(PS8-C51) ACT as Caregiver Stress Supports for Mealtime Behavior

Between 25% and 45% of the general population is estimated to have a feeding problem and feeding disorders are one of the most prevalent conditions affecting children ages birth to 18 (Clark et al., 2019). It is no surprise then that parents of children with pediatric feeding disorders (PFD) experience higher levels of caregiver-related stress, often reporting significant overall stress, parenting stress associated with parent–child dysfunctional interactions, and defensive responding (Silverman et al., 2020). According to Folkman and Lazarus’ (1985) theoretical concept of stress, stress is a product of a person’s interaction with their environment, especially when environmental stressors exceed the individual’s resources. Parenting stress, then, arises when individuals experience a stressor related to parenting (i.e., challenging mealtime behavior) and are then unable to manage it with their usual coping strategies (Hayes & Watson, 2013). To improve the well-being of children with PFD and their families, treatment models that utilize cognitive-behavioral supports must be implemented, evaluated, and disseminated alongside other common behavioral interventions for PFD. 

One way psychological stress in parents has been addressed is through Acceptance and Commitment Therapy (ACT)-oriented interventions. ACT focuses on a values-driven approach to guide behavior and decision-making within the individual’s past experiences and current environmental context (Bach & Moran, 2008). ACT highlights a flexible approach to finding solutions; by becoming more adaptable in their parenting approach, parents ideally also become more open to trying new methods of addressing child challenging behavior (Whittingham & Coyne, 2019). ACT can be used to guide and support parents to engage in flexible and compassionate parenting, in an effort to bring meaning and fulfillment to their lives even in the face of psychological stress.  

This study sought to evaluate the effectiveness of a combined behavioral feeding intervention with caregiver stress management on outcomes including caregiver stress and youth mealtime behavior. The presentation will describe evidence-based components of parent-mediated interventions for youth with pediatric feeding disorders and the evidence for delivery of stress supports alongside parent-mediated interventions. Additionally, considerations for implementing telebehavioral health interventions for youth with pediatric feeding disorders and families from diverse backgrounds will be presented. Finally, the study will review the implications of implementing a packaged intervention addressing youth mealtime behavior and caregiver stress. As this study was implemented through a mostly telehealth feeding clinic, considerations for enhancing access to behavioral health interventions will also be addressed.