Diet Safety

6 posts

Yield sign with safety first, used here to remind "patient safety first!"

Patient Safety First: Transitional Foods (Part 2)

Patient Safety First: Transitional Foods (Part 2) By Karen Sheffler, MS, CCC-SLP, BCS-S of Introduction Welcome back to Part 2 of my 3-part article on Transitional Foods (in the dysphagia diet framework on In Part 1 of this blog series, I addressed what transitional foods are, how to test them, ideas on their use in dysphagia treatment, and an example of a transitional food product. Next, it is important to address potential choking risks […]

IDDSI revised the framework March 2019 to include the Easy To Chew Level 7

IDDSI Resources

INTERNATIONAL DYSPHAGIA DIET STANDARDISATION INITIATIVE (IDDSI) IDDSI_framework_with_creative_commons_Mar2019 IDDSI Resources complied by Karen Sheffler, MS, CCC-SLP, BCS-S of & IDDSI Champion Changing the world to this new dysphagia diet global standard will be no simple feat. However, it is crucial that we set goals for our facilities now in order to start our implementation by the goal of May 1, 2019 in the USA, per the American Speech-Language and Hearing Association and the Academy […]

FNCE: Food & Nutrition Conference & Expo by the Academy of Nutrition & Dietetics. This sign shows that the AND and FNCE are 100 years old! This blog is about SLPs learning to collaborate in dysphagia field with dietitians.

Collaboration in Dysphagia

ASHA + AND = Better Together: SLP & RD Collaboration in Dysphagia by Karen Sheffler, MS, CCC-SLP, BCS-S of “Are you going to /fɛnsi/?” (Yes, that was the international phonetic alphabet (IPA) to show SLPs how to pronounce FNCE. I am a Speech-Language Pathologist (SLP) who has specialized in swallowing and swallowing disorders (dysphagia) since 1995. I have collaborated with numerous dieticians across the continuum of care, and I did not know what “FNCE” was. […]

IDDSI: Interview with an Early Adopter of IDDSI Framework

IDDSI: Interview with an Early Adopter by Karen M. Sheffler, MS, CCC-SLP, BCS-S of Introduction I had the pleasure to speak with Kim Bradley, PhD, SLP reg.CASLPO, who is a speech-language pathologist (SLP) and manager at St. Michael’s Hospital in Toronto, Canada. Bradley is also an Assistant Professor in the Department of Speech Language Pathology at the University of Toronto. I asked her: Why was it so important for you and your healthcare facility be early implementors of this […]

“No Dysphagia Diet Modification without Standardization!”

Support Dysphagia Diet Standardization by Karen Sheffler, MS, CCC-SLP, BCS-S of Overview: On social media, in lectures and in blogs, I have been repeating: A global consensus on dysphagia diets, based on evidence, is coming soon. The International Dysphagia Diet Standarisation Initiative ( now asking us to “spread the word.” I think it is very appropriate that I write this blog in Boston, inspired by Boston’s revolutionary past. About 265 to 255 years ago (1750-1760’s) in […]

A typical meal on the Dysphagia Advanced diet. Soft fish, well-cooked potatoes and vegetables.

Diet Safety: Terminology & Definitions Matter

Diet Safety: Terminology Matters! By Karen Sheffler, MS, CCC-SLP, BCS-S of This blog is inspired by my own frustrations with different diet names across different institutions. Dysphagia ground, mechanically altered, mechanical soft, and chopped really mean the same thing? This blog is also based on the following session at the ASHA convention in 2014: Steele, C. (2014, November). 1038: Diet Texture Terminology: Establishing an International Consensus. Seminar presented at the annual convention of the American Speech-Language-Hearing […]