Nutrition Interventions for Children with Special Health Care Needs

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Chapter 23 - Nutrition Interventions for Autism Spectrum Disorder Table 23-2: Nutrition Interventions for Autism Spectrum Disorders Assessment Intervention Evaluation/Outcome Anthropometric * Growth and weight-for-length or BMI are appropriate If underweight or overweight, work with family to change child’s energy intake by type of foods offered, energy-density of foods, frequency of eating, adapting feeding environment, and addressing behavior problems (see Dietary below). Measure and plot on appropriate growth chart: • Length/height for age • Weight for age • Weight for length or BMI • Head circumference (8 years of age • Reduce screen time, if greater than 2 hours per day, if appropriate for child’s overall program • Determine usual activity level • Assess any constraints on physical activity due to safety or other issues • Assess amount of time spent at computer, TV, video, games, etc (screen time)
Assessment Intervention Evaluation/Outcome Dietary Subsequent re-evaluation or food records indicate appropriate energy and nutrient intake from a variety of foods Assess: Caregivers report dietary practices consistent with nutrition care plan. • If child is overweight or underweight, adjust energy intake by altering portion sizes, increasing or decreasing snacks, and changing beverage volume and/or energy-density. Plan should accommodate child’s food limitations and preferences as much as possible. See chapter 13 or 14. • For nutrient inadequacies, collaborate with family to find alternative food sources that might be acceptable, i.e. for those on GFCF diet consider calcium-fortified soy milk and cheese • Provide vitamin-mineral supplements if needed; work with family regarding form (chewable, liquid, crushed), color, taste, etc. Treat supplements as “medicine” or using behavior approach to increase compliance • Provide family education and counseling regarding ULs for supplements, evidence-based effectiveness, and any dangers of toxicity or negative side effects • Discourage use of food as a reward in all environments; work with family and professionals to identify other reinforcers • Support family meals and regularly-scheduled meals and snacks • Typical food intake, timing of snacks and meals, and eating environment • Methods of preparation, preferences, i.e. brands, presentation, color, shape, temperature • Early feeding development history • Food aversions, refusals • Use of food as a reward • Feeding behaviors -- current and past • Previous dietary interventions • Use of special diets, i.e. GFCF, SCD, and nutrients at risk, i.e. calcium, Vit D, folic acid • Vitamin and/or mineral supplements, herbals, etc • Other complementary and alternative medicine (CAM), i.e. enzymes, probiotics • Determine usual energy and nutrient intake Section 3 - Condition Specific Nutrition Interventions Nutrition Interventions for Children With Special Health Care Needs 269 Obtain a 3- to 7-day food record.† Family/Social Child makes slow, but consistent progress with food acceptance and improvement in feeding behaviors. Determine: Periodic re-assessment of family’s concerns and goals • Nutrition counseling for caregivers, educators and others to set small goals, with expectation that progress will be slow. 6 Food exposures should be step-wise, i.e. child tolerates, smells or touches food, but does not eat. See Fig. 23-1 • Refer for feeding therapy by OT, SLP, and/or behavior specialist at early intervention, school, or other program (with consultation from RD) • Consider feeding group therapy for preschool children • Family’s concerns about child’s nutrition and feeding, and current goals for change • Child’s behaviors that limit or alter food intake • Previous attempts to improve diet and intake, and their outcomes • Use of CAM therapies and family’s expectations *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 9 - Behavior Issues Related
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Chapter 10 - Enteral Feeding Other
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Table
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Chapter 10 - Enteral Feeding Refere
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Chapter 11 - Community Monitoring o
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Chapter 12 - Accommodating Special
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Chapter 13 - Nutrition Intervention
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Page 234 and 235: Chapter 19 - Nutrition Intervention
Page 264 and 265: Chapter 22 - Ketogenic Diet for Sei
Page 292 and 293: Appendix A Please list any other nu
Page 294 and 295: Appendix A Baby formula What kind o
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Page 298 and 299: Appendix C 282 Nutrition Interventi
Page 300 and 301: Appendix D 284 Nutrition Interventi
Page 308 and 309: Appendix E 292 Nutrition Interventi
Page 314 and 315: Appendix E Table 3: Parent-Specific
Page 316 and 317: Appendix F Percentiles of Upper Arm
Page 318 and 319: Appendix F 302 Nutrition Interventi
Page 320 and 321: Appendix G 304 Nutrition Interventi
Page 328 and 329: Appendix H 312 Nutrition Interventi
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Appendix H 318 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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Nutrition Interventions for Children with Special Health Care Needs

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