minced-and-moist