Date of Paper/Work


Type of Paper/Work

Research Project

Degree Name

Master of Arts in Occupational Therapy


Occupational Science/Occupational Therapy

First Advisor

Paula Rabaey


Occupational Therapy


Background: Feeding disorders are defined by the World Health Organization as a dysfunction in oral intake which often co-occurs with feeding skills, nutritional health, and psychosocial well-being. Feeding disorders affect children with disabilities (CWD) living in low-and-middle income countries (LMIC) disproportionately more than CWD living in high income countries. Due to a lack of access to appropriate assistive technology, issues of malnutrition, caregiver stress, and delays in development can occur as a result. Limited research is available on feeding disorders and the impact of seating assistive technology in one LMIC.

Methods: A mixed methods approach was used in this study. Quantitative methods included data from the Eating and Drinking Ability Classification System, the UCICEF child’s height board and SECA two in one scale to collect height and weight, the Non-communicating Children’s Pain Checklist, Assessment of Feeding Position, Chair Observation Form, Responsive Feeding Behavior Checklist, and parent subsection of the Feeding Impact Scale. Qualitative feedback was gathered from stakeholders through focus groups and interview sessions. Caregiver focus group data was transcribed and analyzed to identify themes. Overall themes were identified based on core ideas participants conveyed for each prompted question.

Results: Most child-caregiver dyads saw an increase (N=13) or no change (N=3) in Responsive Feeding Behavior Checklist elements. General observations included increase in swallowing quality while fed in the chair, increased eye contact between caregivers and children, and increased recognition and responsiveness to child’s cues. Four themes emerged from caregiver focus groups including: [my] child was comfortable, it was easier for me [as a caregiver], [my child] seems to eat better, and my child can go [places] and not be left behind.

Conclusion: These findings suggest the SPOON Chair can improve Responsive Feeding practices between caregiver and children with feeding disorders living in LMIC. Caregivers were satisfied with the chair and saw endless possibilities of the chair for occupational engagement. Further research on the SPOON Chair and other low-cost assistive technology and application in low-middle income countries is recommended.