Nutrition Interventions for Children with Special Health Care Needs

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Chapter 23 - Nutrition Interventions for Autism Spectrum Disorder Fig. 23-1 Autism, Nutrition, and Picky Eating… Some common behaviors in children with autism can cause problems around food and eating. (Your child may or may not have these behaviors.) BEHAVIOR HOW IT MIGHT RELATE TO CHILDREN’S EATING Hypersensitivity to texture, smell, taste Refuses to eat foods with specific textures, smells, tastes Need for routine Refuses to eat food that looks “different”… or is in a new bowl … or is at a different place at the table Overstimulated or overwhelmed by the environment Distracted from meal and does not eat Typically developing children may need 10 or more exposures to a new food before they will eat it. … children with autism who are especially sensitive to tastes, textures, smells, or new things may need even more exposures! Eating (and enjoying food) is not as simple as it looks. It is natural for children to refuse to eat some foods at some times. This is one way to show independence and to make decisions. Eating is an interactive process with many steps Tolerates food • in room • at table • on plate Smells food • in room • at table, on plate Picky eating can be a nutrition risk when: Touches food • with fingers, hands • with mouth Tastes food • licks food • bites food • one or more food groups is excluded from a child’s food pattern • “not enough” food leads to weight loss or lack of weight gain • fights over eating (or not eating) put a strain on parent-child relationships Eats food chews and swallows independently Adapted from “Steps to Eating” by Kay Toomey, Ph.D., Denver CO 272 Nutrition Interventions for Children With Special Health Care Needs
WHAT MAY WORK ...but not in the long run “Bribing” your child to eat a food. (“If you eat your vegetables, you can have some candy.”) Forcing your child to “take a bite” or “have at least one taste.” Section 3 - Condition Specific Nutrition Interventions WHY THIS IS NOT IDEAL Teaches your child that he/she shouldn’t like vegetables as much as candy, because vegetables are less desirable Creates negative associations with food and eating. Takes control away from your child. Suggestions to help your child enjoy new foods Avoid overwhelming your child with too many changes: 1. Keep mealtimes constant. Use the same plates and utensils. Eat at the same place and at the same time. 2. Offer small servings of a few (2-3) foods at one time…avoid offering TOO MUCH FOOD and TOO MANY CHOICES. 3. Offer new foods along with foods your child already likes to eat. Introduce foods in forms that are similar to foods your child already eats, and make changes gradually. For example, if your child eats crackers, but not sandwiches: • First, offer sandwiches made with crackers • Then, offer sandwiches made on toast • Finally, offer sandwiches made with bread Expect slow changes. Follow your child through the steps of the process… set realistic goals. For example: 1. Child will let peas stay on plate. 2. Child will pick up peas but not put in mouth. 3. Child will lick peas. Ask your child’s teacher for help. 1. Pick one “goal food” to offer at snack time and/or lunch. Offer this same food at home. 2. Use non-food reinforcers. Using food as a reinforcer teaches your child to value this food— and can teach your child not to value other foods. 3. Incorporate eating behaviors into your child’s token reward system—a token for a “goal behavior,” such as leaving peas on plate. Remember NOT to use food as the end reward! Developed by Beth Ogata, MS, RD and Betty Lucas, MPH, RD 4. Child will take a bite of peas. Adapted from “Steps to Eating” by Kay Toomey, Ph.D., Denver CO Center on Human Development and Disability, University of Washington, Seattle, WA September 1999 Nutrition Interventions for Children With Special Health Care Needs 273
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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 238 and 239: Chapter 19 - Nutrition Intervention
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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
Page 336 and 337: Appendix I 320 Nutrition Interventi
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Appendix I 322 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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