Swallowing & NDIS

Elephant in the Room Training & Consultancy

Servicing country, rural and remote towns in NSW.

Swallowing! What’s the big deal?

What’s the big deal?

6th of September 2019

Speech Pathology Australia recommends that: 

1.Clients should be screened for feeding/swallowing safety before being given food, drink or oral medications. Swallow screening should only be undertaken by individuals who have been trained, and using a validated tool. 

2. Clients who fail a swallow screen should be referred to a speech pathologist for a clinical assessment +/- oral/feeding trial. The speech pathologist will determine whether an instrumental assessment is indicated to support appropriate management.

The hard facts

In accordance with Speech Pathology Australia’s Dysphagia Position Paper, 2012;

  • Up to 60% of people with an acquired brain injury will experience swallowing difficulties.
  • Up to 60% of infants or children with a developmental disability will have a swallowing or mealtime disorder.
  • Swallowing disorders can be caused by developmental, congenital, functional or acquired disorders.

NDIS & Mealtime Management

The Commonwealth Government recently decided, as an interim measure, the NDIS will fund the ongoing development, assessment and monitoring of meal plans for NDIS participants with dysphagia who aren’t in a hospital or acute care setting.

When you meet with your NDIS planner you can ask for help with eating and drinking by; 

  • Asking for a swallowing assessment to be completed by a TRAINED speech pathologist.
  • Requesting for a review of their mealtime plan



  1. Assess people who are having trouble with eating and drinking.
  2. Complete a mealtime management plan for the person 
  3. Train services and families in mealtime management and safety.
  4. Review mealtime plans on a regular basis as required.
  5. Offer recommendations to maintain health & wellbeing or help with developing new mealtime skills.

For further information or to make a referral please contact:

Caroline Arndell on 0499 383 882 or email at admin@elephantintheroom.net.au

Let’s talk about sex!

Sexuality is an integral part of a person. All humans are sexual, regardless of how their sexuality is expressed. People with disabilities are denied sexual rights in part to keep them outside of mainstream society, and probably in part because people with disabilities are treated as if they are children.

Most people with intellectual disability can have rewarding personal relationships. However, some may need additional support to develop relationships, explore and express their sexuality, and access sexual health information at their level of ability and literacy.

Sometimes, a person with intellectual disability may exhibit inappropriate sexual behaviour, such as public masturbation. This is more likely to occur when the person has not been provided with appropriate education. The reason that non-disabled people deny people with disabilities access to sex education is because they believe that it will encourage them to want sex.

People with intellectual disability often need information and support to help them make decisions and formal education is particularly important for people with intellectual disability. They are less likely to informally learn about sexuality from movies, the internet, magazines and talking to friends. They also find it harder to learn what is ok and not ok sexual behaviour.

There are lots of Myths about people with a disability and sexuality that have been disproved over time and they include:

  • People with disabilities and chronic illnesses are not sexual
  • People with disabilities and chronic illnesses are not desirable and can’t have ‘real’ sex
  • There is a right way and a wrong way to have sex
  • People with disabilities are a bad choice for romantic partners
  • Disabled people have more important things to worry about than sex
  • People with disabilities are childlike and need to be told how to prioritise their lives.
  • People with disabilities are not sexually adventurous
  • People in institutions shouldn’t have sex
  • Sex is private- (may need help from a third party to have sex with your partner)
  • People with disabilities don’t get sexually assaulted
  • People with disabilities don’t need sex education

EITR can provide support and education to people with intellectual disability in the area of sexuality and relationships, as well as provide training to their support people, including service providers, teachers and health care workers. For information on services we provide please contact us on admin@elephantintheroom.net.au or 0499 383 882

Silence Isn’t Always Golden……..

When you think of a speech pathologist and what they do, you may not think about mealtime and swallowing disorders. Difficulties in swallowing are often detected by loud coughing, choking or difficulties with breathing, making it easy for families and staff to detect an issue with a person’s swallowing. But what happens if there is silence? Does that mean everything is alright? Is everything normal? Is there no cause for concern?????

Silent aspiration (food or drink entering the lungs) is common in people with swallowing difficulties. Silent aspiration has been reported as high as 67% in patients with a disability.

The big problem for the family and staff is that unfortunately these silently aspirating people, who are at most risk of pneumonia, are the most likely people to be missed……

So how do we combat such a scary and life-threating statistic?

People with a disability should be monitored closely for eating and drinking difficulties, including problems with;

  • Saliva and food management.
  • Chewing difficulties
  • Food refusal
  • Rapid and unexplained weight loss
  • Difficulties in using utensils and mealtime equipment
  • Choking, gasping and coughing; either during or after a meal
  • Reflux
  • Looking distressed, appears to be in discomfort or has watery eyes
  • Recurrent chest infections
  • Changes in behaviour around eating and drinking times e.g. verbalizing more, pushing away with their hands
  • Speech pathologists who work with people with disabilities often have years of extra training to detect swallowing disorders and manage them so that the person is safe to eat and drink and still maintain their quality of life by enjoying the mealtime environment.

An eating and drinking Assessment can be conducted by a qualified speech pathologist to investigate any difficulties and concerns you may have in regards to how a person is swallowing. Eating and drinking plans can be completed by the speech pathologist to ensure all safety measures have been considered around the mealtime environment.

Our Elephant In the Room Speech Pathologists are only a phone call or email away, so why not contact them on 0499383882 or at info@elephantintheroom.net.au to ensure your eating and drinking plans are all up to date.

10 easy steps to prepare for your NDIS planning meeting


1. Meet your NDIS Planner in person to do your plan.
2. Make sure the person with a disability goes to the meeting.  It helps planners put a face to the name!


3. Remember to consider SUPPORT COORDINATION.  We can coordinate your services and connect you with your community.  We can assist with your budget and planning around your funding.


4. If you choose to leave your plan with the NDIA you will have to use NDIS registered service provider.  Sometimes in our rural areas our services are not registered.  EITR is a registered NDIS provider.


5. Your supports need to be goal specific for example you cannot just ask for “speech pathology services” or an “occupational therapist”, you need to think about how these supports will help every day activities.


6. Goals should be disability related, e.g. NDIA will not fund a pool pass as this something that would be paid for regardless of if a person has a disability.


7. Remember All aspects of your life – what’s important to you! Goals must be about helping the person with a disability, for example respite is not called respite, it is social inclusion for the person with a disability.


8. CHOICE – you DON’T have to have one provider do everything, your needs can meet by multiple service providers. Beware of “one stop shops”



9. Take a friend or relative with you to your NDIS planning meeting.


10. Try to fill out NDIS pre-planning workbook before going to your meeting:  https://www.ndis.gov.au/participants/planning-process