Oral Feeding Management in the School Setting: A Scoping Review.

Importance: School-based occupational therapists are well positioned to provide oral feeding management, yet understanding of how they can effectively address oral feeding goals in school systems is limited.

Objective: To evaluate the current role of occupational therapy in pediatric oral feeding management in school-based settings.

Evidence review: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews was used as a guide. Six databases (CINAHL, Medline, PsycINFO, Embase, Web of Science, and Google Scholar) and four search engines (Bing, Google, Yahoo, and Ask.com) were searched with the keywords feeding, school, and occupational therapist. Studies with the following criteria were included: written in English, services provided in a school setting, children from junior kindergarten to Grade 12, and the management of oral feeding by occupational therapists in schools.

Findings: An initial 189 articles were generated, and 10 articles met the eligibility criteria after elimination of duplicate studies and title and abstract screening. Four areas emerged regarding the role of occupational therapy in feeding in schools: (1) using a multidisciplinary collaborative approach to support students with feeding needs; (2) offering assessment strategies that range from informal to standardized methods; (3) implementing various intervention techniques, but evidence is limited, and (4) formalizing policies to include feeding goals in students' individual education plans, although the process for doing so remains unclear.

Conclusions and relevance: The field of occupational therapy needs more evidence-based practice, more training in oral feeding management, and updated policies for oral feeding management in schools. Plain-Language Summary: Occupational therapists are well positioned to support the feeding needs of children in schools. This scoping review identifies four key roles for occupational therapists: collaborating with multidisciplinary teams to address feeding issues, conducting assessments from informal to standardized methods, providing a range of intervention strategies, and advocating for formal policies that incorporate feeding goals into students' individual education plans to better manage oral feeding challenges in the school setting.