Nutritional Needs
Developmental disability is a diverse group of chronic conditions that are due to mental and physical impairments. It is not a disease that may not require medicines but it is necessary to provide good balance diet also. Different disabilities and physical condition need different nutritional plan.
Nutrition is a science that interprets the interaction of nutrients and other substance in food in relation to maintenance, growth, reproduction, health & disease of an organism. A poor diet can cause deficiency disease if it is not met with additional nutrients in food
Children with cognitive and adaptive disabilities are at increased risk for developing feeding difficulties and secondary nutritional deficiencies. Problems such as poor oral motor coordination, swallowing dysfunction, gastro-oesophageal reflux and aversive feeding behaviours comprise significant obstacles to growth, prevent the achievement of developmental potential and threaten clinical stability. Feeding and nutritional problems in patients with developmental disabilities have been well documented and malnutrition has been reported in upto 90% of the non-ambulatory children with cerebral palsy. Although diverse factors certainly contribute to this startling and disturbing observation, feeding disorders have been observed in a high percentage of children with major motor and cognitive disabilities. Failure to asses and treat these problems in a timely fashion not only hastens the onset of significant nutrient deficits but also heightens the incidence of complications, increase hospitalization rates and results in impaired quality of life. In children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status.
Generally optimal number of servings to be eaten each day and that include vegetables, grains, fruits, oils and sweets, milk and milk products, meat and beans. Some children with autism does not need high fiber, they need gluten free diet while hyper children’s do not need milk and milk products. Like a wise we need to be careful with their nutrients. Nutrition’s is an important part to treat this type of children compared to medicines. Iron, Zinc, Calcium, other mineral also plays important role in their rehabilitation.
Nutrition Risk Factors
- Altered growth, short stature, genetic
- Altered energy & nutrient needs
- Feeding problems
- Gastrointestinal issues
- Medication, med-nutrient interactions
- Physical, mental / behavioral concerns
Effects on Developmentally Disabled Person
- Slowed growth, low wt/lg, FTT
- Under or overly nourished; reduce or increase fat
- Lengthy feeding times, decrease volume / fluid
- Dehydration, constipation
- Vitamin/mineral deficiencies
Nutrition Goals
- Adequate nutrition in a safe, tolerated way
- Macronutrients: Protein, Carb’s, Fat
- Micronutrients: Vitamins, Minerals
- Fluids, Fibre
- To maintain acceptable body stores
- To meet energy demands for growth
- Achieve and maintain “Ideal Body Wt.”
Nutrition Perspective
- Start early, involve others support
- Make a change as a family
- Be consistent make a plan Be consistent, make a plan
- Monitor progress, adjust as needed
- Team intervention more successful
- Utilize technology to increase activity
Tips and Resources for Families
What nutritional concerns are common in children with disabilities?
Many children with disabilities have health issues that can impact their nutritional well-being and eating habits. This makes meeting your child’s nutritional needs even more important. Some issues that might affect your child include:
- Slower oral-motor development
- Larger tongues, smaller teeth, challenges with chewing
- Food texture preferences
- Constipation
- Picky-eating or eating the same foods
- Weight gain – Body metabolism burns fewer calories
- Hypothyroidism
- Celiac disease
- Acid reflux
What is included in a healthy diet for your child?
You can work to improve these issues by providing your child with a well-rounded diet. The amount of foods recommended from each food group varies by age. Include a variety of different foods from each food group: Fruits/ Vegetables, Protein, Grains, and Dairy.
What is important to know about each food group?
Fruits and vegetables are an excellent way to provide your child with essential vitamins and minerals that may reduce risks for certain chronic diseases, such as heart disease, certain types of cancer, and type-2 diabetes. They also provide an excellent source of fibre that helps to fight weight gain, heart disease, and prevent constipation.
When preparing your child’s meals, try to fill half of their plate with fruits and vegetables. Fruits and vegetables can be purchased fresh, frozen, canned, or dried. When possible, choose fresh local produce. Frozen vegetables are also a good option since they are picked and frozen at their peak ripeness. Just aim for variety and watch out for added salt and sugar!
Foods that contain protein include: meat, fish, poultry, beans, peas, eggs, nuts, and seeds. Protein supports growth, builds muscles, and develops bones. When thinking about your child’s protein choices go lean and choose a variety of different sources.
Protein-rich foods provide a variety of nutrients, including vitamins B and E, iron, zinc, and magnesium. These are needed to help the body release energy, carry oxygen around the body, and to keep a healthy immune system. Additionally, adding fish such as tuna or salmon to your child’s diet will provide essential fatty acids that may help prevent heart disease.
Aim to buy the leanest cuts of beef or pork. For ground meats, try to purchase at least 90% lean. Also, remove the skin from poultry. Try dried or canned beans, tuna, and salmon, but watch out for sodium. Limit buying processed meats such as sausage and deli meats. Aim for variety!
