Source: Journal of the American Dietetic Association: Volume 104(1); 2004, 97-107
This paper outlines the position that the American Dietetic Association holds on the role nutrition services should play in providing medical and community services to children and adults with special health-care needs. The committee points out that 79-90% of all children with developmental disabilities have at least one nutrition-related problem that should be regularly evaluated. This is supported by noting nutrition problems frequently seen in certain disabilities, how oral-motor/feeding problems can negatively impact a child?s nutrition status, how difficult it can be to accurately calculate calorie needs in some of the disabilities, and how obesity is becoming more prevalent in children with special needs. The paper outlines how a dietitian can spear-head efforts to evaluate and treat all of these nutrition issues. A useful table categorizing different disabilities and related nutrition issues is provided in the paper.
The paper points out that nutrition services are frequently not reimbursed by insurance and offers some suggestions on how to improve reimbursement efforts. It also emphasizes the need for nutrition education materials in a number of languages incorporating multi-cultural foods, as there are a growing number of non-English speaking children with disabilities. The paper also points out that nutrition should be part of any IDEA plan or any medical home concept; and while nutrition should be provided directly to help improve the nutrition status of a child, education should also be given to those who provide services such as the schools and in community services/outreach programs. They also encourage more emphasis on incorporating nutrition in Special Olympic and other wellness programs designed for people with special needs. One initiative they use as an example is a new Special Olympics Healthy Athletes initiative, which will pilot health-promotion programs for Special Olympics athletes.
In addition, the committee describes the role that technology is playing in offering nutrition services and the role the Internet now plays in helping people obtain medical and nutrition information. The need for accessible and reliable nutrition information is critical, as there is currently so much available that is, at best, questionable.
Finally the position paper provides many examples of major agencies and support services focused on providing services to children with special needs. They emphasize that nutrition should always be included in policy development and grant applications when geared towards this population. Nutrition education or training should be available to both the family and those who provide services to the family.
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