Date Presented 04/21/2023
This work raises awareness and increases understanding about the role of OT in avoidant/restrictive food intake disorder (ARFID) and provides information about existing literature, current OT practices, and future directions.
Primary Author and Speaker: Rebecca Willman
Contributing Authors: Jennifer Thomas, Midge Hobbs
PURPOSE: The purpose of this work is to raise awareness and increase understanding about the role of occupational therapy in Avoidant/Restrictive Food Intake Disorder (ARFID) as well as provide information about existing literature and current OT practices related to ARFID. ARFID is an eating disorder characterized by a disturbance in eating or feeding without the fear of weight gain, drive for thinness, or body dysmorphia that defines other eating disorders. This work aims to justify a call for higher levels of research to support and guide evidence-based OT practice, including future research directions.
DESIGN: This is a scoping review of current research and practices. Several databases (e.g., PubMed, CINAHL, PsycINFO, ERIC) were used to recruit data. Clinicians were recruited for interviews through digital communication via the MGH Eating Disorders Clinical and Research Program (EDCRP).
METHOD: A preliminary exploratory inquiry was conducted to investigate OT knowledge and interprofessional collaborative practice gaps in ARFID treatment. Methods included literature review, interviews, and interprofessional collaboration in the clinical context.
RESULTS: Existing literature supports an interprofessional approach to treating eating and feeding disorders, however there is little evidence to specifically support the role of OT in ARFID. OT theories and frames of reference are currently being utilized to inform ARFID treatment: Sensory Integration, Biomechanical Frame of Reference and Adaptation, and trauma-informed and relational practice. OT practitioners can also conduct holistic, theory driven evaluations to determine individuals’ strengths and barriers.
CONCLUSION: There are several potential roles for OT throughout the continuum of care for individuals with ARFID, though higher levels of evidence and increased clinician education are needed. Such advancements in knowledge and practice can very likely expand access of OT services in ARFID cases.
References
American Occupational Therapy Association. (2017). The Practice of Occupational Therapy in Feeding, Eating, and Swallowing. The American Journal of Occupational Therapy, 71(1), 7112410015p1–7112410015p13. https://doi.org/10.5014/ajot.2017.716S04
Coelho, J. S., Fernandes, A., Suen, J., Keidar, A., & Cairns, J. (2020). Perceived occupational performance in youth with eating disorders: Treatment-related change. Canadian Journal of Occupational Therapy, 87(5), 423–430. https://doi.org/10.1177/0008417420953229
Dean, E. E., Little, L., Tomchek, S., & Dunn, W. (2018). Sensory processing in the general population: Adaptability, resiliency, and challenging behavior. American Journal of Occupational Therapy, 72, 7201195060. https://doi.org/10.5014/ajot.2018.019919
Sharp, W. G., Volkert, V. M., Scahill, L., McCracken, C. E., & McElhanon, B. (2017). A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: How standard is the standard of care? The Journal of Pediatrics, 181, 116–124. http://dx.doi.org10.1016/j.jpeds.2016.10.002
