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I attended the "National Dysphagia Diet" presentation at the ASHA Convention and was surprised to learn that ASHA's dysphagia special interest division contributed to the development of this "blanket dysphagia diet." I hope speech-language pathologists realize that such a diet can have serious ramifications on our job security, as well as the safety of thousands of patients who have dysphagia. It is already a serious problem in hospitals and nursing homes where physicians are placing patients on dysphagia diets without first consulting an SLP for an evaluation. I understand the intent is to establish consistency in diets and agree it is needed at the food-preparation level, but blanket dysphagia diets do not work for all patients and should not be endorsed by SLPs. Patients with dysphagia require individualized diets (not all patients tolerate small cut or chopped foods, and some even do better with ground meats, contrary to what the National Dysphagia Diet proposes). I can envision many nursing homes and hospitals implementing the National Dysphagia Diet in their facility as a substitute for consultations to SLPs. It would be very naive of us to think this would not happen—it already does. Let's not encourage it by implementing "blanket" dysphagia diets.
C. Evans
Chicago, IL
Editor's note: The National Dysphagia Diet was published by the American Dietetic Association (ADA). Although SLPs participated in the project, ASHA asked the ADA to add a disclaimer indicating that the diet is not the product of a joint relationship between the ADA and ASHA, and has not been peer reviewed or approved by representatives of ASHA or its Special Interest Division 13, Swallowing and Swallowing Disorders.
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