Nutrition Interventions for Children with Special Health Care Needs

Section 1 - Determination of Nutrition Status
community-based settings, but also promotes their involvement in fitness activities
with other family members. Programs in the community also offer the possibility
of transitioning children from individual physical therapy or occupational therapy
sessions to lifelong fitness programs (15). In one study evaluating a conditioning
program of aerobic exercise, flexibility exercises and weight training for adolescents
with CP, significant improvements in strength were documented (18). However, an
unanticipated outcome of the program was a dramatic change in self-perception
for the participants, with some participants gaining enough confidence to enroll in
a regular aerobics class after the study. This self-initiation represents an important
step in health promotion for these adolescents.
Other benefits of community based activity programs for children with special health
care needs are the positive effects on motivation and compliance. Many individuals,
including both children and adults, are more motivated to exercise in a group
setting. Parents reported difficulties in getting their young children with physical
disabilities to comply with home exercise programs (HEP) (19). But when involved in
a group fitness program incorporating strength and endurance training, attendance
and adherence to the exercise program was high, prompting parents to request
continuation of the program. Improvements in many of the outcome measures such
as energy expenditure, strength, fitness, and self-perception were also documented
for the study subjects.
The Role of the Nutritionist in Promoting Physical
Activity for CSHCN
The role of the nutritionist is to collaborate in the development of an overall physical
activity plan for the child through the following activities:
• perform screening as indicated in Table 3.1
• provide information regarding the benefits of physical activity and
contraindications
• make referrals to other health care professionals when appropriate
• provide appropriate resources
• facilitate partnerships among other health care professionals, families, and
community agencies (e.g. schools, YMCA)
• serve as an advocate
• provide support and encouragement
One of the most important benefits a nutritionist can provide to these children and
their families is anticipatory guidance to help prevent complications of inadequate
nutrition and inactivity. Once family activity patterns are identified, guidance about
Nutrition Interventions for Children With Special Health Care Needs 43