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Primary Focus: Children and Youth

Learning Objectives:

  1. Describe the role of occupational therapy in addressing feeding performance in children birth to five years.
  2. Identify and apply evidence-based feeding interventions used by occupational therapists.
  3. Compare interventions discussed today to those commonly used in clinical practice.


Objective: The purpose of this presentation is to systematically review the literature to identify evidence-based interventions to improve feeding and eating in children ages 0-5 years with feeding difficulties.

Background: An estimated 25-45% of typically developing children and nearly 80% of children with developmental disabilities has some type of feeding problem (Bryant-Waugh, Markham, Kreipe, & Walsh, 2010). Feeding difficulties include abnormal food intake, delay in mechanics of eating and self-feeding, restricted food preferences, or inappropriate mealtime behaviors (Chartoor, 2002). Feeding problems can lead to inadequate nutritional intake and are associated with cognitive deficits and behavioral problems (Schuberth, Amirault, & Case-Smith, 2010). Feeding and eating are essential occupations that impact a child’s social, emotional, and cultural development, and occupational therapists are uniquely equipped to address childhood feeding problems through a variety of interventions (Schuberth et al., 2010).

Methods: A systematic search of the databases PubMed, CINAHL, Ovid Medline and Ovid PsycINFO yielded 662 results, in addition to 9 articles identified from other sources. After removing duplicates, abstract screening based on inclusion/exclusion criteria identified 69 eligible articles. Full text articles were screened based on criteria and 14 articles were identified. Articles were critiqued using the Law and MacDermid (2014) quantitative form and the PRISMA checklist for systematic reviews (Moher, Liberati, Tetzlaff, Altman, & The PRISMA Group, 2009).

Findings: Results demonstrate a variety of interventions including behavioral strategies, environmental and task adaptations, oral-motor exercises, and sensory approaches improved feeding participation in children ages 0-5 years. A combination of these interventions was most effective for increasing food intake and meal participation. Study limitations included lack of statistical analysis due to small sample sizes.

Conclusion: This systematic review provides clinical support for occupational therapists to use a variety of interventions to improve feeding and eating in children ages 0-5 years with feeding difficulties. These interventions can enhance children’s participation in ADLs, IADLs, and social occupations by improving feeding and eating performance. Additional research is needed with more rigorous study designs to further support the use of these interventions in practice.

Presentation: 55 minutes