IRB Number


Date of Award

Spring 6-8-2021

Document Type


Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy

First Advisor

Pamela Kasyan-Howe, OTD, OTR/L, Doctoral Coordinator

Second Advisor

Kristin Domville, Dr. OT, OTR/L, Doctoral Coordinator

Third Advisor

Jose Rafols, OTD, MHSA, OTR/L, BCTS, CEAS, Program Director

Medical Subject Headings

Feeding and Eating Disorders, Children, Parents, Meals, Habits, Occupational Therapy, Pediatrics


Pediatric feeding disorders (PFD) affect approximately 25-35% of children with typical development, 40-80% of children with developmental disabilities, and 90% of children with autism spectrum disorder (ASD). Feeding disorders affect families by disrupting mealtime routines, changing family dynamics, and increasing parental stress. Occupational therapy (OT) focuses on client-centered care that facilitates independence in meaningful occupations, including feeding and eating. OTs also play an essential role in assisting, training, and educating parents on effective mealtime strategies that can be implemented and carried over into the home environment. Few research studies show how parents manage behaviors and stress during mealtime routines, and little attention has been placed on how PFD can affect parental stress. This study reinforces the value of OT services that focus on family-based interventions and family-based training, considering rituals, routines, and environment to help decrease parental stress during mealtime routines.

Data was collected during face-to-face interviews with parents of children diagnosed with PFD. The data gathered was used to identify and analyze how parents of children with PFD manage behaviors and stress during mealtimes. This study benefits families of children with PFD because it will provide additional resources and advocacy for parents. The benefit of having more resources available for parents regarding mealtime stress and mealtime behaviors is that parents will have more opportunities to find a strategy that will benefit the family routine and dynamic. This study will benefit OT practitioners because it will help guide OT family-based interventions reinforcing the importance of carry-over strategies for parents.

Analysis of the data suggested that parents of children with PFD perceive mealtime behaviors as highly stressful. The analysis also showed that parents tend to ignore maladaptive mealtime behaviors during mealtime. However, when this was not successful, they would soothe the child or use punishment such as taking away electronic devices. To relieve stress, parents reported getting outdoors and talking to family or friends as the primary way of reducing stress. The findings from this qualitative study support the need for OTs to incorporate families’ unique habits, routines, and cultural and social norms into parent training to ensure the carry-over of strategies into the respective home environment.


Capstone project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy