Nutrition Interventions for Children with Special Health Care Needs

Chapter 12
Section 2 - Problem-Based Nutrition Interventions
accommodating Children With Special
Dietary Needs in School Nutrition
programs
Betty Marcelynas, MA, RD and Bette Brandis, RD
Updated by Donna Parsons, MS, RD
It has been estimated that 15% of all students have special health care needs (1).
Case studies conducted in eight school districts have shown that most school food
service managers serve at least one student with special nutrition needs in their
school on a regular basis (2).
Some students attend special education classes due to developmental disabilities,
while others with arthritis, pulmonary disease, lactose intolerance, diabetes, and
inborn errors of metabolism (e.g. PKU, galactosemia) may attend regular classes.
The medical conditions reported most frequently by schools include food allergies,
diabetes, and a variety of disorders that require modifications to the texture of food
(2).
Legislation
Several federal laws have been passed with the intent of ensuring that all enrolled
students, regardless of disability, have access to meals served at school and, that
those students eligible for free or reduced-price meals receive them. Under Section
504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA),
a “person with a disability” is defined as anyone who has a physical or mental
impairment that substantially limits one or more major life activities, has a record of
such an impairment, or is regarded as having such an impairment (3).
Major life activities covered by this definition include caring for one’s self, eating,
performing manual tasks, walking, seeing, hearing, speaking, breathing, learning,
and working (3).
One effect of these laws and the Individuals with Disabilities Education Act (IDEA,
1990) has been an increase in the number of children with disabilities who are being
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