Translational Research

Parent Education Class for Children With Feeding Difficulties

Adina P. Schwartz, Judy Hopkins, OTD, OT/L, SWC, CLC
Children’s Hospital Los Angeles, Los Angeles, CA, USA

Downloaded from http://research.aota.org/ajot/article-pdf/75/Supplement_2/7512520400p1/46207/ajot400_1630408669_69468.pdf by Integracion Sensorial Acis, Adriana Ramirez on 12 November 2022
DOI: 10.5014/ajot.2021.75S2-RP400

Date presented: Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Primary Author and Speaker: Adina P. Schwartz, adinayogi@gmail.com

The purpose of this study was to determine the feasibility and effectiveness of a multidisciplinary educational class for parents in
improving child feeding behaviors and reducing caregiver distress associated with feeding difficulties. Feeding is a primary co-
occupation of a child with their parent. When difficulties arise, negative behaviors towards food, impairment of weight gain and growth
can result. Children with food allergies and gastrointestinal conditions are particularly vulnerable to feeding difficulties due to limited
diets, delayed oral motor skills, gastrointestinal symptoms, and altered mealtime practices. Effective treatment of children with
feeding difficulties frequently involves an interdisciplinary team approach because of its complex nature. (McComish, et al, 2016) This
study utilized a pre-post for the class. Participants were recruited from the divisions of Clinical Immunology and Allergy and Division
of Gastroenterology in a Children’s hospital for participation in the class. Eligible participants were caregivers of children, aged 0-18
years, with food allergy and/or gastrointestinal disorders, who have expressed concerns about their child’s feeding behaviors.
Potential participants were screened by a team member. Exclusion criteria include caregivers of a child who are not eating by mouth.
The intervention consisted of a 100-minute educational class led by a multidisciplinary team of mental health providers,
occupational therapists, a speech language pathologist, and registered dietitians. The study utilized two measures, administered at
three time points: baseline, immediately post-treatment, and at the 1-month follow-up. Participants were contacted to complete the
follow-up measures. Feeding Knowledge Survey: Developed for this study to assess change in caregiver knowledge and retention
of information about feeding behaviors following participation in the class. Administered at baseline, at the end of the class, and 30-
60 days after participation in the class. Behavioral Pediatrics Feeding Assessment (BPFAS) – Behavior Section: The BPFAS was
used to measure feeding impairment before, and 30-60 days after the intervention. This assessment measures the child’s behavior,
as well as parental attitudes and behavior. Parent Mealtime Assessment Scale (PMAS): identify dimensions of mealtime behaviors
used by parents. Descriptive statistics were used to summarize scores on PMAS, BPFAS, and parent survey. Of the participants on
the parent survey, 97.4% said they would recommend the class. For the BPFAS, both the frequency and problem scores, of
parent’s report of problematic behaviors, had statistically significant decreases following the class (p < 0.05). For the PMAS, the
direction of the change indicates that setting snack limits increased following the class. This small pilot study examining the
effectiveness of a multidisciplinary parent educational class showed promise in positive parental responses on the BPFAS, PMAS
and parent survey. This class has proven to be effective in educating parents about the intricate and dynamic nature of feeding.
Occupational therapists should continue to educate families in groups as an effective way to build community and educate in
facilitating healthier mealtime behaviors.

References
McComish, C., Brackett, K., Kelly, M., Hall, C., Wallace, S., & Powell, V. (2016). Interdisciplinary feeding team: a medical, motor, behavioral approach to
complex pediatric feeding problems. MCN: The American Journal of Maternal/Child Nursing, 41(4), 230-236.
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project.org/.
Crist et al., 1994; Crist & Napier-Phillips, 2001
Owen, C., Ziebell, L., Lessard, C., Churcher, E., Bourget, V., & Villenueve, H. (2012). Interprofessional group intervention for parents of children age 3 and
younger with feeding difficulties: Pilot program evaluation. Nutrition in Clinical Practice, 27(1), 129-135.

The American Journal of Occupational Therapy, August 2021, Vol. 75, Supplement 2