Date Presented 04/06/19
This quantitative study examined parents’ perspective of caregiver training to support their child’s feeding disorder and how it affected mealtimes. A total of 108 parents completed a web-based survey. Results revealed caregivers feel supported but desire more support; relationships in the family are adversely affected. Implications for OT practitioners include practicing family-centered care; addressing holistic home training topics, and considering treatment in natural environments.
Primary Author and Speaker: Kathryn Carpenter
Additional Authors and Speakers: Mindy Garfinkel
RATIONALE/BACKGROUND: Twenty-five to 45% of the general pediatric population are reported to experience feeding problems and these numbers tend to increase and double when the child has special needs (Lukens & Silverman, 2014). Children with feeding delay/disorder are also more likely to develop mealtime behaviors and experience more negative side effects from lack of proper nutrition. Improper nutrition can lead to a myriad of secondary problems for all of these children including: decreased muscle strength, decreased immune function, decreased cardiac work capacity, decreased bone density, motor delay, cognitive delay, and further developmental delays (Clawson et. al., 2007). Further, mealtime is an important time for families to bond and for parents and caregivers to feel confidence in nourishing their children. When children experience feeding difficulties, parents and caregivers often feel dissatisfied and frustrated with mealtimes and how it affects the entire family unit. If the parent-child relationship is hindered by increased maladaptive behaviors at meal-times, and if families are given strategies to alter meal-based routines, then occupational therapy practitioners (OTPs) need to explore and understand if these strategies are affecting family meals and the parent-child relationship.
PURPOSE: The purpose of this study was to examine the parent’s perspective of home/caregiver training received to aid in treating their child’s feeding delay/disorder and how this training affects mealtimes with their child.
DESIGN, METHOD OF COLLECTING DATA, AND PARTICIPANTS: This quantitative study used an investigator created, web-based survey. Participants were parents of a child with a feeding delay/disorder, aged birth to 13 years old who were actively participating in feeding therapy and receiving home training. One hundred and eight participants completed the survey which included demographic and closed-ended questions.
DATA ANALYSIS AND RESULTS: The data was analyzed for frequencies of responses and overall trends. Results revealed caregivers are receiving current and evidence-based methods of home training to supplement treating their child’s feeding delay/disorder; they feel supported but feel they need more support, especially from their current feeding professional; and relationships in the family are adversely affected. The results also revealed caregivers are seeking connections with other caregivers experiencing the same situations they are and have identified a need for personal stress management and coping skills, not offered as home training.
CONCLUSION: Home training to help treat a child’s feeding delay/disorder is a vital component of feeding treatment and helps support holistic and family-centered treatment models (Adamson et al., 2013). Continuing to provide these treatment models is the way for feeding treatment to advance and can continue to do so by offering more family-focused treatment topics addressing relationships and parent-child interactions, caregiver burden and stress management, and increased caregiver support in various forms.
IMPACT STATEMENT AND RELATION TO RESEARCH PRIORITIES: This research impacts OT practice and supports the AOTA 2025 vision by highlighting the importance of holistic and family-centered care when working with a child with a feeding disorder, the need to address quality of life for the family unit by addressing parent stress and coping skills during this difficult time, and the opportunity to explore new treatment methods in the natural environment with the family.
References
Adamson, M., Morawska, A., & Sanders, M.R. (2013). Childhood feeding difficulties: A randomized controlled trial of a group-based parenting intervention. Journal of Developmental & Behavioral Pediatrics, 34(5), 293-302. http://dx.doi.org.libraryproxy.quinnipiac.edu/10.1097/DBP.0b013e3182961a38
Clawson, E.P., Kuchinski, K.S., & Bach, R. (2007). Use of behavioral interventions and parent education to address feeding difficulties in young children with spastic diplegic cerebral palsy. NeuroRehabilitation, 22, 397-406.
Lukens C.T., & Silverman, A.H. (2014). Systematic review of psychological interventions for pediatric feeding problems. Journal of Pediatric Psychology, 39(8), 903-917. doi:10.1093/jpepsy/jsu040
Rogers, L.G., Magill-Evans, J., & Rempel, G.R. (2012). Mothers’ challenges in feeding their children with autism spectrum disorder: Managing more than just picky eating. Journal of Developmental and Physical Disabilities, 24, 19-33. doi:10.1007/s10882-011-9252-2
