Date of Award

2024

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Roberta Carrlson

Abstract

Purpose: The process of gradually developing from complete dependence to independent self-feeding for a child is critical in social, emotional, physical, and cultural maturation (Korth & Maune, 2020). Of all developing children in America, 25-50% have feeding, eating and/or swallowing difficulties, with the percentage even higher for children that are autistic, premature, and/or have other developmental delays (Gronski & Doherty, 2020). The purpose of this Doctoral Experiential Capstone is to complete a thorough needs assessment to find the current gaps in the literature, frequently used and effective evaluation methods, and research-based interventions in the area of feeding, eating, and swallowing to be applied to an occupational therapy pediatric outpatient clinic and to provide advanced clinical experience for a Doctoral Capstone Student in the area of feeding, eating, and swallowing. The application of the literature was through the creation of an intervention guide and goal bank for therapists. It was hypothesized that these occupational therapy practice tools increased oral motor development, sensory desensitization, and improved social/emotional behaviors and habits for the clients and their families.

Method: To find the need for this product, the author conducted a literature review and an informal meeting with occupational therapy practitioners. The Ecological Model of Human Performance (EHP) was applied to this experience and product development (Dunn, 2017). This model was utilized during the literature search to create search phrases to be used across various search engines and online libraries. The online viii resources utilized to find the literature included in this review are as follows: Cumulated Index to Nursing and Allied Health Literature (CINHAL), American Occupational Therapy Association (AOTA), American Speech-Language-Hearing Association (ASHA), PubMed, Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and the American Society for Nutrition. The inclusion criteria for the search are as follows: from year of 2018 or newer, all types of resources, resources about pediatric clients with feeding, eating, and/or swallowing difficulties. Once the need and focus of the product were clear, the author completed a 14-week advanced clinical placement to create the product and learn the advanced practice skills by supervised treatment of feeding, eating, and swallowing pediatric caseload. The goal bank and intervention guidelines were then given to the pediatric occupational therapy practitioners to meet the need specified by the need’s assessment.

Results: Through the completion of this product and the implementation in a pediatric outpatient clinic, the author saw first-hand how the goal bank allowed the occupational therapy practitioners to create more direct goals for the targeted skills their client needed to improve. The creation of the intervention guidelines also allowed occupational therapy practitioners to effectively progress towards those goals and see a positive change in the child, as evidenced by a progression in the child’s skills reflected in charted progress notes. These skills included increased oral motor development, sensory desensitization, and improved social/emotional behaviors and habits for the client and family. ix

Conclusions: The intended result of this product was to further the feeding, eating, and swallowing program at the local clinic, improve mealtime behaviors and skills of pediatric clients, and provide advanced clinical skills in the area of feeding, eating, and swallowing for the Doctoral Capstone Student. This product was used by occupational therapy practitioners with advanced-level training in feeding therapy, utilizing the goal bank to creating client-centered, occupation-based goals and implement the appropriate interventions from the intervention guidelines. Although the author saw short-term gains through the implementation of this product, further evaluation of the results is ongoing. Through the comparative results between the mid-term and final review of the Capstone student, the results may show increased knowledge and advanced clinical practice skills in the area of feeding, eating, and swallowing.

Download

Share

COinS