What is IDDSI?

IDDSI is a standardised framework that classifies:

• drinks/liquids into Levels 0–4, and

• foods into Levels 3–7 (with Level 7 being regular foods).

A key benefit of IDDSI is that it provides a consistent “common language” for textures and thickness across settings (home, hospitals, aged care, disability supports), along with simple testing methods to check the consistency is correct.

In Australia, Speech Pathology Australia notes that the IDDSI framework was adopted nationally in 2019.

Why might someone need texture modification? 

Texture modification may be recommended when swallowing is less efficient or less safe. Common reasons include:

• neurological conditions (e.g., stroke, Parkinson’s disease, MND)

• deconditioning, frailty, or fatigue affecting swallowing endurance

• cognitive changes impacting safe pacing/supervision

• head/neck or respiratory conditions (where relevant)

• developmental or disability-related swallowing challenges

The right strategy depends on the person. Sometimes texture changes are part of the solution; other times, positioning, pacing, supervision, or mealtime environment changes are equally important.

How Palms can help

Our Speech Pathology support may include:

• clinical assessment of swallowing and mealtime function (as appropriate)

• education on IDDSI levels and what they mean day-to-day

• advice on positioning, pacing, supervision, and fatigue management

• collaboration with OT for seating/equipment where relevant

• clear written guidance for families, carers, support workers, and schools

• review and adjustments over time as needs change

Where clinically indicated, we may recommend coordination with your GP/specialist or additional investigations (outside the scope of this page).

What do we do? 

At Palms Physiotherapy & Allied Health (Malaga), our Speech Pathologists can support clients and families with:

• understanding IDDSI levels in plain English

• practical mealtime strategies and education

• mealtime management plans (where appropriate)

• communication with carers/support teams around consistency and implementation

Who can benefit?

Feeding & Swallowing assessments and plans may help:

Children with feeding challenges, sensory-based preferences, limited food range, or mealtime distress

Adults with swallowing difficulties (dysphagia), neurological conditions, or post-illness deconditioning

Older adults experiencing coughing/choking risk, fatigue, reduced appetite, or swallowing changes

People with disability who need consistent, safe mealtime strategies across settings

Funding & referrals

We welcome a range of funding pathways and can help you understand the best option for your situation.

We see clients using:

Private (self-funded)

NDIS (self-managed and plan-managed)

Aged Care / Home Care Packages

Medicare (where eligible, with a GP referral)

DVA (eligible veterans)

Other funding pathways (e.g., insurers or schemes, where applicable)

Where clinically appropriate, we can provide supporting documentation to inform service planning and care coordination.

Chewing & Drinking Assessment FAQ

Is this different to a swallowing assessment?
It can overlap. Oral function focuses on skills for chewing/drinking and oral control; swallowing assessment focuses more directly on swallow safety and airway protection. We’ll tailor the assessment to your concerns.

Will you recommend texture changes?
Where clinically appropriate. Recommendations depend on assessment findings and may require additional medical input if risk is elevated.

Can you provide a plan for support workers or school?
Yes—where appropriate we can provide practical written guidance to support consistency.

IDDSI FAQs

Is IDDSI the same as a swallowing assessment?
No. IDDSI is a framework for describing and testing textures/thickness. A swallowing/mealtime assessment helps determine what strategies (including any texture modification) are clinically appropriate for the person.

Can you tell me what IDDSI level I need without seeing me/my family member?
No—because recommendations must be based on individual assessment. We can provide general education, but clinical recommendations should be personalised.

Do you provide IDDSI education for support workers/schools/aged care staff?
Yes. Where appropriate, we can provide training and written plans so that strategies are consistent across settings.

Do you provide thickener products or pre-thickened drinks?
We can provide education and guidance, but product supply is usually via retail/medical suppliers. We can discuss options and what to consider.

Does everyone with dysphagia need thickened fluids or pureed foods?
Not necessarily. Some people benefit from other strategies (positioning, pacing, supervision, or specific swallow techniques). The plan should be individualised.

Signs you should seek urgent medical advice

Please seek urgent medical review if you notice any new or worsening:

frequent coughing/choking during meals or drinks

wet/gurgly voice after swallowing

recurrent chest infections or suspected aspiration

significant weight loss, dehydration, or inability to maintain intake

sudden change in swallow function, weakness, or breathing issues

In an emergency - pelase call 000.

Speech Therapy Services in Perth for Children & Adults

Speech Therapy (also called Speech Pathology) focuses on assessing, diagnosing, and treating communication and swallowing difficulties. At Palms Physiotherapy & Allied Health, our speech pathologists support children, teens, and adults to improve speech clarity, language skills, social communication, voice and fluency and swallowing safety.

How Can Speech Therapy Help You?

Speech therapy can help with a wide range of concerns, including:

• Speech delays in children: Supporting speech sound development, clarity, and age-appropriate communication.

• Speech sound disorders: Including articulation (sound production) and phonological (sound patterns) difficulties.

•  Language disorders: Helping with both receptive language (understanding) and expressive language (using words and sentences).

• Swallowing and feeding difficulties (dysphagia): Supporting people who have difficulty swallowing safely due to conditions such as stroke, traumatic brain injury, or neurological conditions.

• Social communication differences: Supporting conversational skills, turn-taking, perspective-taking, and understanding non-verbal communication.

•  Stuttering and fluency disorders: Helping clients manage fluency, reduce effort/tension, and build confidence in communication.

Speech Therapy Services We Provide

Paediatric Speech Therapy

• Paediatric speech therapy supports children with speech, language, communication, and early literacy needs using evidence-based and child-friendly approaches. Sessions may be play-based (especially for younger children), while still being structured and goal-directed.

