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Abstract
The role of occupational therapy in feeding and swallowing evaluation and treatment has declined over the past two decades. Up until late 1970s and early 1980s, in many parts of the Western world, occupational therapists conducted swallowing assessments and treatment in adult and pediatric populations. With the adoption of Modified Barium Swallow Study or Video-fluoroscopy as a diagnostic tool, feeding and swallowing assessment and treatment has predominantly become associated with speech and language pathology. This viewpoint article addresses the past, present, and future of occupational therapy's role in swallowing evaluation and feeding training of adult and pediatric populations.
Key words
Feeding, swallowing, Modified Barium Swallow Study (MBSS), Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Introduction
The role of occupational therapy in feeding and swallowing evaluation and treatment has a long standing history but it has declined over the past two decades (AOTA, 2007, 2008). Although occupational therapists training and domain of concern are an ideal fit for feeding and swallowing evaluation and treatment, this role has largely been taken over by other professionals such as speech-language pathologists (SLP) and special education teachers (Gibbons, Williams, 8c Reigel, 2007; Williams, Witherspoon, Kavask, Patterson, 8c McBlain, 2006). The purpose of this paper is to reflect on the past, analyze the present and offer suggestions for the future of occupational therapy's role in the feeding and swallowing assessment and treatment of adult and pediatric populations.
Occupational therapy traditionally works with patients in a collaborative manner to facilitate independence and increase functional skills through 'patient-centered care' based on meaningful occupations. Feeding oneself is a basic activity of daily living (ADL), one which is addressed in numerous ways. For example, through sensorimotor training, proper body positioning and posture, adaptive equipment, body maneuvers, and swallowing techniques. Since eating is an essential and lifelong activity, occupational therapists work with patients with various disabilities and special needs from infancy through to older age.
Literature points to evidence that patients who are more independent in feeding skills have a healthier body weight, and suffer from fewer nutritional problems in comparison to those who are dependent on others to help them eat (Colonel et al., 2008; Poels, Brinkman-Zijlker, Dijkstra, 8c Postema, 2006). Lack of quality intervention in this human function can lead to long...