Barriers and facilitators to implementation of a guideline for school-aged children with feeding difficulties. Issue 3 (3rd July 2021)

• Record Type: Journal Article
• Authors: Miles, Anna; Wong, Celine; Jackson, Bianca
• Is Part Of: Journal of intellectual & developmental disability. Volume 46:Issue 3(2021)
• Page Start: 217
• Page End: 226
• Publication Date: 2021-07-03
• Subjects: school-aged children -- dysphagia -- feeding difficulties -- special needs -- risk feeding; Learning disabilities -- Periodicals; Developmental disabilities -- Periodicals; Mental retardation -- Periodicals; 362.1968
• DOI: 10.3109/13668250.2021.1877645
• Languages: English
• ISSNs: 1366-8250

Abstract

ABSTRACT: Background: Swallowing difficulties are common and complex in children with physical, behavioural, and cognitive needs. This study (i) describes mealtime management and (ii) identifies barriers and facilitators to implementation of a guideline for school-aged children with feeding difficulties in one specialist school. Method: Three data sets were collected: (i) 51 school records, (ii) 48 meal observations, and (iii) seven staff interviews. The model of behaviour COM-B (Capacity Opportunity Motivation and Behaviour) was used to identify barriers and facilitators. Results: 28 school records stated diet modifications and five children were enterally tube fed. Seventy percent of children had mealtime assistance. Only 25% of children had written plans and these did not contain all strategies observed. When feeding plans were vague or disagreements occurred, policy did not support decision-making. Conclusions: A coordinated approach is needed. Target areas for change include staff and family education; defined processes for cross-agency documentation and more detailed plans for all children.