• Common areas we support include:

  1. Speech sound development (clarity and intelligibility)

  2. Language delays and developmental language disorder

  3. Social communication support

  4. AAC (Augmentative and Alternative Communication) where appropriate

  5. Early literacy foundations (e.g., phonological awareness)

Adult Speech Therapy

• Adult speech therapy supports adults with communication and swallowing needs related to neurological conditions, injury, medical events, or age-related changes. Therapy is practical, functional, and designed around everyday participation (home, work, community).

• Common areas we support include:

  1. Communication changes after stroke, traumatic brain injury (TBI), or neurological illness

  2. Dysarthria and motor speech changes

  3. Cognitive-communication difficulties (attention, memory, organisation impacting communication)

  4. Voice therapy where indicated

  5. Dysphagia support and mealtime strategies

NDIS Speech Therapy Services

• NDIS speech therapy is available for self-managed and plan-managed participants. Therapy may focus on functional communication goals, speech clarity, social interaction and participation, and AAC support where required. We collaborate with participants, families, support coordinators, schools, and relevant providers to support practical, meaningful outcomes.

Speech Therapy for Swallowing Disorders (Dysphagia)

• Dysphagia (swallowing) support helps when swallowing difficulties affect hydration, nutrition, safety and confidence with eating and drinking. Our speech pathologists can complete clinical assessments (as appropriate), provide strategies for safer swallowing, recommend targeted exercises when indicated, and support shared-care referral pathways with GPs/ENT/medical teams when needed.

• Why Choose Palms Physiotherapy & Allied Health for Speech Therapy?

• Experienced Speech Pathologists: Skilled in paediatric and adult communication and swallowing support.

• NDIS Provider (self- and plan-managed): Therapy is aligned to participant goals and everyday function.

• Family-Centred Approach: We involve parents, carers, and supports where appropriate so strategies carry over into real life.

• Collaborative, Multidisciplinary Care: We work alongside our broader allied health team when integrated support is beneficial.

Sensory Room and Kids Therapy Gym

• Our sensory room and kids therapy gym can support therapy goals through a motivating, functional environment—particularly helpful for children who benefit from movement-based learning and sensory regulation strategies. These spaces may be used when clinically relevant to support engagement, attention, participation, and goal progress.

Locations

• We offer speech pathology services in Perth, including our Malaga and Noranda clinics.

Speech Therapy – What We Can Help With

Speech pathologists (speech therapists) support children and adults with a wide range of speech, language, voice, fluency, and swallowing needs. Below is a practical overview of the common areas we assess and treat at Palms.

Speech Sound & Motor Speech

• Articulation Disorders: Difficulty producing specific speech sounds clearly (e.g., /s/, /r/, /l/).

• Phonological Disorders: Patterns/rules of sound errors that reduce intelligibility (e.g., fronting, final consonant deletion).

• Apraxia of Speech: Motor planning/programming difficulty; speech errors may be inconsistent and speech can sound “choppy.”

• Dysarthria: Speech changes due to weakness, tone or coordination differences affecting speech muscles.

Language

• Expressive Language Disorder: Difficulty using words/sentences to share ideas, tell stories, ask questions, or use grammar accurately.

• Receptive Language Disorder: Difficulty understanding spoken/written language, following instructions, or processing complex language.

• Mixed Expressive–Receptive Language Disorder: Difficulties with both understanding and expressing language.

• Developmental Delays: Support when speech and language milestones are developing more slowly than expected.

• Aphasia: Language difficulty often after stroke/brain injury, affecting speaking, understanding, reading and/or writing.

Voice

• Hoarseness or Strained Voice: Raspy, breathy, strained or unreliable voice; can relate to vocal load, inflammation, reflux, or vocal fold changes.

• Vocal Cord Paralysis: One or both vocal folds do not move normally, impacting voice, breathing and/or swallowing.

• Resonance Disorders: Speech that sounds overly nasal or “blocked”; may be structural, neuromuscular and/or learned.

• Gender Affirming Voice and Speech Therapy: Support to align voice and communication with gender identity using safe, evidence-based voice techniques.

• Psychogenic Voice Disorders and Conversion Disorder: Voice changes linked to psychological factors; therapy supports voice recovery and functional communication.

Fluency

• Stuttering: Disruptions to speech flow (repetitions, prolongations, blocks) that can impact confidence and participation.

• Cluttering: Fast or irregular speech rate that can reduce clarity and organisation of spoken messages.

Social Communication

•  Pragmatic Language Disorder: Support for conversation skills, turn-taking, topic maintenance, inference, and interpreting non-verbal cues.

Swallowing & Feeding

• Dysphagia (Swallowing Disorders): Assessment and strategies to support safe swallowing and reduce aspiration risk (often alongside GP/ENT/medical teams when needed).

Hearing & Listening

• Hearing Impairments: Therapy to support listening, speech clarity, language development, and communication strategies in partnership with audiology where required.

Neurological Conditions

• Speech Therapy for Neurological Conditions: Communication and swallowing rehabilitation for stroke, TBI, Parkinson’s disease, MS, dementia and other neurological conditions.

Early Literacy & Phonological Awareness

• Phonological Awareness: Therapy targeting sound awareness skills that underpin reading/spelling (rhyming, blending, segmenting, manipulation).

Post-Surgical Head & Neck Rehab

• Post‑Surgical Rehabilitation for Laryngectomy and Head and Neck Cancer: Multidisciplinary support for communication, swallowing and function after surgery/treatment (in shared care with your treating team).

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.