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Meal times and students with an ABI fact sheet

Meal times and students with an acquired brain injury

Following a brain injury, a number of issues can arise for students during the meal time breaks.

How do I know if my student is having difficulties at meal times?

  • Difficulty getting food to their mouth or using utensils.
  • Difficulty opening lunch box, packaging, peeling fruit.
  • Student may forget to eat or continue to eat despite being full (altered sense of hunger).
  • Difficulty with the actions of chewing and swallowing such as,
    • coughing during or shortly after meals
    • wet, gurgly voice during or after eating or drinking
    • complaints of food sticking in the mouth
    • food remaining in mouth after a meal (usually in the space between the cheek and teeth)
    • general lack of awareness of food in the mouth
    • recurrent respiratory infections, or asthma-like symptoms.

What can I do to help my student overcome difficulties at meal times?

  • If possible, have the student seated at a table / bench.
  • Use easy to open packages- parents may need to peel fruit and wrap it in greaseproof paper.
  • Use pop top drink bottles – these are easier to open and can be pulled out with teeth.
  • Some students may need built up handles on spoons to assist with grasp.
  • Non-slip matting may help to stabilise containers / bowls when eating.
  • For students with swallowing difficulties:
    • the student should be seated with head tilted forward slightly to protect their airway
    • distractions should be minimised to promote concentration on the task of feeding
    • do not rush the student – let them dictate the pace at which food is given
    • try to stay calm and relaxed – the student will pick-up on your anxiety
    • interact with the student to make the mealtime a pleasant and fun experience
    • respect the student’s wishes – if they indicate that they do not want to eat or drink it is all right to encourage them but do not force them.

If a student has long term feeding difficulties, their doctor may recommend an alternative to feeding by mouth. The commonest method is a tube directly into the stomach through which liquid foods and drinks can be given. The percutaneous endoscopic gastrostomy, commonly known as PEG, is a surgical procedure done under anaesthetic.

Helping children eat is a common way of showing that you care, however dysphagia can be life threatening as food can block or enter the airway and lead to choking if it is not swallowed correctly. It is therefore very important to follow the advice of the medical team and speech pathologist regarding what food and drink types to offer, and how to feed.

Contact us

Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.