Better training on choking risk and management is needed for staff and caregivers working with people with learning disabilities, according to a new study. 

The study published in Journal of Intellectual & Developmental Disability aimed to determine the prevalence of choking history and risk factors in a population-based sample of adults with intellectual disability (ID). It found that living in a community setting or in a residential care facility almost tripled the odds of choking history.

Choking is a serious health and safety concern for adults with learning disabilities and is often under-recognised and under-reported.

The study found that in many instances, an intervention was required to respond to choking. Yet, previous studies found that, often, staff members, especially those less trained, are not aware of how to intervene in case of choking. This data highlights the importance of caregiver and staff training on how to recognise a near-fatal choking episode and how to promptly intervene to avoid asphyxia.

Challenging behavior increased the odds of choking

The study found that the presence of challenging behaviours increased the odds of reporting choking history. This was because the behaviour may interfere with caregivers providing mealtime support, hence exposing the individual to higher choking risk. Furthermore, challenging behaviours have previously been linked to maladaptive eating behaviours, identified as strong predictors of choking in adults with ID.

The analyses also revealed that the co-occurrence of a range of disabilities increased the likelihood of reporting choking history. The authors said the findings are of critical importance for multidisciplinary involvement in risk identification and management.

The authors concluded: "Training staff and caregivers has the potential to increase confidence in providing mealtime support and adherence to mealtime recommendation. It is equally important to raise the awareness among individuals with ID, especially among those who eat independently. Accessible information should be given on how to prevent choking risk, and on hazard foods in ways that continue to value independence and the enjoyment of meals."