Date of Award

2024

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Roberta Carrlson

Abstract

Background: Up to 20% of typically developing and about 80% of atypically developing infants and children suffer from feeding difficulties (Chatoor & Macaoay, 2008; Nichols et al., 2018). These feeding difficulties may lead to delays in growth and development, refusal to eat, behavioral issues, and medical complications (Chatoor & Macaoay, 2008). Occupational therapists address these feeding difficulties through the therapeutic process, which includes initial evaluation, intervention, re-evaluation, and discharge planning (American Occupational Therapy Association [AOTA], 2020). When completing a feeding evaluation, practitioners often rely on skilled observation and their clinical judgment to determine what is developmentally appropriate. Practitioners also may pull bits and pieces of information from a variety of sources, making the evaluation process difficult to follow. Occupational therapy services for children who have difficulties with feeding often focus on broadening the amount or variety of foods that the child consumes. This is done through a variety of interventions, including caregiver education. Caregiver education is important for ensuring the skills a child is learning in therapy sessions transfer to other contexts. Caregivers are typically included in as many interventions as possible to provide safety and consistency to the child at mealtimes across settings. However, feeding is a complex occupation and can be very difficult to understand.

Purpose: The goal of this project is to provide pediatric occupational therapists with a user-friendly, evidence-based guide through the therapeutic process for children with feeding difficulties. Due to feeding being such a complex topic, occupational therapy practitioners are often forced to pull bits and pieces of information from a variety of sources in order to achieve holistic, client-centered evaluation and interventions. This scholarly project was designed to help fill this gap. vii

Methodology: A literature review and needs assessment were conducted to identify gaps in current services provided at a pediatric outpatient clinic in the Midwest. The author then collaborated with occupational therapy and speech therapy practitioners to develop and implement the final product. The Ecology of Human Performance framework (EHP) and adult learning theory were utilized throughout the development and implementation of the product.

Results: The outcome of this scholarly project is an evidence-based guide through the therapeutic process for therapy practitioners to utilize with children with feeding difficulties. The guide includes an evaluation form, food checklist, and caregiver education handouts. The product is intended to be used in conjunction with skilled therapy services to increase ease of documentation and aid practitioners in holistically evaluating and treating children with feeding and eating difficulties and their families.

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