Back-to-Cafeteria: How To Help Kids Who Struggle With Eating as the New School Year Begins

(Rockville, MD) For some children heading back to school this fall, their biggest challenge may not be reading or math but, rather, something else that’s critical to their academic success: eating meals at school.

Children can experience all types of difficulties with eating, from limited diets (“picky eating”) to feeding and swallowing disorders, according to the American Speech-Language-Hearing Association (ASHA). Feeding challenges may occur due to a medical problem or in conjunction with other developmental differences or disorders. Regardless of the reason, all children need appropriate nutrition and hydration to learn and participate in the school day.

Cafeteria Struggles

The cafeteria can present numerous challenges for children who have difficulty eating. These include:

• Overwhelming sensory environment. The cafeteria can be loud, crowded, and hot. The sights and smells may bother some kids. The tables may be sticky, and the cafeteria benches may be uncomfortable. None of these factors makes eating easy or fun. Some students may require a distraction-free environment to safely eat.
• Time constraints. Students often have a small amount of time to eat—usually, much shorter than they are used to having at home. Students receiving feeding and/or swallowing treatment may need more time to eat. This accommodation may be included in a child’s individualized education program (IEP).
• School-based food restrictions. Some schools have rules about foods that children can or cannot bring, such as no peanut products. For kids who have limited diets, it’s not always easy to find alternatives to a preferred food. Also, some children may not have options if they are provided free or reduced-price meals at school. If a student has a documented feeding or swallowing disorder and requires a modified diet, then the school district’s food services program must offer the meal accommodations recommended in the student’s feeding and swallowing plan.

Twelve Tips for Success

ASHA offers these tips to parents and caregivers to help their child eat successfully in the school setting:

1. Make their lunch gear fun. Let kids pick out a lunchbox with their favorite character or theme, or a Thermos® or bento box of their choice. Alternatively, have them decorate or personalize a basic lunchbox or other items that they already have.
2. Help them prepare. Have kids practice eating in the time they’ll be given at school. Try this for a few days before school starts. If you’re sending in containers or prepackaged food or drinks, make sure that they can open them first before packing such items in their lunchbox.
3. Go grocery shopping together. Look for new items that they may want to bring—or meal ideas to try. Be sure to try them at home first.
4. Brainstorm ideas. Write out a menu of options that are reasonable for you to prepare. Make sure that these foods can also be eaten at school easily (e.g., foods that don’t need to be cut up or kept at a very specific temperature). Have them choose their lunch from that menu each day.
5. Let them pack their meal. Kids love to take ownership and show some independence. They’ll be much more likely to eat what they choose to pack. If you don’t feel comfortable giving them total control, offer choices—let them pick one “main course,” one “side dish,” and one “dessert” out of items that you have pre-selected. Do this the night before, so you aren’t stressed or in a rush the next morning.
6. Troubleshoot together. Ask your child what makes eating in the cafeteria difficult. For example, maybe they don’t have enough time to eat when they buy lunch. Talk it through with them and see if you can solve the issue together.
7. Send foods that your child is comfortable eating. You may desperately want to expand your child’s diet, but you also want to maximize the likelihood that they’ll eat at school so they’re nourished properly during the day. Save the experimentation for home.
8. Aim for foods that will keep them full, but don’t stress over perfect meals. Ideal foods are ones that are protein-rich and/or high in fiber because they’ll keep kids full for longer. But remember, the best foods are the ones that your child will actually eat.
9. Don’t obsess over what they didn’t It’s frustrating when you spend time carefully packing a lunch—only to notice that it comes home lukewarm and untouched. Ask your child why they didn’t eat their meal: Did they not like it? Or did they just not have time to eat it? Try not to scold them about the uneaten food.
10. Arrange for your child to have a lunch Eating with a friend is always more fun. A lunch buddy can be a support—and even a role model—for trying new foods. Talk to the school staff about finding a willing peer for this role.
11. Talk to the cafeteria manager or other school staff. If your child is provided meals at school and isn’t eating what is served, check with the school about alternative options. If a child is regularly not eating the food provided, then this lack of needed nutrition likely will impact their learning and/or behavior.
12. Help your child to advocate for themselves. If your child has an IEP with feeding and swallowing goals and accommodations, help them understand what their goals are and what they can safely eat.

Getting Help for Feeding Problems

Speech-language pathologists (SLPs) help children who have difficulties with their feeding and swallowing. Feeding and swallowing disorders can lead to health, learning, and social problems, so it’s important not to minimize these challenges. SLPs can help children try new foods or textures, can help parents feel more confident feeding their child, and can provide feeding therapy (e.g., using certain exercises to strengthen the muscles in their mouth, moving their tongue around more while eating or drinking).

Children with a diagnosed feeding or swallowing disorder may need additional support eating in school, including modified food and drink consistencies. These students should have an IEP or 504 plan to guide school-based treatment and accommodations. They also may have a swallowing and feeding program (which is typically designed by an SLP) and/or an individual health plan (which is typically designed by a school nurse).

If you have concerns about your child’s eating, talk to your pediatrician and seek an evaluation from the school-based SLP or from a private SLP who specializes in feeding and swallowing. You can find one at www.asha.org/profind.

About the American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 234,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders.