Feeding Matters Leadership Spotlight is a Q & A series that shares the stories of our leadership volunteers. This month we bring you Paula Rabaey.
Tell our feeding community a little bit about yourself. Describe your role as an Occupational Therapist and Researcher. What is your approach to research?
Hello everyone. My name is Paula Rabaey and I have been an OT for 29 years. The past 14 years of my career have been spent as an Associate Professor in the Department of Occupational Therapy at St. Catherine University located in St. Paul, MN. St. Kate’s is also my alma mater where I earned my undergraduate degree in OT. I have a Ph.D. in occupational therapy from Nova Southeastern University located in Fort Lauderdale, FL, and am 3 classes away from earning my master’s degree in Global Public Health. The majority of my career has been spent in pediatrics and I have worked with multiple age groups across different settings including: outpatient, school, early intervention, home health with medically complex children, and currently in a Level 3 NICU.
In my very first OT position, I was introduced to and mentored in OT’s role and scope of practice in feeding children with cerebral palsy and other neurological developmental delays. Mealtime participation as a major childhood occupation has been my passion ever since. My dissertation explored the meaning of mealtime to African American mothers with young children. This was a qualitative study which utilized photovoice as a means for marginalized mothers to talk about their role of mothering and fostering a healthy mealtime environment.
I also believe research should inform practice, especially in the area of pediatric feeding disorder. We need evidenced based practice models that not only inform assessment and intervention, but also that include family and context. While I love qualitative research methodology, I believe that using a mixed methods approach to research (gathering both objective and subjective information) gives a “bigger picture” view of the complexity of pediatric feeding disorder and the impact on both child and family. I have always approached research as a way to “fill the gaps” in our knowledge. It needs to be well thought out and driven by what is currently in the literature and being done in actual practice. I also believe that factors related to feeding such as food insecurity and food access are a major public health issue impacting the world’s children, particularly since COVID.
You will be working in partnership with Hayley Estrem, PhD, RN, our current Research Pillar Chair as the Chair Elect. What excites you most about this new role?
I love collaborative work! We have well-documented research studies that indicate an interprofessional approach to pediatric feeding disorder is the most effective. I have never worked with children with feeding difficulties just in my own “OT silo”; I learned early on that a team approach was imperative. Much of my learning about pediatric feeding disorder has come from working and problem solving with other professionals. I have to admit, the role of “research pillar chair” sounded daunting, so I was very excited that Feeding Matters created a “chair elect” role as a way to learn and receive mentorship. I am a firm believer in mentoring relationships and I know I can learn so much from working alongside Hayley. Research often includes multiple disciplines or professionals. Research with families and all four domains of PFD represented is key when working with children and families. In my OT career, I have worked alongside nurses, nutritionists and dieticians, speech language pathologists, physicians, and neonatologists to name a few, and partnerships bring about the best outcomes.
The PFD Alliance is comprised of four pillars: research, advocacy, education, and family support. The research pillar seeks to advance research in the field of PFD. Can you tell us about research project that you were particularly proud of?
I have always been concerned about not only how we are assessing children with pediatric feeding disorder, but “what” tools are used to gather information to inform our treatment planning. I can say that most of my knowledge about assessing factors related to feeding difficulties came after OT school and included years of continuing education, mentorship, and self-study. When the new proposed definition of pediatric feeding disorder was published, I was so excited to see how it included all domains! When the research pillar of Feeding Matters announced its small research grant, I jumped on the idea of looking at what current assessment tools feeding therapists used and how they aligned with the four factor areas. Together with my colleague, Dr. Kate Barlow, we designed and carried out a small mixed methods pilot study that looked at this question. We presented our results at the 8th Annual International Pediatric Feeding Disorder Conference this past April and we are presenting this topic at the ASHA conference coming up in November in Washington, DC. We also have a manuscript in the works that we plan to submit to a peer-reviewed journal. It is our hope that we can build on this small study to influence how assessment of pediatric feeding disorder is addressed in Occupational Therapy and Speech Language Pathology programs, and develop a more comprehensive assessment tool for feeding therapists.
We asked several questions about your professional life. Please share something about yourself that we find surprising, or we might not know.
I have been married for 29 ½ years and have 5 grown children, the oldest of which recently got married this past May-to a new OT grad none-the-less! We are “new” empty nesters and our wild purchase was a Vespa that we now use to tool around the countryside! I also love horses and own a Quarab (quarter horse/arab mix) mare named Sunny.
I love to travel and experience new cultures and was introduced to international work around feeding and nutrition for children living without families through SPOON Foundation (Supporting Overseas Orphan Nutrition). I volunteer with this NGO as a feeding technical expert and helped develop an assessment tool that looks at caregiver feeding practices and provides solutions for positioning, cup and spoon use, food textures, and responsive feeding practices for caregivers who feed children with disabilities in orphanages. Last year I received copyright on this feeding assessment tool and hope to do more research on its efficacy and usability. I had the privilege of presenting this work in Russia two years ago. Although COVID has paused this project, I look forward to continuing this work and contributing to the Feeding Matters research agenda as well.