The IDDSI framework provides a global standard for texture-modified foods and thickened liquids. Use this card as a clinical quick reference. Always confirm patient-specific recommendations with the treating SLP.
Drink Levels (0–4)
| Level | Name | Description | Flow Test |
|---|
| 0 | Thin | Water, juice, milk — flows like water | Flows through 10mL syringe in <10 sec |
| 1 | Slightly Thick | Thicker than water; requires some effort | Flows through syringe in 1–4 sec |
| 2 | Mildly Thick | Flows off spoon; sippable through straw | Flows through syringe in 4–8 sec |
| 3 | Moderately Thick | Pours slowly; cannot be drunk through straw | Flows through syringe in 8–25 sec |
| 4 | Extremely Thick | Does not pour; eaten with spoon; no straw | Does not flow through syringe |
Food Levels (3–7)
| Level | Name | Description | Examples |
|---|
| 3 | Liquidised | Smooth, no lumps; can be drunk from cup | Smooth pureed soups, thinned yogurt |
| 4 | Puréed | Smooth, moist, cohesive; holds shape on spoon | Smooth mashed potato, puréed meat |
| 5 | Minced & Moist | Small lumps ≤4mm; easily mashed with tongue | Minced meat, soft cooked vegetables |
| 6 | Soft & Bite-Sized | Tender, moist pieces ≤15mm; requires chewing | Soft fish, tender chicken, ripe banana |
| 7 | Regular | Normal everyday foods of any texture/size | No restrictions |
Key Testing Methods
- Fork Drip Test — for Levels 1–4 liquids: observe how liquid drips off a fork
- Spoon Tilt Test — for Levels 3–4: food should fall off spoon in a single cohesive mound
- Fork Pressure Test — for Levels 5–6: food should squash easily under gentle fork pressure
- Tongue Pressure Test — food should be mashable with tongue against palate (no teeth required for Level 4–5)
Important: IDDSI levels must be prescribed by a qualified clinician. This card is for reference only. Visit iddsi.org for full framework documentation and testing videos.