Is a banana a soft food?
It sounds like a simple question.
If you support someone with dysphagia (swallowing difficulty), It isn’t.
A green banana and a ripe yellow banana are completely different in texture. One is firm, the other is soft. Same fruit, different texture.
For someone on a mealtime management plan, that difference matters.
Where this started for me
“Dysphagia” was a word I first saw in my support work training and quietly filed under “complex medical terms”. I recognised it, but I never really understood it.
That changed after a conversation with a speech pathologist who specialises in swallowing and dysphagia support, which led me to enrol in a dedicated dysphagia course. A few lessons in, I had already learned things I wish I’d known earlier.
What I understand now: swallowing difficulties affect people of all ages, not just the elderly. The risks are serious — choking and aspiration (food or drink entering the airway). And the early signs are easy to miss at the dinner table if nobody has taught you what to look for.
Who does what at mealtimes
Here is the part that matters for anyone choosing a support worker.
A speech pathologist assesses the person’s swallowing and writes the mealtime management plan, including which food and drink textures are safe.
A support worker implements that plan — meal after meal, day after day.
That division of roles is important. A support worker doesn’t decide what texture is safe; the speech pathologist does. My job is to make sure the food on the plate matches the plan, every time. A plan the support worker doesn’t fully understand is just a document in a folder.
What IDDSI is, in plain English
The International Dysphagia Diet Standardisation Initiative (IDDSI) is the framework speech pathologists use to describe food textures and drink thickness. It has eight levels, numbered 0 to 7: drinks run from Level 0 (thin) to Level 4 (extremely thick), and foods from Level 3 (liquidised) to Level 7 (regular).
What makes IDDSI practical is that anyone can test a food against a level using ordinary utensils — no lab equipment. A few examples:
- Fork pressure test — press the food with a fork to see how it changes under pressure, used for the pureed-to-soft food levels.
- Spoon tilt test — check whether a food holds its shape on a spoon and slides off without sticking.
- Flow test — a 10 ml syringe test that classifies drinks by how fast they flow.
The rule I follow is simple: check every time, against the person’s plan, with the proper IDDSI test. Not from memory, and never by assuming a food is safe because of its name.
A banana is the perfect example — its name says “soft”, but only the test and the person’s plan can tell you whether this banana, today, is safe for this person.
What this looks like in day-to-day support
For families and support coordinators, here is what I believe good mealtime support should look like from the worker’s side:
- The worker has carefully read the mealtime management plan and can tell you what texture level the person is on.
- Food and drink is checked against the plan at every meal — not just when something looks unusual.
- The worker knows the warning signs during and after meals, and reports concerns to the family and the speech pathologist rather than adjusting things on their own.
- Any change in the person’s eating or swallowing is documented and passed on, because plans are only as good as the information behind them.
None of this replaces professional advice — it supports it. The speech pathologist sets the level; the support worker’s discipline is what makes the plan real, every day, every meal.
A note for culturally and linguistically diverse families
Mealtime is cultural. Congee, steamed egg, soft noodles, soup with rice — many everyday Chinese dishes adapt beautifully to texture-modified diets, but families need someone who can talk through the plan in their own language and respect how they cook. Being able to explain a mealtime plan in both English and Mandarin is one of the things I care most about getting right.
Feng is the founder of Journey In Action Support, an NDIS provider based in Sydney’s Lower North Shore. With a Certificate III in Individual Support, Feng supports participants across household tasks, personal care, transport, and community access — with a bilingual Mandarin and English service that reflects the needs of the local Chinese-Australian community.
