Common IDDSI Testing Mistakes - How Teams Can Improve Consistency
IDDSI testing helps teams describe and check the texture of foods and the flow of drinks. However, the result is only useful when the correct test, equipment, sample and technique are used.
Common mistakes include using the wrong syringe, testing food at a different temperature from when it will be served, changing the published method, testing an unrepresentative sample or assuming that a recipe will always produce the same result.
Common mistakes include using the wrong syringe, testing food at a different temperature from when it will be served, altering the testing method, testing an unrepresentative sample, or assuming that a recipe will always produce the same result.
Consistent IDDSI testing requires clear procedures, suitable equipment and practical staff training—not guesswork.
Why does consistent IDDSI testing matter?
The International Dysphagia Diet Standardisation Initiative, known as IDDSI, provides a standardised framework for describing texture-modified foods and thickened drinks.
A person may have an individual recommendation for food and drinks described using IDDSI levels. Carers, support workers, nurses, cooks and food-service staff need to understand how to prepare, identify and test these items according to their responsibilities.
IDDSI testing describes the properties of a food or drink. It does not determine which level is appropriate for an individual. That decision requires an individual swallowing assessment and recommendation from an appropriately qualified health professional.
Mistake 1: Using the wrong test
Different IDDSI levels and food or drink types require different testing methods. One test cannot answer every question about an item.
Depending on the food or drink, the relevant methods may include:
the IDDSI Flow Test
the Fork Drip Test
the Spoon Tilt Test
the Fork Pressure Test
the Chopstick Test
the Finger Test
checks of particle size or food characteristics
Some items may require more than one test to confirm that they meet all the relevant requirements.
Teams should use the current official IDDSI testing instructions rather than relying on memory, an old handout or an informal demonstration.
Mistake 2: Assuming any 10 mL syringe will work
A common error is assuming that any syringe labelled “10 mL” can be used for the IDDSI Flow Test.
The dimensions of the syringe affect the result. Two syringes with the same stated capacity may have different barrel lengths or nozzle dimensions and may not produce the same flow result.
Check the current official IDDSI instructions for the required syringe specifications. Organisations should also make sure that appropriate syringes are available wherever testing is expected to occur.
If the approved syringe is replaced with a different product, confirm that the new syringe meets the IDDSI requirements before using it for testing.
Mistake 3: Changing the timing or technique
The IDDSI Flow Test follows a defined method. Changes to the timing, how the nozzle is released or blocked, the syringe position or how the result is read may affect the outcome.
Common technique errors include:
starting or stopping the timer at the wrong point
holding the syringe at an angle
covering or releasing the nozzle inconsistently
reading the result from the wrong position
repeating the test with different timing
estimating the result instead of following the full method
Written instructions are helpful, but practical demonstration and observation are often needed. Watching another person complete a test does not automatically mean a staff member can perform it reliably.
Mistake 4: Testing the wrong sample
The sample being tested should represent the food or drink that will be served.
Results may be misleading if staff:
test a freshly prepared sample but serve it much later
test liquid from the top while thicker material has settled
test one part of a mixed meal but not the component being served
test a smooth section while ignoring lumps, crusts or separate liquid
test one portion of a batch that has not been mixed consistently
test a different product from the one given to the person
Where appropriate, the sample should be mixed and selected according to the relevant procedure so that it represents the item being served.
Mistake 5: Ignoring temperature and standing time
The flow and texture of food and drinks can change over time.
A thickened drink may continue to change after preparation. A hot meal may become firmer as it cools. Ice cream may melt. A sauce may separate or thicken. Food may also change during refrigeration, reheating or transport.
Testing only at the point of preparation may not show what the person will receive at the table.
Teams should consider:
when the item is prepared
how long it stands before service
the temperature at which it is served
whether it is reheated, chilled or transported
whether it separates or forms a skin
whether its texture changes during the meal
The testing point should be clearly defined within the organisation’s preparation and service process.
Mistake 6: Applying inconsistent pressure during food testing
Some IDDSI food tests involve applying pressure with a fork, spoon, chopsticks or fingers. Results can vary when staff use very different amounts of pressure or apply the test inconsistently.
Technique should follow the current official IDDSI instructions. Staff may need supervised practice and feedback to understand how to apply the method reliably.
If two staff members repeatedly obtain different results from the same sample, do not simply select the preferred result. Review:
whether they used the same test
whether the sample was consistent
whether the same equipment was used
whether temperature or standing time changed
how each person applied the testing method
whether both staff members followed the current instructions
Unresolved differences should be escalated through the organisation’s quality or clinical process.
Mistake 7: Checking only softness
A food being soft does not automatically mean that it meets all the requirements of a particular IDDSI level.
Depending on the level, other characteristics may also matter, such as:
particle size
whether liquid separates from the food
whether the food is sticky
whether it holds together
whether it can be broken down using the relevant pressure
whether it contains hard, fibrous, stringy or mixed-texture components
Teams should assess all relevant characteristics rather than relying on appearance or softness alone.
