Magazine article The Exceptional Parent

Special Needs in the Lunchroom: Modifying School Meals for Students with Special Eating Needs

Magazine article The Exceptional Parent

Special Needs in the Lunchroom: Modifying School Meals for Students with Special Eating Needs

Article excerpt

Tacos, grapes, carrot sticks, an iced cinnamon roll and milk. Sounds like a typical school lunch, right" Most children have two options - eat hot lunch or bring lunch from home. But what are the options for children who choke on any foods except baby food, easily aspirate liquids (swallow liquids into the lungs), need low-calorie meals due to medical disorders, are allergic to certain foods, or are unable to chew food?

A "typical" lunch could be life-threatening to children with special needs.

Consider Nicki, a seven-year-old girl with head injuries, who cannot chew food and needs it blended to the thickness of pudding. Nicki refuses to eat most vegetables and fruits. Her teacher and parents have noticed that if they mix her food with mashed potatoes, she win eat more. This is crucial because she has lost five pounds m the last year and is now below the fifth percentile when her height-to-weight proportion is graphed on a growth chart.

Liquids also run down Nicki's throat too fast and cause her to choke. The school occupational therapist has recommended that the liquids be thickened using baby food cereal, yogurt or blended fruit such as applesauce.

How can Nicki's school lunch be modified to make it safer and provide her with the nutrition she needs?

School requirements

The Rehabilitation Act of 1973 required recipients of federal funds to make their program and activities accessible to all individuals with disabilities. Section 504 of the act incorporated new regulations for school meal programs into the Child Nutrition Program Regulations of 1988, commonly known as the breakfast and hot lunch program. These regulations require schools to modify or make substitutions in meals at no extra charge for students who meet the definition of having a disability and whose disability restricts their diet A person meets this definition if he or she has a physical or mental impairment which "substantially limits one or more major life activities," has a history of having such an impairment or is believed to have such an impairment.

Since the Child Nutrition Program Regulations are monitored through the U.S. Department of Agriculture (USDA) rather than the U.S. Department of Education, families and professionals who care for children with special needs are often not aware these regulations exist.

A variety of modifications and substitutions may be necessary to allow a student to consume the meals offered to students without special needs. Some students with gastrostomy my tubes may require a liquid formula, while other students may require modifications such as: * Substitutions of menu items to accommodate such dietary restrictions as allergies, or foods that don't puree well. * Recipe modification to provide foods that are low or high m certain elements such as fat sugar, fiber or protein. * Texture modifications such as thickening liquids, or grinding or chopping foods. * Other modifications in food characteristics such as temperature, portion size and nutrient composition.

It is imperative that nutritional value be considered when making any modifications to the meal. For example, if certain foods are prohibited, substituted foods should be similar in nutrient content.

Updated instructions issued in October 1994 by the USDA provide guidance to schools participating in breakfast and hot lunch programs. …

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