Nutrition & Students with Disabilities The Developing Child

1. Nutrition & Students with DisabilitiesThe Developing Child Margaret McGough KIN 583

2. “Typical” diet provides all nutrients, minerals, vitamins needed for normal growth & development

3. In Children with Disabilities, the “Typical” Diet May Not Be the Case… • Difficulty ingesting food • Food selectivity • Hyperphagia – pathological eating • Obese due to inactivity

4. What is the Child’s Environment Like? • Food selection • Preparation • Finances • Culture • Obesity – family problem

5. Disability or Not, There are Nutritional Struggles with Children! Children without disabilities Children with disabilities Over/underweight Refusing to eat, drink Fighting for control at mealtime Over/underweight Refusing to eat, drink Fighting for control at mealtime Oral motor skills Medical problems

6. A Closer Look at Nutritional Issues in Children with Disabilities • Obesity • Increasing worldwide • What is the ideal way to assess risks of obesity in children? • BMI, but may not apply (scoliosis and height) • Undernutrition • Increased energy needs in children who are born prematurely, acutely ill, recovering from surgery, medication side effects

7. Nutritional Issues Cont’d • Stature • Extra calories won’t “normalize” growth • Down syndrome, turner syndrome, FAS, microdeletion syndromes, etc. • Providing extra calories may result in obesity • In certain disabilities, it’s not that the child is truly undernourished • Disability limits eating • Child may not want to eat • May have physical difficulties

8. Comprehensive Care for Children with Disabilities

9. Medical Nutritional Therapy What is it? • Manipulation of nutrients and dietary components to affect a disease or condition Idea: • Improve child’s health and nutritional status • Promote family enjoyment of child at mealtimes

10. 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?

11. Nutritional Care Plan • Recommendations • Monitors follow up • Addresses the role of food in family (culture, patterns) JUST A FEW of the sample activities in a NCP: • Demonstrate how to determine portion sizes • Select foods to address food texture (avoid choking) • Monitor planned weight gain/loss/catch up

12. What 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)

13. Concerns • Food Allergies – increase in concern between types of food allergies and chronic illness and disabilities Ex: lactose and gluten free restrictions to treat individuals with disabilities, hypoallergenic infant formulas • Constipation Ex: whole wheat instead of white, apple with peel instead of juice *laxatives, daily doses • Celiac Disease – sensitivity to gluten • ASD, down syndrome, Turner syndrome, Williams syndrome

14. Concerns Cont’d • Dietary Self Restriction – food refusal, selectivity, oral motor motor delay, dysphagia (Color, texture, temperature) OVER 60% OF CHILDREN WITH ASD ARE SELECTIVE EATERS *Vitamins, adding new foods one at a time

15. Just A Few Exs: Disability/Disease Issue/Problem/Concern Cerebral Palsy Autism PraderWilli Spina Bifida, Down Syndrome Ingesting food Food selectivity Hyperphagia Obesity

16. Strategies for Teachers • Get to know your students • Develop report with parents • Give ideas and suggestions for at home • Fact Sheets – Handouts – Newsletters – Guest Speakers – Food Days • Incorporate nutrition in everyday teaching • TEACH that we are all different! COMPREHENSIVE!!!!! Discuss and share these issues and concerns! WHAT ELSE CAN WE DO?