Table 6.

Updated Dysphagia Severity Rating Scale incorporating International Dysphagia Diet Standardisation Initiative (IDDSI) levels²⁵.

Score	Fluids	Score	Diet	Score	Supervision
4	No oral fluids	4	Non oral feeding	4	No oral feeding
3	IDDSI level 4 - extremely thick	3	IDDSI level 4 - pureed or level  5 - minced & moist	3	Therapeutic feeding (SALT/trained staff)
2	IDDSI level 3 - moderately thick	2	IDDSI level 6 - soft & bite sized	2	Feeding by third party (untrained)
1	IDDSI level 1- slightly thick or level 2 - mildly thick	1	IDDSI level 7 - easy to chew	1	Eating with supervision
0	IDDSI level 0 - thin	0	IDDSI level 7 - regular	0	Eating independently

DSRS supervision score 3 is always chosen when a patient is on limited or consistent oral trials and still requires NG/ PEG tube.

Oral trials are scored from the fluid and diet subscales (i.e. 3 onwards) and can be either trials of food or fluid or trials of food and fluids.