2 APPLICATIONS IN CONTRAST IMAGING CE Information Diagnosis and Management of Swallowing Physiology: Standardized Contrast, the MBSImP™, & the IDDSI Framework Summary Dysphagia (difficulty swallowing) is a serious physiologic disorder seen in individuals of all ages. The modified barium swallow study (MBSS) is widely used, together with barium sulfate radiographic contrast media and the Modified Barium Swallow Impairment Profile (MBSImP), to diagnose and assess dysphagia. In 2013, the global International Dysphagia Diet Standardisation (IDDSI) Initiative developed a framework of new, standardized terminology and testing methods to describe food textures and drink thickness with the goal of developing international standardized terminology and descriptors for dysphagia diets. The goals of MBSImP, Varibar ® , and IDDSI are all standardization, so what are the differences, and how are they each used in clinical practice? The goal of this article is to assist clinicians and other healthcare providers tasked with diagnosing and managing the patient with dysphagia in understanding the relationship between the MBSImP, and Varibar and IDDSI terminology, and how to utilize them in clinical practice. Considerations specific to pediatric patients, as well as clinical practice–related policies and procedures, are also addressed. Learning Objectives At the conclusion of this activity, participants should be able to: • Explain how a standardized set of barium sulfate products is used during a modified barium swallow study (MBSS) to identify pathology related to swallowing physiology • Describe how the Modified Barium Swallow Impairment Profile (MBSImP) is used to ensure objective scoring and communication of the results of an MBSS • Review what the global International Dysphagia Diet Standardisation (IDDSI) framework is and how it is used to classify foods and liquids according to their physical properties (ie, consistency, stickiness, etc.) • Describe any pediatric-specific considerations related to use of the MBSS, Varibar, and the IDDSI framework to assess and manage dysphagia in infants and children • Summarize best practices for assessing swallowing physiology using the MBSS in the clinical setting Authors Catriona M. Steele, PhD, is a senior scientist and director of the Swallowing Rehabilitation Research Laboratory, KITE – Toronto Rehabilitation Institute – University Health Net- work; and a professor of speech-language pathol- ogy at the Rehabilitation Sciences Institute, Univer- sity of Toronto, Toronto, Canada. Bonnie Martin-Harris, PhD, is the Alice Gabrielle Twight Professor and Associate Dean for Faculty Affairs, Rox- elyn and Richard Pepper De- partment of Communication Sciences and Disorders School of Communication; Otolaryngology-Head and Neck Surgery and Radiation Oncology, at the Feinberg School of Medicine, North- western University, Evanston, IL, USA. Stephanie Edwards Allen, BSRT, MBA, is Continual Read- iness Coordinator at Monarch, Creedmoor, NC, USA. Memorie Gosa, PhD, is an Associate Professor of communicative disor- ders at The University of Alabama, Tuscaloosa, AL, USA.