Transitional Foods in Dysphagia and Feeding Management: Perspectives of Speech-Language Therapists in Singapore

Transitional foods (TFs) are foods that change texture with moisture and/or temperature. Despite their potential to aid chewing development and swallowing rehabilitation, TFs remain underutilized in clinical practice. This study explored the perspectives of speech and language therapists (SLTs) in Singapore regarding TFs in dysphagia and feeding management, aiming to inform the development of TF products to expand available food options. A cross-sectional online survey was conducted among actively practicing SLTs. The survey included closed and open-ended questions on understanding of TFs and its usage, and perceived facilitators and barriers to the use of TFs. Fifty-eight registered SLTs who had managed clients with feeding difficulties and/or dysphagia within the last five years participated. Most worked in public health institutions with adult clients. While 93.1% had heard of TFs, only 22.4% accurately described them per the International Dysphagia Diet Standardisation Initiative (IDDSI) definition; 56.9% provided partially correct descriptions lacking key defining features, and 12.1% gave erroneous definitions. Over half (58.6%) had recommended TFs, primarily to expand food options and support therapy, despite infrequent client-driven requests for TFs. Key barriers included concerns about swallowing safety, variability in texture transitions, limited training, and institutional constraints. The findings highlight a gap in SLTs' knowledge and confidence regarding TFs. Despite the perceived benefits of TFs, unclear definitions, lack of safety data, and systemic barriers hinder consistent use. The broad IDDSI definition may limit clinical applicability; refining it through subcategorization based on specific characteristics could improve safety assessment and support wider adoption in dysphagia and feeding management.