Ingestion-related Factors in the Risk of Suffocation by Food among Mentally Handicapped Children in School

Abstract

In 2013, a mentally handicapped child suffocated during lunch time at a special school for handicapped children in A-prefecture, Japan. The Ministry of Education sent to all schools in Japan a special message concerning this problem, recommending consultations with doctors or experts in this field, or experienced teachers, in the case of children having feeding disorders.

However, most school teachers have no criterion to distinguish children having these difficulties. In our survey on previous studies, we could not find any detailed survey on the cases of suffocation among mentally handicapped children. Therefore, we carried out a questionnaire regarding those children’s food feeding behavior in order to find some methods that enable school personnel to distinguish children having the risk of suffocation.

According to our survey, 14 children out of 489 respondents have nearly suffocated and there are significant differences in the 7 eating habit items between those who might have suffocated and the others.

Moreover, we found the following three items, (i) to (iii), especially show very significant differences: (i) to barely chew food before swallowing, (ii) to fill one’s mouth full of food while eating, and (iii) to put one’s tongue out with one’s mouth open when swallowing food. This result indicates that these criteria could help detect the risk of mentally handicapped children suffocating during the time of eating. Therefore, these eating habits would be useful for school personnel to screen children having the risk of suffocation and, if it is necessary to consult doctors or experts, to inform them about these habits.