Nutrition & Students with Disabilities The Developing Child

Margaret McGoughKIN 583Nutrition & Students with DisabilitiesThe Developing ChildTypical diet provides all nutrients, minerals, vitamins needed for normal growth & development

In Children with Disabilities, the Typical Diet May Not Be the CaseDifficulty ingesting foodFood selectivityHyperphagia pathological eatingObese due to inactivity

What is the Childs Environment Like?Food selectionPreparationFinancesCultureObesity family problem

Disability or Not, There are Nutritional Struggles with Children!Children without disabilitiesChildren with disabilitiesOver/underweightRefusing to eat, drinkFighting for control at mealtime Over/underweightRefusing to eat, drinkFighting for control at mealtimeOral motor skillsMedical problems

A Closer Look at Nutritional Issues in Children with Disabilities ObesityIncreasing worldwideWhat is the ideal way to assess risks of obesity in children?BMI, but may not apply (scoliosis and height)

UndernutritionIncreased energy needs in children who are born prematurely, acutely ill, recovering from surgery, medication side effects

Nutritional Issues ContdStatureExtra calories wont normalize growthDown syndrome, turner syndrome, FAS, microdeletion syndromes, etc.Providing extra calories may result in obesityIn certain disabilities, its not that the child is truly undernourished

Disability limits eatingChild may not want to eat May have physical difficulties

Comprehensive Care for Children with DisabilitiesMedical Nutritional TherapyWhat is it?Manipulation of nutrients and dietary components to affect a disease or condition

Idea:Improve childs health and nutritional statusPromote family enjoyment of child at mealtimes

MNT:Nutritional Assessment answers 3 questions:Is child being fed a diet that meets his/her age, gender, and condition?Is child growing as expected for his/her age, gender, and condition?Is there a feeding or eating problem?Nutritional Care PlanRecommendationsMonitors follow upAddresses the role of food in family (culture, patterns)

JUST A FEW of the sample activities in a NCP:Demonstrate how to determine portion sizesSelect foods to address food texture (avoid choking)Monitor planned weight gain/loss/catch upWhat About the Child who Cannot Eat?Enternal feeding(gastrostomy: feeding directly into stomach)complications involved!Cerebral Palsy, Tay-Sachs Disease, uncontrolled seizures

Parenteral feeding: when feeding has to bypass GI tract(nutrients directly into bloodstream)hospital setting

Nutritional Support Formulas(food replacements, supplements)

ConcernsFood Allergies increase in concern between types of food allergies and chronic illness and disabilitiesEx: lactose and gluten free restrictions to treat individuals with disabilities, hypoallergenic infant formulas

ConstipationEx: whole wheat instead of white, apple with peel instead of juice*laxatives, daily doses

Celiac Disease sensitivity to glutenASD, down syndrome, Turner syndrome, Williams syndrome

Concerns ContdDietary Self Restriction food refusal, selectivity, oral motormotor delay, dysphagia(Color, texture, temperature)

OVER 60% OF CHILDREN WITH ASD ARE SELECTIVE EATERS

*Vitamins, adding new foods one at a time

Just A Few Exs:Disability/DiseaseIssue/Problem/ConcernCerebral PalsyAutismPrader WilliSpina Bifida, Down SyndromeIngesting foodFood selectivityHyperphagiaObesityStrategies for TeachersGet to know your studentsDevelop report with parentsGive ideas and suggestions for at homeFact Sheets Handouts Newsletters Guest Speakers Food DaysIncorporate nutrition in everyday teachingTEACH that we are all different!

COMPREHENSIVE!!!!!Discuss and share these issues and concerns!

WHAT ELSE CAN WE DO?