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Mealtime Guidelines. How to Decide on an Appropriate Diet?

While it is important that the SLT has a working knowledge of the textures and different food types within each texture in the NDD, the NDD alone will not guide the clinician in terms of choosing an appropriate diet for the patient. The SLT must decide this by using information from the clinical and instrumental assessments and their own clinical judgement. The "Task Force" behind the NDD found that when looking for a fairly systematic way to begin choosing an appropriate diet for a patient with dysphagia, a 'severity rating scale' was useful (NDD Task Force ,2002). The Task force decided that a rating scale called the "Dysphagia Outcome and Severity Scale" (O'Neill, Purdy, Falk, & Gallo,1999), appeared to have the best correlation to the solid food texture levels of the NDD, and could best help the clinician decide which National Dysphagia Diet is appropriate for a particular patient ( NDD Task Force, 2002).

It is very important here to realise that we are not saying that choosing a diet for a person with swallowing difficulties is as simple as matching severity and ratings scales with diferent textures. Each patient is different, will present with different aetiologies ,(in our case side effects caused by a partial glossectomy and radiotherapy) ,and cannot be ticked into a pre- decided diet according to a severity scale. While we can use the NDD and the Dysphagia Outcome and Severity Scale to help us guide the choices that we make, they should only be used as an adjunct to other assessments, clinical judgements, and the patients rights and preferences