Back-to-Cafeteria: Advising Families Whose Children Struggle With Eating

It’s back to school time, and, as speech-language pathologists, we know that students who have difficulty eating or drinking—with or without a diagnosed feeding or swallowing disorder—can face a lot of additional stress. So can their families. Eating challenges for students can also aggravate other health, learning, and social issues.

These students likely have IEP or 504 plans to guide school-based accommodations. They might also follow a swallowing and feeding program designed by an SLP and/or a health plan designed by a school nurse.

Here are challenges these students—and others not diagnosed—might face, and insights SLPs can share with the students, their families, and school staff.

Cafeteria challenges 

The cafeteria can present numerous challenges for children who have difficulty eating. SLPs can help identify and share reasons a student might find eating in the cafeteria particularly challenging, along with strategies to overcome or avoid them: 

Overwhelming sensory environment. The sights and smells in a loud, crowded, hot cafeteria might bother some students. Tables can be sticky, or benches might feel uncomfortable. Finding a quiet, comfortable space with distraction-free environment can help students eat safely.  

Time constraints. Students often have a short amount of time to eat—those receiving feeding and/or swallowing treatment might need more time to eat, which can be included as an accommodation in an IEP or 504 plan.  

School-based food restrictions. Some schools have rules about foods that children can or cannot bring, such as no peanut or tree nut products. For student with limited diets, it’s not always easy to find alternatives to a preferred food. Also, some students might not get options if they receive free or reduced-price meals. If a student requires a modified diet for a documented feeding or swallowing disorder, the school district must provide the meal accommodations in their feeding and swallowing plan. 

Twelve strategies for lunchtime success 

You can share these strategies with families to help their child eat and drink successfully in the school setting: 

1. Make their lunch gear fun. Let your child pick out a lunchbox with their favorite character or theme or find compartmented containers like a bento box. Alternatively, make decorating a plain lunchbox or food containers into an engaging art project.
2. Help them prepare. Before school starts, practice eating lunches at home in the time they’ll be given at school.  Make sure that they can open containers or packages before including them in their lunchbox.  
3. Grocery shop together. Look for new foods they might want to try or prepackaged versions of preferred foods and drinks. Be sure to sample them at home first.
4. Collaborate on menus. Write out a menu of options that are reasonable for you to prepare and can be eaten easily, then let your child choose their lunch from the menu.
5. Let them pack their meal. Kids thrive on taking ownership and showing some independence. They’ll be 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.” Do this the night before, so they don’t feel rushed 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. Aim for filling foods, but don’t stress over perfect meals. Foods protein-rich and/or high in fiber keep us full longer. But the best foods are the ones your child will actually eat. 
8. Don’t worry about what they didn’t eat. It’s frustrating when you spend time carefully packing a lunch only to have it come home 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 and maybe discuss other options. 
9. Arrange a lunch buddy for your child. 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 or the parent of a friend.
10. Talk to school staff. If your child gets school meals and isn’t eating what they serve, check with school administrators or the cafeteria manager about alternative options. If a student regularly misses meals, then this lack of needed nutrition can affect their learning and/or behavior. 
11. Help your child advocate for themselves. If your child has an IEP with feeding and swallowing goals and accommodations, help them understand what their goals are, what they can safely eat, or who to talk to if they need help.

Stefanie LaManna, MS, CCC-SLP, CNT (she/her/hers), is an ASHA associate director of health care services in speech-language pathology. She is a certified neonatal therapist. [email protected].

Lisa Rai Mabry-Price, MS, CCC-SLP (she/her/hers) is an ASHA associate director of school services in speech-language pathology.  [email protected].