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What Are the Primary Concerns for Caregivers of Children With Pediatric Feeding and Swallowing Disorders (PFSD)?

Rhonda Mattingly Williams, Ed.D, CCC-SLP, Pam Smithy, MS, OTR/L

March 1, 2026

Question

What are the primary concerns for caregivers of children with pediatric feeding and swallowing disorders (PFSD)?

Answer

According to Dr. Rhonda Mattingly Williams, in one study, researchers interviewed 30 caregivers whose children had received treatment for feeding issues at a feeding program at Mass General. When asked, “What matters most to you?” parents consistently reported that difficulties with feeding affected their children’s everyday activities, especially their ability to socialize. They worried about things like birthday parties and other typical events where food is central. They wanted their children not only to be invited, but to be able to participate and even to want to go, very much like the mother I mentioned earlier, who longed for her child to enjoy something as simple as a trip to McDonald’s.

Caregivers in this study prioritized enhancing their child’s overall well-being and health. Of course, as parents, that is what we would expect, but they also wanted to see their children genuinely enjoying life, not just surviving from a medical standpoint. They recognized that positive outcomes were supported by factors related to both the child and the caregiver. Still, they also acknowledged that challenges such as limited time, financial constraints, restricted access to services, and a lack of clear, consistent information hindered progress. In many cases, it was not just a lack of information, but also confusing or conflicting information that made things more difficult.

Not surprisingly, these parents expressed a strong preference for interventions guided by family-centered care. They saw themselves and their children as part of an interconnected family unit and wanted services that recognized and honored that reality. Their message was clear: effective intervention must be rooted in the family, with approaches that respect, include, and support everyone involved.

This Ask the Expert is an edited excerpt from the course, Using Adult Learning Theory to Enhance Coaching in Pediatric Feeding and Swallowing InterventionRhonda Mattingly, Ed.D, CCC-SLP, Pam Smithy, MS, OTR/L.


rhonda mattingly williams

Rhonda Mattingly Williams, Ed.D, CCC-SLP

Rhonda Mattingly Williams, EdD, CCC-SLP, is a professor in the Department of Otolaryngology, H/N Surgery, and Communicative Disorders at the University of Louisville. She teaches courses in early language evaluation and intervention, pediatric feeding and swallowing, cognitive-communicative disorders, and professional issues.

Dr. Williams has been practicing for over 35 years and currently provides clinical services to neonates, adolescents, and adults with a variety of disorders, including aphasia, cognitive impairment, voice dysfunction, slow feeding of the newborn, and dysphagia within the University of Louisville Healthcare System. She is active in research, publishes in scholarly journals, maintains membership in several professional organizations, and provides interdisciplinary continuing education to professionals across the globe.

 


pam smithy

Pam Smithy, MS, OTR/L

Pam Smithy, MS, OTR/L, serves as a Professor and Program Director of the Occupational Therapy Assistant Program at Jefferson Community and Technical College. She teaches a diverse range of courses, including pediatrics, physical disabilities, mental health, community practice, and professional transitions/management.

With over 37 years of occupational therapy practice and 28 years as a private practice owner, Pam has extensive experience collaborating with speech-language pathologists, physical therapists, and occupational therapy assistants to deliver comprehensive, interdisciplinary care. She remains actively involved in the Kentucky Occupational Therapy Association. She is a member of several other professional organizations, reflecting her ongoing commitment to advancing the profession and fostering collaboration across disciplines.


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