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    NDD vs IDDS: Dysphagia Diet Standardization ecourse

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    Appropriate Disciplines

    • Certified Occupational Therapy Asst
    • Occupational Therapist
    • Speech Language Pathologist
    • Speech Language Pathology Asst
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Course Description

Speech-Language Pathologists and Occupational Therapists play a vital role in recommending appropriate diets and liquids after bedside evaluations, MBSs, or FEES assessments. However, clear and consistent communication with nursing and dietary teams is essential for patient safety and successful outcomes.

In 2002, the National Dysphagia Diet (NDD) was developed to standardize terminology and identify diet level challenges. While widely used, variability in definitions and terminology across care settings and cultures became a significant barrier to safety.

To address these inconsistencies, the International Dysphagia Diet Standardization Initiative (IDDSI) was launched in 2013. IDDSI provides a globally standardized framework for describing texture-modified foods and thickened liquids. As of 2021, it is the only professionally recognized and supported framework across disciplines—including SLPs, OTs, physicians, nurses, and dietary staff.

Yet, many facilities continue to rely on outdated NDD guidelines or use inconsistent internal criteria, creating risk for miscommunication and potential litigation.

This course emphasizes:

  • The differences between NDD and IDDSI

  • Why standardization matters

  • The importance of testing foods and liquids to confirm the correct consistency

  • How to align your facility’s practices with current professional standards to improve safety and outcomes for individuals with dysphagia

Course Requirements:
  • Computer with internet and working speakers/sound are required for this course.
  • Course must be completed within 30 days of activation (activate course within 6 months of purchase).
  • An online multiple-choice quiz (80% passing score) and submission of an online evaluation form are required for successful completion.
  • A certificate of completion will be available to print immediately after course is successfully completed.
  • SLPs - ASHA CEUs may be obtained by completing the online ASHA form and checking the "Report to ASHA" box.

Course Objectives

Upon successful completion of this course, participants will be able to:

  • Summarize the differences between the NDD and the IDDSI
  • Identify terminology and characteristics for liquid viscosity, food consistencies and diet levels
  • Explain consistency testing methods for food and liquids
  • Recognize why foods might meet the criteria for different diet levels
  • Use liquids with the IDDSI funnel for accuracy

Denise Dougherty

MA, CCC-SLP

Denise Dougherty, MA, CCC-SLP
Denise owns and operates a private practice in Indiana, PA, where she conducts therapy with both children and adults. She is a legal consultant/expert witness in wrongful death/negligence lawsuits involving dysphagia. Denise is a co-editor of Private Practice Essentials: A Practical Guide for Speech-Language Pathologists, published by ASHA Press. She has presented workshops and written numerous articles appearing in the ASHA Leader on the topic of private practice. Denise served as a consultant for The Arijah Children’s Foundation in Anguilla, BWI, providing evaluations and therapy programs for special needs children. Ms. Dougherty was an adjunct faculty member at York College of Pennsylvania and Wesley College in Dover, Delaware. She is a past President of the American Academy of Private Practice in Speech Pathology and Audiology (AAPPSPA), and received the Academy’s 2007 Honor Award and 2014 Award of Excellence for her achievements. Ms. Dougherty is a member of the Technical Experts Panel for Quality of Insights of Pennsylvania, working on initiating quality measures for CMS to improve effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. She received her bachelor’s degree in communication disorders from Marywood University in Scranton, Pennsylvania; a master’s degree in communication disorders from St. Louis University. Ms. Dougherty is certified in VitalStim® therapy and is a VitalStim® instructor, has completed additional training in orofacial myology, is a member of the American Speech, Language and Hearing Association, is a consultant for DOJ and has received numerous ASHA ACE Awards. For more information, please visit www.dldspeechpath.com.

Financial Disclosure Denise receives honoraria from CIAO for the presentation of her live courses and royalties for the sale of her online courses. Denise is in private practice and receives legal consultant/expert witness fees
Non-Financial Disclosure: There are no non-financial relationships to disclose.

15 Minutes
NDDS development and guidelines
15 Minutes
Shortcomings and lack of standardization
15 Minutes
IDDSI development and guidelines
15 Minutes
Key differences, terminology – IDDSI vs. NDD
30 Minutes
Food criteria and testing methods
15 Minutes
Liquids, viscosity and testing methods
15 Minutes
Red flags with diets – terminology, food criteria
2.0 Hours
Total

Delivery VIA:

  • Online - This course is offered in an online, on demand format.
  • Club CIAO - Club CIAO: This course is also part of Club CIAO, our all-you-can-eat buffet of online courses for one low price. Club CIAO Members also receive 25% off of all Live Stream courses!

Contact hours pre-approved for:

  • 2 Hours
  • CIAO is an ASHA Approved Provider #AAWA (0.2 ASHA CEUs) bubble sheet submission required
  • ASHA CE Provider Approval and use of the Brand Block does not imply endorsement of course content, specific products, or clinical procedures.
  • This course meets PDU requirements for NBCOT (2 PDUs)
  • CIAO is an Approved Provider for the Florida Board of Occupational Therapy
  • Approved for:
  • 2 Hrs. OT/COTAs in FL (CE Broker #20-1338925)
  • 2 Hrs. Registered with CEBroker for OT/COTAs in AL, AZ, GA, LA, MS, SC, TN

Course meets requirements for:

  • OT/COTAs in AL, AK, AZ, AR, CA, CO, CT, DE, DC, GA, HI, ID, IL, IN, IA, LA, KS, KY, ME, MD, MA, MI, MN, MS, MO, MT,
  • OT/COTAs in NE, NV, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY

    • Intermediate Level
    0.2 ASHA CEUs


    CIAO Automatically reports to CE Broker for Florida Occupational and Physical Therapists and Assistants. Florida SLPs can either use the ASHA CE Participant Form (Bubble Sheet) or self-submit through CE Broker.


    CIAO is recognized on the NBCOT Provider Registry (meets PDU requirements for NBCOT)


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