Nutrition Interventions for Children with Special Health Care Needs

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Chapter 13 - Nutrition Interventions for Overweight and Obesity assessmeNT iNTerveNTioN evaluaTioN/ouTcome If child is ambulatory and able to follow instructions, develop with caregivers and child a plan for increasing daily activity. 7 Consider: • weight-bearing activities • work up to 30 minutes of aerobic activity • activities that are enjoyable • done with a partner or friend • Special Olympics program for children >8 years of age Caregivers, educators, and others involved in child’s daily care report increased activity. If child is in wheelchair or has some degree of physical disability, refer to physical or occupational therapist regarding a plan for increasing activity. Determine activity level and physical capability for increasing activity. Reduce television and media viewing time 8 If child is quadriplegic or unable to move voluntarily, manage weight by diet alone. See Chapter 3 for more information about physical activity. 146 Nutrition Interventions for Children With Special Health Care Needs Dietary† Subsequent food records or interview indicate appropriate energy intake for current body size and activity level. Estimate energy needs based on the following factors: Interview caregivers and child (if possible) to get the following information: • Current energy intake (kcal/cm height) • Degree of obesity • Activity level Child and caregivers report dietary practices consistent with nutrition care plan. (Examples of energy needs based on diagnosis: Prader-Willi syndrome –10-11 kcal/cm for maintaining growth in channel; 8.5 kcal/cm for weight loss5 • Typical content and time of snacks and meals • Types of foods and methods of preparation usually available to child at home, school, and/ or day care • Access to food away from home (school, other homes, stores) • Assess to food used for rewards Re-evaluate nutrition care plan according to changing energy needs due to growth, changes in body composition, and activity level Spina bifida -- 9-11 kcal/cm for maintenance; 7 kcal/cm for weight loss) 5 Obtain a 3- to 7-day food record. Calculate average daily energy intake.
assessmeNT iNTerveNTioN evaluaTioN/ouTcome Develop individualized nutrition care plan based on the following: • Estimated energy needs • Child’s food likes, dislikes, allergies, and intolerances • Family’s and child’s eating patterns • Child’s feeding skills and mode of feeding (oral or tube) • Family’s financial resources Provide counseling to family regarding positive feeding interactions, support for self-regulation of food intake, allowing for choices, and avoiding unnecessary rigidity or “rules” related to food8 Help design reinforcement strategies at home and school that do not involve food Section 3 - Condition-Specific Nutrition Interventions Obtain periodic food records or diet history as indicated. Assess average daily energy intake. Family/Social Determine: Family acknowledges need for weight management and agrees to work with RD and other health providers to achieve appropriate weight. If family does not consider child’s weight a problem, arrange for all health care providers to meet and agree on an appropriate message to be reinforced by all. • Family’s feelings about child’s weight status • Previous attempts to control weight • Family’s pattern of reinforcement for eating and any use of food as rewards Nutrition Interventions for Children With Special Health Care Needs 147 *For reference data and guidelines for taking accurate measurements, see Chapter 2. † For more information about dietary assessment, see Chapter 1.
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Nutrition Interventions for Childre
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Kay Kopp, OTR/L Occupational Therap
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Appendices Appendix A Sample Screen
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ii Nutrition Interventions for Chil
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Population “Children with special
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vi Nutrition Interventions for Chil
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Chapter 1 - Nutrition Screening and
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Chapter 2 - Anthropometricss needs,
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Chapter 2 - Anthropometricss Statur
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Chapter 2 - Anthropometricss Techni
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Chapter 2 - Anthropometricss paraly
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Chapter 2 - Anthropometricss time a
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Chapter 2 - Anthropometricss measur
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Chapter 2 - Anthropometricss Mild m
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Chapter 2 - Anthropometricss 9. Re-
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Chapter 2 - Anthropometricss 5. Per
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Chapter 2 - Anthropometrics Table 2
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Chapter 2 - Anthropometricss Refere
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Chapter 2 - Anthropometricss 26. Kr
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Chapter 3 - Physical Activity for C
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Chapter 4 - Breastfeeding recommend
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Chapter 4 - Breastfeeding Table 4-1
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Chapter 4 - Breastfeeding Assessmen
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Chapter 4 - Breastfeeding 58 Nutrit
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Chapter 5 - Medication-Nutrient Int
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Chapter 6 - Nutrition Interventions
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Chapter 8 - Oral-Motor Feeding Prob
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Chapter 17 - Nutrition Intervention
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Chapter 22 - Ketogenic Diet for Sei
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Appendix A Please list any other nu
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Appendix A Baby formula What kind o
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Appendix B Manufacturer Description
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Appendix C 282 Nutrition Interventi
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Appendix D 284 Nutrition Interventi
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Appendix E 292 Nutrition Interventi
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Appendix E Table 3: Parent-Specific
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Appendix F Percentiles of Upper Arm
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Appendix F 302 Nutrition Interventi
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Appendix G 304 Nutrition Interventi
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Appendix H 312 Nutrition Interventi
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Appendix I 320 Nutrition Interventi
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Appendix J 328 Nutrition Interventi
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Appendix K 336 Nutrition Interventi
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Appendix K 338 Nutrition Interventi
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Appendix L 340 Nutrition Interventi
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Appendix M 342 Nutrition Interventi
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Appendix M 344 Nutrition Interventi
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Appendix N Gastrostomy Tube Feeding
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Appendix N activities. When feeding
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Appendix N Feeding Sets/Extensions
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Appendix N Fluid and Electrolytes W
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Appendix N osmolality of full-stren
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Appendix N Modular Products Modular
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Appendix N his family, and the home
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Appendix N • The feeding tube may
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Appendix N equipment. The Special S
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Appendix N Table N-2: Common Compli
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Appendix N Complication Possible Ca
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Appendix N 368 Nutrition Interventi
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Appendix O Some conditions increase
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Appendix O Table O-3: Recommended P
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Appendix O 374 Nutrition Interventi
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Appendix P Diet Prescription for Me
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Appendix Q Goals Considerations for
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Appendix R Condition Description Nu
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Appendix R Condition Description Nu
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Appendix R References 1. Ekvall SW
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Appendix S Table S-1: Infant Formul
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Appendix S Comments Osmolality (mOs
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Appendix S Table S-2: Pediatric For
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Appendix S Table S-3: Modular Produ
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Appendix S Comments Energy (kcal) P
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Appendix S Contact Information Abbo
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Appendix T Powdered Formulas Accura
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Appendix T Table T-1: Liquid Concen
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Appendix T 402 Nutrition Interventi
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Appendix U Nutrition Strategies for
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Appendix U ADA Pocket Guide to Nutr
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Glossary Autism Spectrum Disorders
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Glossary Early intervention service
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Glossary Length (recumbent length)
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Glossary Stadiometer moveable headb
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Index specialist 98 target 108 Bink
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Index elemental formula 348 elimina
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Index I ICF. See International Clas
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Index risk indicators 4 screening 1
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Index suppositories 72, 77 Surmonti
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