Mistake 8: Assuming a blender guarantees the result
Using a blender does not automatically produce a particular IDDSI level.
The final texture can be affected by:
the ingredients
the amount and type of liquid added
blending time
batch size
equipment performance
temperature
standing time
reheating
natural variation between ingredients
A food should be tested in its final prepared form according to the organisation’s procedure. The appliance used does not replace testing.
Mistake 9: Treating recipes as infallible
A standardised recipe can improve consistency, but it cannot account for every variation.
Results may change when staff:
substitute ingredients or brands
estimate quantities
alter the amount of liquid
change the cooking time
prepare a different batch size
use different equipment
reheat the meal differently
do not follow the documented sequence
If substitutions are necessary, the final item may need to be checked again. Organisations should clearly define who can approve substitutions and what testing is required.
Mistake 10: Recording the label without completing the test
Writing an IDDSI level on a container does not prove that the item meets that level.
Labels are important for communication, but they must reflect an item that has been prepared and checked according to the relevant procedure.
Documentation may need to record:
the item or batch tested
the date and time
the temperature or stage of service, where relevant
the testing method used
the result
who completed the test
what action was taken if the item did not meet requirements
The exact documentation required will depend on the organisation’s quality system and the staff member’s role.
Mistake 11: Guessing when a result is borderline
A borderline or unexpected result should not be adjusted informally until it “looks right”.
Staff should follow the organisation’s procedure. This may involve:
checking the official testing instructions
repeating the test correctly with a representative sample
checking the equipment, timing and technique
reviewing the recipe and preparation process
asking an appropriately trained person to observe or repeat the test
escalating the result if it remains unclear
Do not serve an item under a preferred IDDSI label simply because the team expected it to reach that level.
Mistake 12: Assuming that passing a test makes an item suitable for everyone
An IDDSI test describes characteristics of a particular food or drink. It does not determine whether that item is appropriate for a particular person.
Individual suitability depends on the person’s current swallowing recommendations and other documented requirements.
A person may also have needs relating to:
assistance or supervision
positioning and pacing
allergies or intolerances
nutrition and hydration
medication
equipment
communication
personal and cultural preferences
Passing an IDDSI test does not replace the person’s mealtime management plan.
How teams can improve consistency
Reliable testing depends on the whole system, not only the individual staff member.
Organisations can improve consistency by:
using current official IDDSI instructions
providing the correct equipment at the point of testing
defining which tests apply to each product or process
establishing standardised recipes and preparation methods
specifying when and at what temperature testing occurs
documenting approved products and substitutions
using clear visual work instructions
providing hands-on training and observed practice
checking staff technique rather than relying only on course completion
documenting results according to the organisation’s procedure
reviewing repeated failures for underlying process problems
providing a clear escalation pathway for uncertain results
When an item repeatedly fails testing, investigate the process. The cause may involve ingredients, measurements, temperature, standing time, equipment, transport, staff technique or an unsuitable recipe.
Frequently asked questions
Can any 10 mL syringe be used for the IDDSI Flow Test?
No. Syringes with the same stated capacity can have different dimensions, which may affect the result. Check the current official IDDSI specifications and make sure the approved equipment is consistently available.
Should every meal or drink be tested?
Yes. Testing frequency depends on the item, preparation method, product consistency and the organisation’s quality procedures. The organisation should clearly define what is tested, when testing occurs and who is responsible.
What if two staff members obtain different results?
Repeat the test using the same representative sample, method and equipment. Observe each person’s technique and check factors such as temperature and timing. Escalate unresolved differences rather than selecting the preferred result.
Can a blender guarantee an IDDSI level?
No. A blender is only part of the preparation process. Ingredients, quantities, blending time, temperature and standing time can affect the final texture. The finished food should be checked using the relevant IDDSI methods.
Does passing one test confirm the IDDSI level?
No. Some foods and drinks require more than one check because different tests examine different characteristics. Follow the current official instructions for the food and intended level.
Does passing an IDDSI test mean the item is suitable for a particular person?
No. Testing describes the food or drink. The person’s current clinical recommendations determine which food textures and drink thicknesses are appropriate for them.
What to do next
If staff obtain inconsistent results or are unsure how to apply IDDSI testing methods, review the process before treating the issue as an individual mistake.
Swallowing & Dysphagia Support provides practical IDDSI training for carers, support workers, nurses, cooks, food-service teams and organisations.
Contact Swallowing & Dysphagia Support to discuss practical training for your team.
Important information
This article provides general education. It cannot determine an individual’s food texture, drink thickness, suitability for oral intake, treatment, supervision or level of swallowing risk.
Always use current official IDDSI resources and follow the person’s individual swallowing or mealtime management plan.
This article and Swallowing & Dysphagia Support training are independently developed educational materials. They are not official IDDSI resources, education programs or certification, and they do not replace current materials available from IDDSI.
About the author
Written for Swallowing & Dysphagia Support and clinically reviewed by Vanessa Chan, Speech Pathologist.