Grains include wheat, barley, rice, oats, or other cereal grains. When thinking about your child’s grain choices, aim for whole grains. Whole grains are a great source of fibre that helps reduce the risk for heart disease and prevent constipation. Grains also help with weight maintenance. B vitamins and iron help with the body’s energy and delivery of oxygen, while magnesium and selenium build bones, selenium build bones, release energy, and protect the immune system.
Choose products that list 100% whole grain or whole wheat in the first three ingredients. If you child does not like the look of whole wheat pastas or flours, try purchasing the whole wheat white pastas and breads. Try brown rice instead of white and aim for cereals without added sugars.
Dairy products include milk, cheese, and yogurt. For individuals who are lactose intolerant, try soy, coconut, or almond milk varieties. When purchasing dairy products, choose low-fat options.
Most dairy products are an excellent source of calcium, potassium, vitamin D, and protein, which are all essential for proper bone development and prevention of osteoporosis. Since children and teens are growing rapidly, it is important they get sufficient amounts of these nutrients. Milk products may also help reduce the risk of heart disease and type-2 diabetes.
Autism
Folate may help some young autistic children. It is reported that the combination of supplemental vitamin B6 and magnesium often results in improvements in days. This may be because supplemental magnesium has been shown to help those under extreme physical stress, by increasing venous oxygen and because vitamin B6 is a coenzyme for many reactions that lead to the production of several neurotransmitters. It has been found that the combination of vitamin B6 and magnesium in moderate amounts results in reports of behavioral improvement by parents of autistic children. Vitamin C itself is believed by some to be helpful for the prevention and treatment of autism basically because it is highly concentrated in the brain, is protective against heavy metals, and seems to help with the socialization of some autistic individuals. Tryptophan depletion has been found to increase negative behaviors such as flapping, banging, and hitting, as well as to increase calmness and happiness in autistic adults. Gluten free diet is suggested to help autistic children.
Cerebral Palsy
Diet Prescription:
- Increased calories
- Texture changes—could be chopped, pureed, or blended
- Special utensils for self-feeding
- Positioning (correct positioning often improves the child’s chewing and swallowing ability)
- Thickened liquids
Proper calcium, magnesium, and parathyroid support can be indicated for these individuals.
Down Syndrome
Diet Prescription
- Low calories for the child who is overweight
- Texture modification for chewing and swallowing problems
- Self-feeding devices
Prader Willi (PW) Syndrome
Diet Prescription:
- Decreased calories
- Supervision to prevent food seeking (Environmental controls are essential because children with PW cannot control this continual urge to obtain additional food.)
Gluten Free Foods
| Foods to Allow | Foods to Avoid |
|---|---|
| Milk Products—Milk, cream ice cream, Cheese yogurt | Malted milk, ice cream made with ingredients not allowed |
| Breads—Breads and baked products made with amaranth, arrow root, buckwheat, cornmeal, cornstarch, flax, legume flours, millet, potato flour, potato starch, rice bran, rice flour, sago, sorghum flour, soy flour, sweet potato flour, tapioca and teff. | All bread products containing wheat, rye, triticale, barley, oats, wheat germ, graham flour, gluten flour, durum flour, wheat starch, oat bran, bulgur, farina, wheat based semolina, spelt, kamut, einkorn, emmer, faro, imported foods labeled gluten free but containing wheat starch. |
| Cereals Hot—Amaranth flaxes, cornmeal, cream of buckwheat, cream of rice, grits, rice flakes, soy flakes and soy grits Cold—puffed amaranth, puffed buckwheat, puffed corn, puffed millet, puffed rice, rice flakes and soy cereals. | Cereals made with wheat, rye triticale, barley and oats cereals with added malt extract and malt flavoring. |
| Pastas—Macaroni, spaghetti, noodles made from beans, corn, pea, potato, quinoa, rice, soy and wild rice. | Pastas made from wheat, wheat starch, and other ingredients not allowed. |
| Miscellaneous—corn tacos, corn tortillas. | Wheat flour tacos, wheat tortillas. |
| Meat and alternatives,–Meat, Fish, Poultry, fresh. Eggs, Lentils, chick peas, peas, beans, nuts, seed tofu. | Fish canned in vegetable broth containing HVP/HPP Deli or processed meats, sausages, wieners, salami, meat loaf, bacon, frozen meat patties. |
| Fruits and Vegetables—All fresh frozen and canned. | Scalloped potatoes containing wheat flour, battered dipped vegetables. |
| Soups—Homemade broth, gluten-free bouillon cubes cream soups and stocks made from ingredients allowed. | Soups made with ingredients not allowed Bouillon and bouillon cubes containing HVP/HPP or wheat. |
| Fats—Butter, margarine, lard, vegetable oil, cream, shortening, homemade salad dressing made with allowed ingredients. | Some mayonnaise and salad dressings that contain wheat flour or wheat starch Packaged suet. |
Reference: Vanderbilt Kennedy Center Nashville; Feeding Disorders in Children With Developmental Disabilities Schwarz, Steven M. MD, FAAP, FACN
Handbook for Children with Special Food and Nutrition Needs – National Food Service Management Institute The University of Mississippi
http://www.healthresearch.com/special.htm
Important: The information contained on this Web site should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances.