Feeding, eating, and swallowing are essential components of successful social participation in daily meals; therefore, children with feeding difficulties are at risk of being excluded from full participation in meals at home, school, and in other social situations. This introductory course defines feeding and eating occupations and presents the theoretical foundations for planning occupation-based intervention for children with feeding difficulties in home, school, and other community settings. Dr. Jennifer Pitonyak presents contemporary, occupation-based theories and frames of reference that guide intervention aimed at supporting the participation of children with feeding difficulties in mealtime experiences. This course is the first introductory course in a series on occupation-based approaches to intervention for children with feeding and eating difficulties. This is the first in a two course series by Dr. Pitonyak.
Jennifer Pitonyak, PhD, OTR/L, SCFES, is a licensed occupational therapist with 20 years of clinical experience working with children with feeding difficulties. She has previously worked in both inpatient and outpatient multidisciplinary feeding programs at Kennedy Krieger Institute in Baltimore and the Children’s Hospital of Philadelphia, providing occupational therapy services to children with oral motor impairments, self-feeding problems, and other sensory-behavioral needs related to feeding. Dr. Pitonyak has also worked in early intervention and neonatal intensive care unit (NICU) settings where she specialized in supporting breastfeeding in infants with a history of prematurity and developmental delays. She holds specialty certification in feeding, eating, and swallowing from the American Occupational Therapy Association and is also a Certified Infant Massage Instructor. Currently, Dr. Pitonyak is faculty in the School of Occupational Therapy at the University of Puget Sound, where she teaches courses on occupational performance adaptations and psychosocial and biomechanical approaches to intervention. She is also coordinator for the onsite occupational therapy clinic at Puget Sound. Dr. Pitonyak has presented nationally on the topic of occupational therapy for children with feeding difficulties and has authored several publications on the role of occupational therapy in breastfeeding promotion. She values a family-centered, culturally-relevant approach to occupational therapy, as well as the importance of interprofessional collaboration and communication to best support children with developmental needs and their families. She is currently a per diem therapist on the infant team at Seattle Children’s Hospital. Dr. Pitonyak earned a BA in Psychology from Allegheny College, a MS in Occupational Therapy from the Washington University School of Medicine in St. Louis, and a PhD in Health Policy from the University of the Sciences.
Feeding and eating are essential occupations for health, well-being, and social participation of children in family and other social routines. Dr. Pitonyak defines feeding and eating according to the Occupational Therapy Practice Framework: Domain and Process, 3rd Edition (AOTA, 2014) and discusses how successful feeding and eating is intertwined with other areas of occupational participation.
Using the OT Practice Framework, this chapter presents on outcomes for occupation-based approaches to feeding. Dr. Pitonyak highlights the outcomes related to health, wellness and wellbeing, including participation, quality of life, role competence and occupational performance.
In this chapter, Dr. Pitonyak provides an overview of three general approaches to intervention and examines how each approach supports participation and performance of mealtime occupations. Contemporary models and frames of reference, such as SCOPE-IT, are introduced for guiding an occupation-based approach to intervention.