After a child witnesses a choking incident, it’s normal for them—and those around them—to feel anxious about mealtimes. For elementary-aged children, these emotions can feel even more overwhelming due to their developmental stage, which is rooted in concrete, black-and-white thinking. This means children at this age are more likely to make firm rules or conclusions in their minds about what is "safe" or "dangerous," sometimes in ways that don't make sense logically but feel very real to them.
As parents, you want to provide emotional support and practical guidance to help your child regain a sense of safety. Below are some compassionate ways to talk to your child about the incident, ease their anxiety, and help them confidently re-engage with eating and school environments.
Understanding Your Child’s Cognitive Stage
Children in the elementary school age group are typically in what psychologists call the Concrete Operational Stage of development, which occurs between the ages of 7 and 11. At this stage, kids begin thinking logically about concrete events but often form rigid rules or beliefs about the world. When a traumatic event like a choking incident happens, their minds might create strong but flawed conclusions such as:
“If I eat at school, I will choke.”
“The cafeteria is a dangerous place.”
“I can only eat at home where it’s safe.”
While these “rules” make sense to a child trying to protect themselves, they can lead to increased fear, avoidance, and anxiety. It’s essential to acknowledge these thoughts and guide your child toward healthier, more balanced thinking about mealtimes and safety. Here’s how you can help them reshape these rules:
1. Open a Conversation with Reassurance and Compassion
Start by gently addressing their concerns. Acknowledge how scary the experience must have been for them, whether they directly experienced the choking or witnessed it happen to someone else.
You might say:
"I know what happened was really scary, and it’s okay to feel nervous about it.”
"Sometimes, when something like this happens, our brains try to protect us by thinking of rules to keep us safe. But some of those rules don’t work the way we want them to."
Let your child express their fears, no matter how irrational they may sound. By listening first, you gain a deeper understanding of their thoughts. Then you can create a sense of safety and connection before you guide them toward new ways of thinking.
2. Set Healthy, Practical Safety Rules
Once your child has shared their thoughts, you can help them understand that while mealtimes do require mindfulness, they can still be safe and enjoyable. To counteract their black-and-white thinking, introduce new rules that help them feel in control while maintaining a sense of safety. For example:
"Did you know that we eat so many times daily—breakfast, lunch, dinner, and snacks—and choking almost never happens? It's very rare, especially when we're careful and take our time while eating. We all have little rules we follow, like chewing our food well and sitting down while we eat, and those keep us safe. So even though what happened was scary, it’s something that almost never happens, and there are lots of ways to make sure we stay safe."
It’s important to emphasize that eating at school or in other environments can be and is usually very safe for them. Reassure them that adults are there to help and support them at all times.
3. Gradually Reintroduce the Cafeteria or School Lunches
If your child is avoiding the cafeteria or is scared to eat at school, reintroducing them to these environments slowly and gently can help reduce their anxiety. Here are some strategies you can use:
Start Small: If they’re nervous about going to the cafeteria, consider arranging a visit outside of mealtime hours. Let them sit in the space and become more comfortable without the pressure of eating. You can slowly increase exposure by having them eat a snack in the cafeteria when fewer students are present.
Positive Reinforcement: Praise your child for taking small steps toward re-engaging with school mealtimes. Even sitting in the cafeteria for a few minutes without eating can be a significant achievement. I have a list of affirmations for children to choose from, allowing them to pick the ones that resonate most and give themselves a positive pep talk. Go to www.thatmakessenseot.com/affirmations to download your copy. (I don’t have this set up yet but I can get it set up easily.)
Plan Together: Collaborate with your child to create a plan that helps them feel safe. This could be having them choose their lunch, packing familiar and easy-to-eat foods, or sitting with a trusted friend during meals. Small changes like these can give your child more control and confidence.
4. Model Calm, Safe Eating Practices
Children look to adults for cues on how to react in certain situations. Modeling calm, mindful eating at home can help them feel more confident during mealtimes. Show them what it looks like to chew thoroughly, eat slowly, and take breaks if needed.
Encouraging them to notice how their body feels when they eat—whether they’re feeling full, hungry, or nervous—can help them reconnect with their own internal signals in a safe way.
5. Provide Emotional Support for Anxious Feelings
It’s common for children to experience lingering anxiety after a choking incident, especially if they witnessed it happen to a friend or peer. Remind them that it’s okay to feel nervous, and that those feelings won’t always feel as strong as they do right now. Help them name their emotions and offer validation, while also providing coping mechanisms to manage anxiety.
It’s important to validate fears about choking while also guiding them toward new, healthier “rules” that allow them to feel safe and secure. As a feeding and sensory specialist, I can offer personalized strategies to address ongoing anxiety, help them regain confidence with eating, and provide practical tools for ensuring safe and peaceful mealtimes. Feel free to reach out if you’re looking for one-on-one consultation or additional resources. Together, we can work through these challenges and create a path toward healing and confidence for your child.
Brenda Chilstrom, OTR/L
Pediatric Occupational Therapist and Feeding Specialist
That Makes Sense OT
239-595-7018