✓ DAILY USE
Level 2 — Mildly Thick liquids. This is Louie's everyday drink consistency. All drinks at all meals should be thickened to mildly thick.
⚠ SLP ONLY
Level 0 — Thin liquids (regular water, juice, milk). Small controlled amounts by teaspoon, ONLY under direct supervision of a speech-language pathologist during therapy. Never at home.
✗ NOT ALLOWED
Level 1 — Slightly Thick. Not recommended at any time — it's the in-between consistency that is least safe for Louie.
⚠️ Ignore the "no liquids" line in the May 2026 IEP — it's a documentation error currently being formally amended. The swallow study below is the correct, authoritative protocol.
Source: Modified Barium Swallow Study · Cohen Children's Hospital · November 20, 2025 · Dr. Gantwerker (ENT) / Samantha Ackerman (clinician)